ADHD Questions
How anxiety makes ADHD less severe
Charles Li, MD
May 3, 2023
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While anxiety is linked to more stronger ADHD symptoms overall, it can also make certain symptoms less severe.
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Studies have suggested that those with ADHD and anxiety have less hyperactivity.
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They also may be less impulsive, leading to fewer behavioral issues.
Anxiety and ADHD are closely linked conditions. Studies have consistently shown that having ADHD increases our odds of developing an anxiety disorder. Around 25-33% of those with ADHD also likely 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
Kessler et al. 2006
Swanson et al. 2008
Overall, those with ADHD and anxiety tend to have more severe symptoms:
One study found that those with ADHD and anxiety are more likely to have issues regulating their emotions. Having ADHD and anxiety also potentially amplifies ADHD symptoms.
But, researchers and experts have found that certain ADHD symptoms may be less severe among those with ADHD and anxiety.
Can anxiety make certain ADHD symptoms less severe?
There is some evidence that having anxiety alters your ADHD symptoms. In certain ways, it can make symptoms less severe.
For example, ADHD can make us more impulsive and less inhibited, leading to difficulties at work and school.
Studies have shown that children with ADHD and anxiety may be better at inhibiting themselves than those with only ADHD:
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Children with ADHD and anxiety do better on stop signal paradigms that measure response inhibition (Brown, 2000, p. 141). On the other hand, working memory tasks and serial addition tasks are particularly challenging for patients with comorbid ADHD and anxiety (Brown, 2000, p. 141).
Brown, 2000
Those with anxiety and ADHD may be less impulsive than those with only ADHD:
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In summary, the presence of anxiety may partially inhibit the impulsivity and response inhibition deficits seen in ADHD. It may also, however, make working memory and other cognitive deficits worse.
Another study showed that anxiety may decrease hyperactivity in children with ADHD:
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Two recent texts on comorbid conditions seen in ADHD (Brown, 2000; Pliszka et al., 1999) have posited that anxiety may inhibit impulsivity while making attentional tasks worse. Pliszka et al. (1999, p. 155) reviewed their own studies showing that children with ADHD and anxiety are less likely to display off-task and hyperactive behavior and have longer reaction times than pure ADHD children.
Brown, 2000
Pliszka et al. 1999
However, these differences aren’t universal. Many with ADHD and anxiety have less severe symptoms; some can have more severe symptoms.
But, generally, experts tend to agree that anxiety likely reduces hyperactivity and behavioral issues in children with ADHD, issues that often arise from difficulties with self-control:
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These data show there is considerable heterogeneity among subjects with ADHD depending on the presence or absence of an ANX. The presence of a comorbid ANX tended to attenuate the teacher ratings of inattention and overactivity, as well as those of oppositional behavior and defiance, though the ratings clearly remained in the disturbed range.