How to Tell If It’s ADHD, Anxiety, or Both
How to Tell If It’s ADHD, Anxiety, or Both
If you’ve ever asked yourself:
“Am I anxious… or do I just have ADHD?”
“Why can’t I focus — even when I’m not stressed?”
“Is it overthinking or executive dysfunction?”
You’re not alone. In fact, up to 50% of adults with ADHD also have an anxiety disorder — and the symptoms overlap more than most people realize.
At Keystone Counseling Boston, we see clients every day who’ve been misdiagnosed, over-diagnosed, or left feeling like “none of the labels fit.” That’s why we focus on functional patterns, not just diagnoses.
Let’s break down what sets ADHD and anxiety apart — and what it looks like when you have both.
ADHD vs Anxiety: What’s the Difference?
ADHD (Attention-Deficit/Hyperactivity Disorder)
- Trouble starting or finishing tasks
- Easily distracted (even by internal thoughts)
- Frequently misplacing things, forgetting details
- Feels disorganized even when “trying really hard”
- Often underestimates how long things take
More about attention regulation, not just focus
Anxiety (Generalized or Social)
- Constant worry or fear of bad outcomes
- Overthinking decisions, even small ones
- Muscle tension, GI issues, sleep disturbance
- Feels guilt or shame about “not doing enough”
- Can focus well… but can’t relax or stop worrying
More about fear regulation, not attention
What If It’s Both?
Here’s where things get tricky — and where many people struggle without realizing why.
Having both ADHD and anxiety often looks like:
- Getting stuck in analysis paralysis (ADHD can’t initiate + anxiety fears messing up)
- Procrastination that causes panic → panic that worsens procrastination
- Starting 10 things at once, finishing none — and beating yourself up for it
- Perfectionism that hides underlying executive dysfunction
- Avoiding emails, texts, or “adulting” tasks (not laziness — overstimulation + shame)
This is where therapy with someone who understands both becomes essential.
How We Treat ADHD + Anxiety Together
At Keystone Counseling, we take an integrative approach:
- CBT to challenge anxious thought patterns and rigid rules
- Executive Function Coaching to improve planning, initiation, and time awareness
- Mindfulness & Somatic Tools to manage overwhelm and sensory stress
- Emotion Regulation Techniques for clients who mask, shutdown, or “people please”
- Medication consult support (in coordination with prescribers, if needed)
Our goal isn’t to label you. It’s to help you function better, feel more confident, and reclaim energy lost to shame and stress.
Covered by Insurance, Available Across Massachusetts
We proudly accept:
- Aetna
- Cigna
- Optum / UnitedHealthcare
- Harvard Pilgrim
- Mass General Brigham
- Medicaid & Medicare (in select cases)
Therapy is available in person in Boston/Cambridge and via secure telehealth statewide.
You don’t need a referral or diagnosis to start — just readiness for real support.
Not Sure Where You Fit? That’s What We’re Here For.
Many of our clients start by saying, “I’ve been high-functioning for years, but now it’s too much.”
We get it. You don’t need to figure it all out alone.
Schedule a free 15-minute consult
Let’s find a therapist who understands ADHD, anxiety — and everything in between.
