Why Does ADHD Make Me So Stressed and Anxious?

By J. Russell Ramsay, author of The Adult ADHD and Anxiety Workbook

Let’s take a closer look at the adult ADHD–anxiety connection. One frustration of the consistent inconsistency of ADHD is that when dealing with matters that you enjoy, find interesting, or are confident you can accomplish, you may be anxiety-free. You’re a great consultant face-to-face but agonize over the summary report, for instance. You earned As in challenging, interesting classes, but you fell behind and had to drop easy but boring courses. You’re never late for personal training sessions but forget meetings with your child’s teacher. When facing situations that expose your ADHD related weaknesses, you may be likely to seize up with emotions such as anxiety, fear, worry, or stress because your history shows that they’re risky for you.

An aspect of changing your relationship with anxiety (and other emotions) as part of coping with ADHD is to decipher the themes of their signals to you. Until recently, the theme associated with anxiety was the perception of threat or danger risks. No doubt, these are still relevant. We use a lot of words interchangeably to describe anxiety, but let’s differentiate it from the more common ones, which include fear, worry, and stress.

Fear is a current, visceral feeling when facing (or misperceiving) an immediate danger, such as seeing a spider (or reacting to a rubber toy spider that you thought was real), a near-accident while driving, or other here-and-now events. In contrast, anxiety is future oriented.

Worry, also deemed “death by doubt” (Hallowell 1997), is rumination about specific, real-life events, such as taking a high-stakes exam or running late for a job interview. For example, you may worry about an email, stew over it to make sure your thoughts are organized, and end up spending an hour on a twenty-word message.

Stress is a feeling that runs through anxiety. Stress is your reaction to an external demand, such as being overextended at work and then having to deal with a car problem, too. Even positive demands are stressful, such as receiving a job promotion or readying for a vacation. You probably use the word stress for the feeling of juggling all your duties and responsibilities. You’ll hear friends complain about similar life stresses. ADHD adds degrees of difficulty due to executive dysfunction. For example, you may work to employ all the necessary organization and time-management skills to juggle work and family commitments but still fall behind. The differences in the degree of stress are like two people describing heavy winds. The person without ADHD is concerned that a stiff breeze will carry away loose papers. Someone with ADHD worries about hurricane-force winds blowing the roof off their house. Generally, the adult ADHD–anxiety connection stems from the apprehensive associations with various tasks based on past ADHD-related frustrations.

The adult ADHD–anxiety connection doesn’t have to match a formal anxiety diagnostic category, such as a phobia, to cause problems and be worthy of attention. The most relevant anxiety issue for the adult ADHD–anxiety connection is that of generalized anxiety disorder (GAD), which affects 2 to 6 percent of the general population (Brown, O’Leary, and Barlow 2001; Roemer, Eustis, and Orsillo 2021). GAD has been called the basic anxiety, akin to an anxious disposition, like excessively stressing about unfounded risks for identity theft. I’d make the case that the worries associated with dealing with ADHD are come by honestly. These feelings are the effects of long-standing ADHD related frustrations despite your best efforts to power through them.

PP. 23-24 Excerpt taken from The Adult ADHD & Anxiety Workbook

J. Russell Ramsay, PhD, ABPP, is a licensed psychologist specializing in the assessment and psychosocial treatment of adult ADHD. He has authored five books on adult ADHD; lectures internationally and virtually; and is in the Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) Hall of Fame.