This blog is part of a three-part series discussing mental health in children and teens. In this series, we’ll explore how to tell the difference between typical developmental behavior and potential mental health concerns, examine the signs of conditions like anxiety, depression, and ADHD, and provide practical tips for supporting your child’s emotional well-being.

When your child struggles with focus, experiences emotional outbursts, or seems overwhelmed in certain situations, it’s natural to wonder whether anxiety, ADHD, or something else entirely might be to blame. Identifying the root of these behaviors is crucial to support their growth and well-being—but how can you tell the difference?

At Capital Area Pediatrics, we specialize in caring for children of all ages and understand the complexities of child development. Serving families across Northern Virginia, our knowledgeable pediatric team is here to help you decipher your child’s behavior and create a personalized care plan that suits your child’s unique needs. If you are concerned about your child’s behavior or mental health, schedule an appointment with us today for expert guidance and support.

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Understanding the differences between anxiety and ADHD is the first step toward helping your child thrive.

Understanding ADHD & Anxiety in Children

ADHD (Attention-Deficit/Hyperactivity Disorder) and anxiety disorders are among the most common mental and behavioral health conditions in children. Both can cause difficulty with focus, behavior, and emotional regulation—but they are not the same.

• ADHD is a neurodevelopmental disorder that affects attention, impulse control, and activity levels.
• Anxiety disorders involve persistent worry, fear, or nervousness that interferes with a child’s ability to function in daily life.

On the surface, it might seem like it would be difficult to mistake one of these conditions for the other. However, both of these conditions can affect a child’s ability to focus, regulate emotions, and navigate school or social environments. Adding to the complexity, it's not uncommon for children and teens to have both ADHD and an anxiety disorder.

Common Symptoms of ADHD & Anxiety

A child or teen with ADHD or anxiety may appear to be very high-energy, hyperactive, or impulsive. Conversely, they may appear reserved or withdrawn, with their mind constantly racing and worrying about multiple things at once. This can make it difficult for parents, teachers, and other caregivers to pinpoint the root cause of their behavior.

Both conditions can produce symptoms like:

• Inattention or Distractibility: A child with ADHD may struggle to stay focused because their brain is wired for novelty and stimulation. In contrast, a child with anxiety might seem distracted because their mind is preoccupied with worry or fear.
• Restlessness or Fidgeting: In ADHD, restlessness stems from hyperactivity and an internal drive to move. In anxiety, it often shows up as nervous energy—pacing, nail-biting, or an inability to sit still due to inner tension.
• Irritability & Emotional Outbursts: Both conditions can lead to emotional dysregulation. Children may become overwhelmed, frustrated, or prone to crying or meltdowns, especially when tasks feel too hard or expectations aren’t clear.
• Difficulty with Sleep: Kids with ADHD may resist bedtime due to a lack of structure or trouble winding down. Anxious children may struggle with racing thoughts or nighttime fears.

This overlap can make it challenging to pinpoint what’s driving your child’s behavior—but looking at when, how, and why the symptoms occur can offer clues.

The Key Differences Between ADHD & Anxiety

To better understand the difference between ADHD and anxiety, it helps to examine the internal experience of the child—and how those experiences impact behavior:

Can a Child Have Both ADHD & Anxiety?

Yes—and this is more common than many people realize. Data from the CDC shows that about 1 in 4 children with ADHD also have an anxiety disorder. However, it's important to understand that this only goes in one direction—while ADHD can lead to anxiety over time, anxiety does not cause ADHD.

How ADHD Contributes to Anxiety

ADHD is a neurological condition. It affects the brain’s ability to manage attention, control impulses, and regulate activity levels. These challenges can make even simple tasks—like completing homework or getting ready for school—feel overwhelming for children. Over time, this ongoing struggle can lead to frustration, self-doubt, and worry. For many kids, these experiences create the perfect conditions for anxiety to develop.

Here’s how it typically happens:

• Repeated Struggles or Failure: A child with ADHD may frequently forget assignments, lose belongings, or get in trouble for interrupting in class. These repeated “failures” can lead to anxiety about performance or punishment.
• Negative Feedback & Social Rejection: Many children with ADHD experience criticism from teachers, peers, or family members. They may start to worry constantly about making mistakes or being “too much.”
• Internalized Stress: Kids with ADHD are often aware they’re falling behind or having a hard time, even if they can’t always explain why. This awareness can turn into chronic worry, avoidance behaviors, or perfectionism.

In other words, anxiety can emerge as a response to the challenges that untreated or unrecognized ADHD creates. It becomes a coping mechanism—one that might mask the ADHD symptoms underneath when the child uses fear and hyper-vigilance to try and stay on top of tasks they struggle to manage otherwise.

Why Anxiety Doesn’t Cause ADHD

While ADHD can contribute to anxiety, the reverse isn’t true. Anxiety is an emotional and physiological response to perceived stress or danger. It can influence attention and behavior, but it doesn’t alter the brain structure or function in the same way ADHD does.

ADHD is a neurodevelopmental disorder, meaning it originates from differences in brain wiring and function that are present from early childhood. Anxiety is a mental health condition—a reaction to stress, trauma, or environment. It can cause a child to seem distracted or scattered, especially when they’re overwhelmed, but those symptoms are typically temporary and context-dependent.

Here’s a key distinction:

• A child with anxiety might lose focus because they’re worried (e.g., thinking about a test, a conflict, or being away from a parent).
• A child with ADHD loses focus regardless of the situation—even during activities they enjoy.

This difference matters. Treating anxiety in a child whose real issue is ADHD can leave the underlying challenges unaddressed—and the anxiety will likely return.

How Your Pediatrician Can Help

Your pediatrician plays a crucial role in identifying and managing both ADHD and anxiety in children. At Capital Area Pediatrics, we provide:

• In-depth discussions with parents and children to identify patterns, triggers, and family history.
• Developmental and behavioral screenings to understand how your child’s symptoms impact daily life.
• Referrals to specialists, such as child psychologists or developmental pediatricians, when more advanced testing is needed.
• Care coordination with schools, ensuring your child receives appropriate accommodations like IEPs or 504 Plans.
• Basic medication management for conditions like ADHD and anxiety.

Our team works closely with parents and children to create a customized treatment plan that addresses your child's unique needs.

Strategies for Managing ADHD & Anxiety

Treatment depends on the specific diagnosis—but in many cases, similar strategies can benefit children with either or both conditions.

Tips for Managing ADHD:

• Use tools like timers, checklists, and color-coded folders to stay organized
• Offer short, simple instructions one step at a time
• Consider ADHD medication

Tips for Managing Anxiety:

• Help your child identify and name their feelings
• Teach coping strategies like deep breathing or visualization
• Gradually expose them to anxiety-inducing situations with support
• Consider anxiety medication

Tips for Managing ADHD or Anxiety:

• Keep routines predictable and structured
• Provide positive reinforcement for effort and behavior
• Use calm, consistent responses to challenging behavior
• Encourage good nutrition, physical activity, and adequate sleep
• Work with a therapist or counselor

Let’s Work Together to Support Your Child

Understanding the difference between ADHD  and anxiety is a crucial first step toward helping your child thrive. While both conditions can impact behavior and learning, the right diagnosis leads to the right support.

If you're seeing signs that concern you—whether at home, school, or both—schedule an appointment(opens in a new tab) with Capital Area Pediatrics. Our compassionate team is ready to listen, evaluate, and help your child find their path forward.

Frequently Asked Questions

How do I know if my child has ADHD, anxiety, or both?

It can be hard to tell the difference because both conditions can cause similar behaviors, like trouble focusing or emotional outbursts. Generally, ADHD symptoms are consistent across most settings and situations, while anxiety tends to be more situation-specific (e.g., around school, social settings, or performance). A pediatrician can help you distinguish between the two through screening and observation.

Can ADHD cause anxiety in children?

Yes. Many children with ADHD develop anxiety over time due to repeated struggles with schoolwork, social interactions, and behavior expectations. When children face constant challenges or criticism, they may begin to feel worried, overwhelmed, or anxious about making mistakes or falling behind. Treating ADHD effectively can often reduce anxiety symptoms that stem from it.

Can anxiety cause ADHD?

No—anxiety does not cause ADHD. ADHD is a neurodevelopmental condition, meaning it’s related to how the brain is wired and functions from an early age. Anxiety is a mental health condition that may mimic some ADHD symptoms (like distractibility), but it does not lead to the neurological patterns associated with ADHD.

What’s the biggest difference between ADHD and anxiety in kids?

The key difference is why a child is struggling. A child with ADHD may be inattentive due to a brain-based difficulty with focus, regardless of the task. A child with anxiety might lose focus because they are preoccupied with a specific worry or fear. Understanding the “why” behind the behavior is essential for finding the right support.

Can my child be treated for both conditions at the same time?

Yes. In fact, when a child has both ADHD and anxiety, addressing both together is often the most effective approach. Treatment may include behavioral therapy, school accommodations, and—in some cases—medication. Your pediatrician can help create a personalized plan based on your child’s specific needs.

Should I rely on online ADHD or anxiety quizzes to diagnose my child?

While an ADHD or anxiety quiz can help raise awareness, it’s not a diagnostic tool. These quizzes may highlight symptoms worth discussing, but only a healthcare provider can conduct a full evaluation. Talk with your pediatrician for a professional assessment.