Anxiety and Depression: Symptoms of ADHD, Not Just Separate Diagnoses

Anxiety and depression have been seen as independent mental health disorders for years. They are often treated separately from other conditions. However, research and clinical experience suggest that in many cases, these emotional struggles are actually symptoms of undiagnosed, misdiagnosed, or untreated Attention-Deficit/Hyperactivity Disorder (ADHD). Recognizing this overlap of symptoms is important for accurate diagnosis and effective treatment.

ADHD is most widely known for its symptoms of hyperactivity, inattention, and impulsivity. However, many individuals with ADHD, especially those with the inattentive subtype, experience continual anxiety and depression. These emotional difficulties often stem from the core symptoms of ADHD rather than existing as stand-alone disorders.

March 2025, Tracy Birkinbine, Therapist @ Agave Health

Anxiety as a Symptom of ADHD

Many people with ADHD often report anxiety, but it can be due to the challenges associated with ADHD rather than from an independent diagnosis of anxiety disorder. Factors to consider are:

• Executive Dysfunction: People with ADHD may struggle with organization, time management, and task completion. Feeling overwhelmed by daily responsibilities can lead to constant worry and stress, which looks a lot like anxiety disorder.

• Rejection Sensitivity Dysphoria (RSD): Many people with ADHD experience strong emotional reactions to what they perceive to be rejection or criticism. This sensitivity can lead to social anxiety and avoidance behavior.

• Hyperawareness of Struggles: People with ADHD may repeatedly compare themselves to friends, and others their age, feeling inadequate or incapable. This self-doubt can present itself as anxious thoughts and physical symptoms of anxiety.

  
  

Depression as a Symptom of ADHD

Similarly, symptoms of depression often show up as a secondary response to unaddressed or untreated ADHD rather than as a separate mood disorder. Some of the main reasons for these depressive symptoms may include:

• Chronic Frustration and Failure: Many individuals with ADHD experience many obstacles in school, work, and relationships. Those feelings of hopelessness and worthlessness can resemble clinical depression.

• Problems with Emotional Regulation: People with ADHD may find it difficult to manage their emotions. They may experience wide and intense mood swings, leading to periods of sadness and frustration that can be mistaken for major depressive disorder (MDD).

• Problems with Fatigue and Motivation: ADHD-related difficulties with focus and concentration can make it hard to begin or finish tasks. This can lead to feelings of tiredness and lack of motivation. Those feelings can be some of the main symptoms of depression. People with ADHD may also find themselves overeating or not eating much at all due to their symptoms, which can also mimic depression.

Misdiagnosis

Because anxiety and depression are discussed so much these days, ADHD often goes undiagnosed or misdiagnosed. Many people will be treated for anxiety or depression, but their symptoms continue because the underlying, root cause (ADHD) is overlooked. This can be common in adults, whose ADHD symptoms may be mild or disguised by learned coping skills.

Therapy treatment plans can often be ineffective due to misdiagnosis. For example, treating a person’s anxiety with therapy and medication may help some, but if the root cause is ADHD-related executive dysfunction, the anxiety will likely continue. Similarly, antidepressants may improve mood temporarily, but they will not focus on the cognitive and behavioral challenges of ADHD.

A Comprehensive Approach

For those experiencing anxiety and depression along with symptoms of ADHD, a comprehensive evaluation by an Agave Health therapist or other mental health professional (familiar with ADHD) is essential. When ADHD is accurately identified as the source of the described symptoms, treatment can be more effective and may include:

• Medication for ADHD: ADHD medication can improve executive functioning, lessening the secondary symptoms of anxiety and depression. Medication can be prescribed by your general practitioner or a psychiatrist. 

• Cognitive-Behavioral Therapy (CBT): Agave Health therapists use ADHD-focused CBT to help individuals learn and establish coping strategies for executive dysfunction, emotional dysregulation, and problems with self-esteem. It can be beneficial to have a trusted therapist to confide in, who will listen, educate, and validate your feelings.  

• Lifestyle Changes: Improving your sleep habits, exercise, nutrition, and mindfulness practices can greatly help manage ADHD and its emotional impact.

• Executive Function Coaching: Learning practical and realistic strategies for organization, time management, and task completion can decrease stress and feelings of inadequacy. At Agave Health, all of our coaches have ADHD themselves, so they know firsthand the challenges that ADHD presents in our daily lives, and can help you to find ways to better manage those challenges. They’ve got your back!

Conclusion

Learning that anxiety and depression can be symptoms of ADHD instead of separate mental health disorders is imperative for the correct diagnosis and effective treatment. By addressing the underlying ADHD, many people find that their emotional struggles improve significantly. A holistic, ADHD-informed approach can change lives, provide relief, and empower those who have long struggled with misdiagnosed or untreated symptoms. Check out www.agavehealth for a comprehensive ADHD evaluation, ADHD Coaching, or Therapy.