ADHD vs Anxiety vs Depression: How to Tell the Difference

Summary

If you scored high on an ADHD screener, it is worth checking for common overlaps like anxiety, depression, sleep disruption, and burnout. ADHD, anxiety, and depression share many symptoms—difficulty concentrating, restlessness, and emotional dysregulation—but they have different underlying causes and treatment approaches. This guide helps you understand the differences, spot patterns, and prepare for a more productive clinical conversation.

Understanding each condition

Before diving into overlaps, it helps to understand what each condition is:

ADHD (Attention-Deficit/Hyperactivity Disorder) is a neurodevelopmental condition that affects approximately 4.4% of U.S. adults. It is characterized by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with daily functioning. ADHD symptoms typically begin in childhood (before age 12) and are chronic throughout life, though they may change in presentation over time.

ADHD is not a character flaw or a lack of willpower—it is a brain-based difference in how the nervous system regulates attention, motivation, and executive functions. The condition affects the prefrontal cortex, which is responsible for planning, impulse control, working memory, and sustained attention. People with ADHD often have differences in dopamine and norepinephrine signaling, which impacts reward processing and focus.

Anxiety disorders are among the most common mental health conditions, affecting approximately 19% of U.S. adults annually. Anxiety involves excessive worry, fear, or nervousness that interferes with daily activities. Unlike normal worry, anxiety disorders involve persistent, intense fear or worry that is out of proportion to the situation and difficult to control.

Anxiety can develop at any age and may be episodic or chronic. It activates the body's fight-or-flight response, leading to physical symptoms like rapid heartbeat, sweating, trembling, muscle tension, and gastrointestinal issues. Common types include Generalized Anxiety Disorder (GAD), Social Anxiety Disorder, Panic Disorder, and specific phobias.

Depression (Major Depressive Disorder) is a mood disorder marked by persistent feelings of sadness, hopelessness, and loss of interest in activities. It affects approximately 8% of U.S. adults annually. Depression is more than temporary sadness—it is a persistent low mood that lasts for at least two weeks and significantly impacts daily functioning.

Depression can develop at any age and is often episodic, with periods of remission and recurrence. It affects how you think, feel, and handle daily activities. Biological factors, genetics, life events, and brain chemistry all play roles in depression. Unlike ADHD, which is neurodevelopmental, depression is typically considered a mood disorder that can be triggered by life circumstances, though it also has biological components.

Common symptoms and where they overlap

All three conditions can cause similar symptoms, which is why differentiation matters. The key is understanding the underlying cause and pattern.

Shared symptoms

All three conditions can cause: difficulty concentrating, restlessness, irritability, sleep problems, fatigue, difficulty making decisions, and memory issues. However, the reasons differ:

ADHD: Symptoms stem from executive function differences and persist regardless of stress.

Anxiety: Symptoms come from worry, hypervigilance, and physical tension.

Depression: Symptoms are tied to low mood, energy, and motivation.

ADHD-specific patterns

Time blindness, chronic lateness, forgetfulness even when calm, hyperfocus on interesting tasks, impulsive decisions, inconsistent performance, and difficulty with routine tasks.

Anxiety-specific patterns

Excessive worry about future events, physical tension, avoidance behaviors, hypervigilance, panic attacks, racing thoughts, and catastrophic thinking.

Depression-specific patterns

Persistent sadness, loss of interest (anhedonia), feelings of worthlessness, appetite changes, suicidal thoughts, and concentration that improves when mood improves.

Key differences: onset, triggers, and patterns

Clinicians use several key factors to distinguish between these conditions. Understanding these differences is crucial for accurate diagnosis and effective treatment.

Onset and duration

ADHD: Symptoms begin in childhood (before age 12) and are chronic throughout life. This is a lifelong neurodevelopmental condition.

Anxiety: Can develop at any age, often triggered by life events. May be episodic or chronic, with periods of remission.

Depression: Can develop at any age, often triggered by life events. Typically episodic with periods of remission.

Context and triggers

ADHD: Symptoms are consistent across settings (work, home, school) and persist even when stress is low. The symptoms are part of brain function, not a response to external circumstances.

Anxiety: Symptoms are often situation-specific or triggered by perceived threats. May fluctuate based on stress levels—symptoms increase during stressful periods and may decrease when the stressor is removed.

Depression: Symptoms are pervasive and affect all areas of life relatively equally. Can be triggered or worsened by life events, and symptoms may improve when circumstances change.

Mood and emotional patterns

ADHD: Does not inherently affect mood, though emotional dysregulation is common. Mood can be positive when engaged in interesting activities. Emotional challenges stem from frustration with executive function difficulties.

Anxiety: Characterized by excessive worry about future events and physical arousal. Mood may be normal between anxiety episodes. The emotional state is tied to worry and fear rather than sadness.

Depression: Characterized by pervasive low mood, loss of pleasure, and negative thinking patterns. Directly affects the ability to experience positive emotions, even in enjoyable situations.

Response to interventions

ADHD: Symptoms improve with ADHD-specific treatments (medication, coaching, accommodations) but typically do not resolve with anxiety or depression treatments alone.

Anxiety: Symptoms improve with anxiety treatments (CBT, exposure therapy, medications) and may decrease when stressors are removed.

Depression: Symptoms improve with depression treatments (therapy, antidepressants) and may lift when life circumstances improve.

Comorbidity: when conditions occur together

It is common for these conditions to co-occur, which complicates diagnosis and treatment:

• ADHD and anxiety: Up to 50% of adults with ADHD also have an anxiety disorder. Anxiety can develop as a coping mechanism for ADHD-related challenges, or both conditions may exist independently.
• ADHD and depression: Approximately 20–30% of adults with ADHD also experience depression. The chronic stress of managing undiagnosed ADHD can contribute to depression.
• Anxiety and depression: These frequently co-occur, with about half of people with depression also experiencing anxiety.
• All three together: It is possible to have ADHD, anxiety, and depression simultaneously, which requires integrated treatment approaches.

When conditions co-occur, symptoms can amplify each other. For example, ADHD-related forgetfulness can trigger anxiety about making mistakes, which can lead to depression if the cycle continues unchecked. This is why comprehensive clinical evaluations are essential—clinicians need to understand the full picture to develop effective treatment plans.

How clinicians differentiate: diagnostic approaches

A thorough clinical evaluation is essential for accurate diagnosis. Clinicians use multiple approaches:

Clinical interviews: Comprehensive interviews exploring symptom history, onset, duration, and impact across different life areas. Clinicians ask about childhood symptoms, family history, and how symptoms present in various contexts.

Screening tools: • ADHD: ASRS v1.1 (Adult ADHD Self-Report Scale) and other validated screeners • Anxiety: GAD-7 (Generalized Anxiety Disorder scale) and other anxiety assessments • Depression: PHQ-9 (Patient Health Questionnaire) and other depression screeners

Medical history: Review of physical health, medications, sleep patterns, and substance use, as these can mimic or worsen symptoms.

Collateral information: Reports from family members, partners, or teachers can provide valuable context about symptom patterns over time.

Clinicians systematically consider which condition best explains the symptom pattern, whether multiple conditions are present, and what treatment approach would be most effective.

Impact on daily life and functioning

Each condition affects daily life differently:

ADHD: Chronic difficulty with time management and organization, inconsistent performance despite ability, relationship strain, and higher risk of accidents.

Anxiety: Avoidance of triggering situations, physical symptoms interfering with daily activities, sleep disruption, and social withdrawal.

Depression: Loss of motivation, difficulty completing basic tasks, social isolation, and work/school performance decline.

Understanding how symptoms impact your life helps clinicians assess functional impairment and prioritize treatment goals.

Treatment approaches

Effective treatment depends on accurate diagnosis and may involve multiple approaches:

ADHD treatment: Medications (stimulants or non-stimulants), CBT adapted for ADHD, coaching, and lifestyle strategies like exercise, sleep hygiene, and organizational systems.

Anxiety treatment: CBT, exposure therapy, mindfulness approaches, medications (SSRIs, SNRIs), and stress management techniques.

Depression treatment: CBT, interpersonal therapy, antidepressants (SSRIs, SNRIs), and lifestyle approaches like exercise and social connection.

When conditions co-occur: Treatment plans must address all conditions simultaneously. This may require multiple medications, comprehensive therapy, and careful coordination. Sometimes treating one condition first makes it easier to address others.

Treatment is not one-size-fits-all. Medication and therapy together are often more effective than either alone, and it often takes time to find the right combination.

Real-world examples: how symptoms present differently

Understanding how symptoms present in real life helps clarify the differences between these conditions. Here are examples of how the same situation might look different depending on the underlying condition:

Scenario 1: Difficulty focusing at work

ADHD: Struggles to focus on routine tasks but can hyperfocus on interesting projects. Concentration issues are consistent across different types of work. May forget what was just discussed in meetings. Time seems to disappear—what feels like 30 minutes is actually 3 hours.

Anxiety: Difficulty focusing because the mind is racing with worries about deadlines, making mistakes, or what others think. Concentration may be fine when working alone but falls apart in meetings or high-pressure situations. Physical tension makes it hard to sit still.

Depression: Difficulty focusing due to low energy and motivation. Everything feels effortful. Concentration may improve slightly when mood is better, but generally feels foggy and slow. May stare at the computer for hours without accomplishing anything.

Scenario 2: Procrastination and missed deadlines

ADHD: Procrastinates because starting tasks feels overwhelming, especially boring or routine tasks. May work frantically at the last minute when urgency creates motivation. Consistently underestimates how long tasks take. This pattern has existed since childhood.

Anxiety: Procrastinates because of fear of making mistakes or not meeting expectations. May avoid starting because the thought of the task creates physical anxiety. Procrastination increases during stressful periods.

Depression: Procrastinates because of low motivation and energy. Tasks feel impossible to start or complete. May not care about deadlines or consequences. This pattern developed or worsened during a depressive episode.

Scenario 3: Social difficulties

ADHD: May interrupt conversations, miss social cues, or zone out during discussions. Struggles to maintain friendships due to forgetfulness (missing plans, not returning calls) rather than social anxiety. These patterns have existed since childhood.

Anxiety: Avoids social situations due to fear of judgment or embarrassment. May cancel plans at the last minute due to anxiety. Physical symptoms (sweating, shaking) make social interactions difficult. Social skills may be fine when anxiety is managed.

Depression: Withdraws from social activities due to low energy and loss of interest. May not respond to messages or invitations because everything feels too difficult. Previously enjoyed social activities no longer bring pleasure.

Scenario 4: Emotional reactions

ADHD: Big emotional reactions that seem out of proportion, often due to frustration with executive function challenges. Emotions may shift quickly. Can experience positive emotions normally. Emotional dysregulation is consistent across situations.

Anxiety: Emotional reactions tied to worry and fear. May overreact to situations perceived as threatening. Emotions are generally fear-based rather than sadness-based. Emotional state may be normal when not in anxiety-provoking situations.

Depression: Emotional reactions characterized by sadness, hopelessness, or numbness. Difficulty experiencing positive emotions even in positive situations. Emotional state is persistently low rather than reactive.

These examples illustrate why context and history matter so much in diagnosis. The same behavior can have very different underlying causes.

Common patterns (not diagnostic)

While only a professional can diagnose ADHD, anxiety, or depression, certain patterns can help you understand what might be going on. These patterns are clues, not diagnoses:

More ADHD-shaped patterns

Longstanding patterns since childhood that persist across settings (not just at work or just at home). Problems with time management, organization, and follow-through even when calm and relaxed. Hyperfocus on interesting tasks but inability to start boring ones, regardless of importance. Forgetfulness and losing things regularly, even when not stressed. Impulsive decisions and difficulty waiting, even in low-stress situations. Inconsistent performance despite ability—excellent at some things, struggling with others. Feedback about "potential not performance" throughout life. Patterns that existed before current job, relationship, or life circumstances.

More anxiety-shaped patterns

Worry loops and excessive concern about future events, often out of proportion to the situation. Difficulty focusing due to threat scanning and hypervigilance—mind jumps from worry to worry. Restlessness with physical tension and muscle tightness (not just mental restlessness). Avoidance of anxiety-provoking situations, even when avoidance creates problems. Symptoms that worsen with stress and improve when relaxed or when stressor is removed. Physical symptoms like rapid heartbeat, sweating, trembling, or gastrointestinal issues. Catastrophic thinking—expecting the worst possible outcomes. Symptoms that are situation-specific rather than constant.

More depression-shaped patterns

Low energy and slowed thinking that persists throughout the day, not just in certain situations. Loss of interest and motivation in previously enjoyed activities (anhedonia). Concentration that improves when mood improves, suggesting mood is driving cognitive symptoms. Feelings of worthlessness, guilt, or hopelessness that persist. Changes in sleep (insomnia or oversleeping) and appetite that are significant. Symptoms that are pervasive and not situation-specific—affects all areas of life relatively equally. Symptoms that developed or significantly worsened during a specific life period or event. Thoughts of death, suicide, or self-harm (requires immediate professional attention).

Important caveat: These patterns are not diagnostic criteria. Many people have mixed patterns, and symptoms can overlap significantly. The presence of these patterns suggests it may be worth exploring that condition with a professional, but they do not replace a clinical evaluation.

What to bring to a clinician

When preparing for a clinical conversation, gather concrete examples and context to help with accurate diagnosis. Good preparation can make the difference between a productive assessment and one that misses important information.

Concrete examples: Instead of saying "I have trouble focusing", bring specific stories with details: • "During meetings, I zone out after 10 minutes and miss important details, which led to mistakes on three projects last quarter." • "I set three alarms to wake up but still oversleep regularly. Last month I missed two important appointments." • "I can spend 6 hours hyperfocusing on a project I find interesting, but I cannot start simple administrative tasks that take 15 minutes."

Specific examples help clinicians understand not just what symptoms you have, but how they impact your life and what patterns they follow.

Timeline: Document when symptoms started and whether they were present in childhood. Create a simple timeline: • Early childhood: Any school reports, teacher comments, or family observations • Adolescence: Academic performance, social relationships, behavioral patterns • Adulthood: How symptoms have changed, periods when symptoms were better or worse • Recent changes: Any new symptoms or worsening of existing symptoms

This timeline helps clinicians distinguish between ADHD (lifelong) and conditions that developed later.

Context across settings: Describe how symptoms show up at work, home, school, and in social situations. Be specific: • Work: Do symptoms affect all tasks equally, or only certain types? How do colleagues or supervisors describe your performance? • Home: How do symptoms affect household management, relationships, parenting? • Social: Do symptoms affect all social situations, or only specific types? • Alone vs. with others: Do symptoms change based on who you are with?

ADHD symptoms are typically consistent across settings, while anxiety may be situation-specific.

Sleep context: Document average sleep hours, sleep quality, snoring/apnea risk, shift work, and any insomnia patterns. Poor sleep can mimic or worsen all three conditions. Include: • Typical bedtime and wake time • How long it takes to fall asleep • How many times you wake during the night • Whether you feel rested upon waking • Any snoring, breathing pauses, or restless legs • Work schedule (day shift, night shift, rotating)

Sleep problems can cause or worsen ADHD-like symptoms, anxiety, and depression.

Stress context: Note major life events, periods of burnout, chronic stress, and how symptoms relate to these stressors: • Recent major life changes (job, relationship, move, loss) • Current stressors (work demands, financial pressure, family responsibilities) • History of trauma or significant adverse experiences • Periods of high stress vs. low stress and how symptoms changed

This helps distinguish between conditions that are stress-related versus those that persist regardless of stress.

Previous treatments: List any medications, therapies, or interventions you have tried and how they affected your symptoms: • What you tried (medication names, therapy types, duration) • How you responded (improved, worsened, no change, side effects) • Why you stopped (if applicable)

This information helps clinicians understand what has and has not worked, which can inform diagnosis and treatment planning.

Family history: Note any family members with ADHD, anxiety, depression, or other mental health conditions, as these can have genetic components. Include: • First-degree relatives (parents, siblings, children) • Extended family if known • Any diagnoses, even if not formally diagnosed but clearly present

Family history provides important context for understanding genetic risk factors.

Screening results: Bring results from any screening tools you have completed, including: • ASRS v1.1 or other ADHD screeners • GAD-7 or other anxiety screeners • PHQ-9 or other depression screeners • Results from our free screener at /test

These provide structured data that complements your narrative description.

Questions to ask: Prepare a list of questions you want answered: • What diagnosis are you considering and why? • How do you think my symptoms relate to each other? • What treatment approach do you recommend? • What should I expect from treatment? • How long will it take to see improvement? • What are the risks and benefits of different treatment options?

When to seek professional help

Consider seeking professional evaluation if:

• Symptoms significantly interfere with work, school, relationships, or daily functioning: If your symptoms are causing problems in important areas of your life, it is time to seek help. This includes: - Repeated work performance issues or job loss - Academic struggles despite ability - Relationship strain or conflict - Difficulty managing daily tasks (bills, appointments, household management) - Avoidance of important activities or responsibilities

• You have been struggling for several months or longer: Occasional difficulties are normal, but persistent symptoms that last months suggest a condition that may need treatment.

• Symptoms are getting worse or not improving on their own: If things are deteriorating or not getting better despite your efforts, professional help can prevent further decline.

• You are using substances, unhealthy coping mechanisms, or experiencing thoughts of self-harm: These are signs that immediate professional help is needed. If you are having thoughts of suicide, contact a crisis line immediately (988 in the U.S., or your local emergency services).

• You scored high on a screening test and want professional evaluation: Screening tests are not diagnostic, but high scores suggest it is worth pursuing a full evaluation.

• Multiple people in your life have expressed concern about your symptoms: Sometimes others notice problems before we do. If several people have mentioned concerns, it is worth taking seriously.

• You are spending significant time and energy trying to manage symptoms: If managing symptoms is consuming a lot of your mental energy or causing significant stress, professional support can help.

• You want to understand what is going on: You do not need to wait until things are severe. Seeking clarity and understanding is a valid reason to see a professional.

Early intervention leads to better outcomes. You do not need to wait until symptoms are severe to seek help. In fact, early treatment can prevent symptoms from worsening and reduce long-term functional impairment. A qualified mental health professional can help clarify what is going on and develop an appropriate treatment plan.

How to find a qualified professional: • Ask your primary care doctor for referrals • Contact your insurance company for in-network providers • Use professional directories (Psychology Today, your country's professional associations) • Look for providers who specialize in adult ADHD, anxiety, or depression • Consider telehealth options if in-person visits are difficult • Check credentials and ensure the provider is licensed

What to expect in your first appointment: • A comprehensive interview about your symptoms, history, and functioning • Discussion of your goals and concerns • Information about diagnosis and treatment options • A plan for next steps • Opportunity to ask questions

Remember: seeking help is a sign of strength, not weakness. Taking care of your mental health is as important as taking care of your physical health.

Why accurate diagnosis matters

Getting the right diagnosis is crucial because treatment approaches differ significantly between ADHD, anxiety, and depression. Misdiagnosis can lead to:

• Ineffective treatment: Treating anxiety when the primary issue is ADHD, or vice versa, often leads to poor outcomes. For example, anti-anxiety medications will not address ADHD executive function challenges, and ADHD medication alone will not resolve anxiety that developed independently.
• Wasted time and resources: Months or years of treatment that does not work can be frustrating and expensive.
• Worsening symptoms: Inappropriate treatment can sometimes make symptoms worse. For example, stimulants can worsen anxiety in some people, and treating only depression when ADHD is also present may not address the underlying executive function challenges.
• Missed opportunities: Without the right diagnosis, you may miss out on effective treatments, accommodations, and support strategies.
• Continued suffering: Living with untreated or inappropriately treated symptoms can lead to worsening functional impairment, relationship problems, and decreased quality of life.

The complexity of comorbidity: When conditions co-occur, treatment becomes more complex but also more important. For example: • Someone with ADHD and anxiety may need both ADHD medication and anxiety therapy • Someone with all three conditions may need a carefully coordinated treatment plan addressing each • The order of treatment matters—sometimes treating one condition first makes it easier to address others

This is why comprehensive evaluation by a qualified professional is essential. Self-diagnosis or relying solely on screening tests is not sufficient when symptoms overlap this significantly.

Common misconceptions to avoid

Several misconceptions can interfere with accurate understanding and diagnosis:

• "I cannot have ADHD because I did well in school": Many people with ADHD do well academically, especially if they are intelligent or had strong support. ADHD does not mean low intelligence or poor academic performance.
• "I cannot have anxiety because I do not have panic attacks": Anxiety disorders take many forms. Not everyone with anxiety has panic attacks. Generalized anxiety, social anxiety, and other forms may not involve panic.
• "I cannot have depression because I can still function": Depression exists on a spectrum. High-functioning depression is real—people can appear to function while struggling internally.
• "If I just try harder, I can overcome these symptoms": These are medical conditions, not character flaws or willpower issues. Trying harder without appropriate treatment often leads to burnout and worsening symptoms.
• "Medication is a crutch": Medication is a legitimate treatment for medical conditions, just like medication for diabetes or high blood pressure. It is not a crutch—it is a tool that can help your brain function better.
• "I should be able to handle this on my own": Seeking professional help is appropriate and necessary for these conditions. You would not expect to treat diabetes or heart disease on your own—mental health conditions deserve the same professional care.
• "If I have one condition, I cannot have another": Comorbidity is common. Having ADHD does not mean you cannot also have anxiety or depression. In fact, they often occur together.
• "A diagnosis is just a label": While a diagnosis is a label, it is also a tool that opens doors to appropriate treatment, accommodations, understanding, and support. It can be validating and empowering.

Understanding these misconceptions helps you approach diagnosis and treatment with realistic expectations and reduces self-blame.

Next steps

If you scored high on the ADHD test, the best next move is to interpret the result as a screening signal and then evaluate the broader picture. That approach reduces false certainty and leads to better outcomes.

Your action plan:

1. 1Take comprehensive screening tests: Start with our free ASRS-based ADHD screening test at /test. Also consider taking anxiety and depression screeners to get a full picture. You can find additional screeners in our Screeners section.

2. Reflect on your patterns: Use this guide to reflect on whether your symptoms might be better explained by ADHD, anxiety, depression, or a combination. Consider: - When did symptoms start? - How do they present across different situations? - What makes them better or worse? - What patterns do you notice?

1. 1Gather information: Start documenting your symptoms, examples, and history. Use the "What to bring to a clinician" section as a guide.

1. 1Seek professional evaluation: Bring your screening results and your reflections to a qualified clinician for a comprehensive evaluation. A thorough assessment will help clarify what is going on and what treatment approach will be most effective.

1. 1Be patient with the process: Diagnosis can take time, especially when symptoms overlap. Multiple appointments may be needed to get a clear picture. This is normal and appropriate.

1. 1Advocate for yourself: If a clinician dismisses your concerns without a thorough evaluation, consider seeking a second opinion. You deserve a comprehensive assessment.

Remember: Screening tests are not diagnoses. They are tools to help you and your clinician have a more productive conversation about what might be going on and what support you need. The goal is not to diagnose yourself, but to gather information that helps a qualified professional make an accurate diagnosis and develop an effective treatment plan.

Resources for next steps: • Take our free ADHD screener: /test • Explore our ADHD Glossary: /glossary • Read about preparing for assessment: /blog/how-to-prepare-for-an-adult-adhd-assessment • Learn about diagnosis pathways: /adhd-diagnosis • Practice with our AI interview: /interview