ADHD vs Anxiety: How to Tell the Difference
Struggling to tell if it's ADHD, anxiety, or both? Learn the key differences and when to seek an assessment. Trusted child psychology, Helensvale & Northern Gold Coast.
Psychologist Hannah
9/2/20265 min read
ADHD vs Anxiety: How to Tell the Difference
Your child cannot sit still through dinner, loses focus mid-sentence, and seems to be everywhere except where they are meant to be. Is that ADHD? Or is it anxiety, showing up in a way that looks nothing like the quiet, worried child most people picture? If you have been searching "ADHD or anxiety in child" or "child psychologist Gold Coast," you are asking exactly the right question, because these two conditions overlap far more than most parents expect, and getting the distinction right matters for what happens next.
Mindaras Psychology Clinic is based in Helensvale and works with children and families across the Northern Gold Coast, including Coomera, Oxenford, Pacific Pines, Hope Island, Upper Coomera, Ormeau and Nerang. Untangling ADHD from anxiety, or working out when a child has both, is one of the most common reasons families come to see us.
Why This Is Genuinely Hard to Tell Apart
It is not just you. Clinicians describe this as a real diagnostic challenge, not a simple checklist exercise. A clinical review of ADHD and anxiety comorbidity found that overlapping symptoms, differences in diagnostic tools, and even differences between what parents, teachers and children themselves report can all complicate an accurate diagnosis (Koyuncu et al., 2022). This is backed up by just how often the two occur together. Anxiety is one of the most common conditions to co-occur with ADHD, with comorbidity rates reported as high as 50 percent in children with ADHD (Khoodoruth et al., 2022, as cited in Janiczak et al., 2025). In other words, a great many children who have ADHD also have anxiety, which is exactly why the picture rarely divides neatly into one or the other.
Where the Overlap Comes From
Several core behaviours can look almost identical on the surface, even though very different things may be driving them underneath.
Trouble concentrating. A child with ADHD may struggle to sustain attention because their brain is drawn elsewhere. A child with anxiety may struggle to concentrate because a worried mind is consuming most of their available mental bandwidth, leaving little left over for the task in front of them.
Restlessness. ADHD hyperactivity can look like constant physical movement. Anxiety can produce a very similar kind of restlessness, sometimes described as being unable to settle because the body is in a low-level state of alert.
Avoidance. A child avoiding schoolwork might be doing so because ADHD makes sustained tasks genuinely difficult to start and finish. A child with anxiety might avoid the same task because of a fear of getting it wrong, being judged, or failing.
Emotional outbursts. Both conditions can produce meltdowns, frustration, or sudden emotional escalation, for quite different underlying reasons.
Some Useful Differences to Look For
While no list replaces a proper assessment, a few patterns can offer a helpful starting point.
What happens with novelty and structure. Children with ADHD often struggle more with tasks that are repetitive, effortful, or lack immediate interest, while sometimes hyperfocusing intensely on things they find engaging. Children with anxiety often struggle more with unfamiliar situations, changes to routine, or anything involving evaluation or judgement, regardless of how interesting the task is.
What is happening internally. ADHD is primarily a difference in attention regulation and impulse control. Anxiety is primarily a difference in threat perception and worry. A child who can tell you they are scared something bad will happen is describing anxiety. A child who genuinely was not aware their mind had wandered is describing something closer to ADHD.
Physical symptoms. Anxiety often comes with physical signs such as stomach aches, headaches, sleep difficulties, or a racing heart, particularly before something the child is worried about. These physical symptoms are less characteristic of ADHD on its own.
How symptoms respond to reassurance or certainty. Anxiety symptoms often ease, at least temporarily, once a worry is addressed or a situation becomes predictable. ADHD-related attention and impulsivity difficulties tend to persist across situations regardless of reassurance.
Why This Distinction Actually Matters
This is not just an academic exercise. Getting the picture right shapes what kind of support will actually help. Research has found that when children with ADHD also have two or more co-occurring anxiety conditions, they show meaningfully poorer quality of life, daily functioning and behaviour than children with ADHD and no anxiety, even after accounting for ADHD severity (Jarrett et al., 2016). Treatment approach matters too. Clinical guidance notes that managing a child's anxiety alongside ADHD requires evaluating which condition is having more impact on daily functioning, and flags a genuine, ongoing clinical debate about whether some ADHD treatments can affect anxiety symptoms, even as growing evidence supports appropriately managed treatment for children with both conditions present (Janiczak et al., 2025).
In plain terms, treating what looks like ADHD when anxiety is the bigger driver, or vice versa, can mean a child does not get the support that would actually help them the most. A thorough assessment is not just about getting a label right. It is about making sure the plan that follows actually fits what is going on.
When to Consider a Professional Assessment
It is worth seeking an assessment if your child's attention, restlessness, or emotional reactions are consistently getting in the way of school, friendships or family life, if you have noticed a pattern that has lasted months rather than weeks, or if you simply are not sure whether what you are seeing is ADHD, anxiety, both, or something else entirely. A proper assessment looks at the whole picture, not just a checklist of symptoms, and considers how a child presents across different settings and informants.
What This Looks Like at Mindaras
Our team takes the time to properly untangle overlapping presentations like ADHD and anxiety, rather than defaulting to the first explanation that seems to fit. This means a thorough clinical interview, validated rating scales completed by parents and, where relevant, teachers, and careful consideration of how symptoms show up across different settings. Where both ADHD and anxiety are present, and this is common, we help families understand which is having the greater day-to-day impact, so support can be genuinely well targeted rather than one-size-fits-all.
Alongside ADHD assessment, Mindaras offers a full range of services for children and families across the Northern Gold Coast, including anxiety and mood support, trauma and EMDR therapy, and ASD assessments.
Get in Touch
If you have been going back and forth trying to work out whether ADHD, anxiety, or both explain what you are seeing in your child, the clearest next step is a proper conversation, not more guessing. Get in touch with Mindaras Psychology Clinic through our Contact page to ask questions or book an assessment. While you are there, take a look through the full range of services we offer the Northern Gold Coast community. The right support starts with genuinely understanding what is going on.
References
Janiczak, K., Brown, A., & Simon, E. (2025). Approaches to treating children with ADHD and common comorbidities. Journal of Pediatric Health Care. https://www.jpedhc.org/article/S0891-5245(24)00231-1/fulltext
Jarrett, M. A., Meter, A. V., Youngstrom, E. A., Hilton, D. C., & Ollendick, T. H. (2016). Evidence for a dual pathway model of anxiety in children with ADHD. Journal of Clinical Child & Adolescent Psychology. https://pubmed.ncbi.nlm.nih.gov/24753534/
Koyuncu, A., Aynacı, G., Yüce, A. E., Konuk, N., & Ertekin, E. (2022). ADHD and anxiety disorder comorbidity in children and adults: Diagnostic and therapeutic challenges. Current Psychiatry Reports, 24(2), 129-140. https://doi.org/10.1007/s11920-022-01324-5
This article is for general information only and does not replace individual clinical advice. If you have concerns about your child's mental health, please book a consultation with a registered psychologist.