ADHD Questions
Does anxiety worsen emotional problems in ADHD?
Charles Li, MD
May 8, 2023
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Those with ADHD have a higher risk of anxiety disorders and difficulties with emotional control.
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There is some evidence that having anxiety can worsen emotional difficulties with ADHD.
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Anxiety and emotional difficulties can also interact to cause effects such as test anxiety.
Studies have consistently found that those with ADHD have a higher risk of anxiety. Around a quarter to a third of those with ADHD may also have an anxiety disorder:
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One quarter to one third of children (Swanson et al., 2008) and adults (Kessler et al., 2006) with ADHD have a comorbid anxiety disorder, a rate of co-occurrence that cannot be accounted for by referral bias or overlapping symptom assessment
Swanson et al. 2008
Kessler et al. 2006
ADHD and emotions
While ADHD is defined by difficulty with attention and hyperactivity, there’s also a link between ADHD and emotions.
Those with ADHD often have more difficulties regulating their emotions.
Researchers found a significant link between emotional dysregulation and ADHD severity.
Those with ADHD often also have difficulties managing their anger:
A study on children with ADHD found that most had experienced irritability symptoms. 31% met the criteria for an irritability mood disorder.
These challenges may be linked to deficits in executive function in ADHD:
What is executive function?
Anxiety and emotions in ADHD
There is evidence that anxiety can make emotional problems worse in ADHD.
The study below confirmed the link between anxiety and ADHD, showing that having one disorder increases your risk of developing the other.
The data also showed that having anxiety specifically increases the severity of emotional problems in those with ADHD.
Effects of anxiety and emotions in ADHD
One effect of ADHD and emotional problems can be found in test anxiety.
ADHD has been linked with a higher risk of test anxiety. Much of this is likely driven by the academic challenges those with ADHD face.
Based on the study below, emotions play a significant role in this relationship.
Those with ADHD and test anxiety reported feeling fear of losing social standing. Their test anxiety also manifested as physical and emotional discomfort.
In this case, ADHD and emotional discomfort appear to create a vicious cycle that perpetuates worsening test anxiety.
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These findings suggest the emergence of a vicious cycle in which problems with attention, concentration, hyperactivity, and impulsivity culminate in problems with test performance. The level of TA rises, test performance is compromised due to elevated TA, and the student attributes the failure to ADHD. Hence, fear of tests increases even more, thus further interfering with test performance.
Key takaways
ADHD is known to be associated with emotional challenges.
Based on the studies above, it’s clear that anxiety can make this worse.
ADHD is a complex condition with different treatment options. If you do experience difficulties with anxiety and emotions with ADHD, be sure to let your healthcare provider know so that you can get the treatment right for you.