Is It ADHD, Anxiety, or Both? A Quick Guide for Parents

In my work as a Licensed Educational Psychologist, one question comes up more than almost any other. After parents share what their child is struggling with, such as difficulty focusing, staying organized, or managing big emotions, they often pause and ask, “Is this ADHD, anxiety, or both?”

If you’ve ever found yourself puzzling over your child’s struggles with attention, organization, or emotional regulation, you’re not alone. When behaviors overlap, it can be hard to tell what’s really driving them. ADHD and anxiety often look similar on the surface, especially in twice-exceptional (2e) kids. Understanding both the differences and the overlap is an important part of supporting your child’s learning journey.

Why ADHD and Anxiety Are So Easily Confused

Both ADHD and anxiety can show up as:

• Difficulty focusing

• Avoidance of schoolwork

• Emotional outbursts or shutdowns

• Trouble getting started on tasks

• Forgetfulness

• Challenges with following instructions

Parents often describe a frustrating cycle. Their child puts off assignments, struggles to stay focused, and then worries about falling behind. The more anxious they feel about their performance, the harder it becomes to concentrate. Before long, both you and your child might wonder what’s really at the root of it all.

That back and forth can feel endless, but understanding the connection between ADHD and anxiety is the first step toward breaking the cycle.

ADHD: A Regulation Challenge, Not a Motivation Problem

ADHD is a neurological difference in how the brain manages attention, impulses, and executive functioning.

Kids with ADHD often:

• Want to focus but can’t sustain attention

• Lose track of time or materials

• Struggle with planning, organization, and follow-through

• Act quickly before thinking things through

  
  

One of the most confusing aspects of ADHD is that these same kids can sometimes focus extremely well. When something is interesting or highly engaging, a child with ADHD may hyperfocus and become deeply absorbed. This can make it hard to understand why tasks like homework or chores feel so difficult.

I often see kids who focus beautifully with structure, guidance, or strong interest. But when that support is removed, everything can fall apart. The same child who completes an assignment easily one day may struggle to get started the next.

That’s the tricky part about ADHD. The skills aren’t missing, they’re just inconsistent. It isn’t about effort or motivation, but about the brain’s ability to regulate attention and access those skills when needed.

Anxiety: When Worry Takes Over the Driver’s Seat

Anxiety is different. An anxious child’s brain is focused on staying safe.

You might see:

• Avoidance tied to fear of mistakes or failure

• Perfectionism or reassurance seeking

• Physical symptoms like headaches or stomachaches

• A child who seems spaced out but is actually caught in worry

  
  

When the brain senses threat, even something like a tough assignment or fear of being wrong, the amygdala sends out an alarm. This fight, flight, or freeze response makes it hard to plan, problem-solve, or remember. At school or home, this can look like avoidance or shutdown—not defiance, but the brain’s way of protecting itself.

When ADHD and Anxiety Co-Exist

Many children, especially 2e learners, experience both ADHD and anxiety. Each can intensify the other, and treating only one often leaves families feeling stuck.

This combination can look like:

• Meltdowns after school

• Big emotional reactions to small setbacks

• Increased avoidance as demands rise

For 2e students, the overlap can be especially strong. These kids are often very aware of their abilities, so they notice when their performance doesn’t match what they know they can do. That awareness can lead to perfectionism, frustration, and worry about not meeting expectations. The result is a constant pull between high potential and real challenges with follow-through—a dynamic that can easily fuel both ADHD and anxiety.

How Can You Tell the Difference?

The key is to look at context and consistency.

With ADHD, challenges appear across settings—home, school, and play. Stress levels may change, but inattention and disorganization are fairly consistent.

With anxiety, difficulties are more situational. Avoidance or inattention flare up when expectations feel high or stress increases, then fade when the worry passes.

Notice what your child says.

A child with ADHD might say, “I forgot again,” or “I just can’t get started.”A child with anxiety might say, “What if I mess up?” or “I don’t want to disappoint anyone.”Their words can offer clues about whether the challenge is rooted in distraction or fear.

If you’re unsure, watch for patterns over time. Is the difficulty constant, or does it spike under stress? Does focus return when your child feels calm and confident?

A comprehensive assessment that looks at attention, executive functioning, and emotional regulation together can clarify what’s really going on, and most importantly, how to support your child in a balanced, effective way.

About the Author

Erica Salzman is a Licensed Educational Psychologist based in Los Angeles. She specializes in strength-based assessment and support for neurodiverse learners, empowering families and schools to help every child reach their potential. Erica is the founder of The Exceptional Learner. www.theexceptionallearner.com