Can ADHD Be Misdiagnosed as Anxiety or Depression?
Attention Deficit Hyperactivity Disorder (ADHD) is a complex neurodevelopmental condition that can sometimes be misdiagnosed as anxiety or depression. This is especially common in adults, where ADHD often presents differently than in children, making it harder to spot. Adults who feel constantly overwhelmed, disorganized, or easily distracted often think the issue is anxiety or depression.
This blog explores how ADHD symptoms can overlap with these conditions, why a comprehensive ADHD assessment is important for diagnosing ADHD in adults, and how getting the right diagnosis can make all the difference in accessing effective support.
Types of ADHD and Overlapping Symptoms
To understand why ADHD might be mistaken for anxiety or depression, it helps to know that there are three main types of ADHD:
Predominantly Inattentive Type: People with this type often have trouble focusing, get easily distracted, and may seem forgetful. These symptoms can easily resemble anxiety, where racing thoughts and inability to focus are common.
Predominantly Hyperactive-Impulsive Type: This type includes behaviors such as restlessness, impulsivity, and a sense of always being “on the go.” This can overlap with anxiety or even mimic mania, often leading to a misdiagnosis.
Combined Type: This type includes both inattentive and hyperactive-impulsive symptoms, making it the most complex. People with Combined Type ADHD may appear disorganized, distracted, impulsive, and forgetful—all traits that can look like depression or anxiety, especially under stress.
These types highlight how varied ADHD can be and how symptoms can appear differently in different people. In adults, ADHD often appears less as hyperactivity and more as a general feeling of being scattered, overwhelmed, or “behind.” As a result, diagnosing ADHD in adults can be challenging, especially when symptoms overlap with common signs of anxiety or depression.
Why ADHD Gets Misdiagnosed as Anxiety or Depression
ADHD is frequently misdiagnosed as anxiety or depression because of overlapping symptoms. Here’s a closer look at why this happens:
Shared Symptoms: Adults with ADHD often have racing thoughts, trouble focusing, and poor time management, which can look like anxiety. Likewise, the ongoing frustration and self-doubt from undiagnosed ADHD can resemble depression. Adding the stress of meeting daily responsibilities and social expectations can intensify these symptoms, making it even harder to recognize the underlying ADHD.
Masking Behaviors: People with ADHD often learn to mask their symptoms to avoid criticism or meet social expectations. Masking can involve pretending to focus when the mind is drifting, or pushing through tasks despite extreme difficulty with concentration. Masking often causes stress and exhaustion, which can mimic anxiety and depression.
Comorbidity: Many people with ADHD experience anxiety or depression alongside their ADHD, a phenomenon known as comorbidity. Because these conditions often co-occur, it can be hard to tell which symptoms belong to which condition without a careful ADHD assessment.
Stigma and Misunderstanding: ADHD is often seen as a childhood condition, leading many adults to believe their symptoms must be something else, like anxiety or depression. Unfortunately, this misunderstanding can prevent people from seeking an ADHD evaluation that might better explain their experiences.
The Importance of a Comprehensive ADHD Evaluation
Because ADHD shares so many symptoms with anxiety and depression, a thorough ADHD assessment is essential to get a clear and accurate diagnosis. Unlike a quick doctor’s visit, diagnosing ADHD in adults requires a more in-depth evaluation. A comprehensive ADHD evaluation often includes a mix of interviews, self-reports, and ADHD testing tools to fully understand how ADHD might be affecting someone’s life.
Clinical Interviews: Licensed professionals will usually conduct a clinical interview to understand a person’s background, experiences, and specific challenges. The interview gives insight into patterns, personal history, and specific ADHD symptoms that might otherwise go unnoticed.
Standardized Testing: ADHD testing tools, like the Diagnostic Interview for ADHD in Adults-5th Edition (DIVA-5) or the Brown Executive Function/Attention Scales (Brown EF/A), help clinicians gather more structured information. These tools provide objective data about symptom frequency and intensity, making it easier to distinguish ADHD from other conditions.
Family and Peer Feedback: Input from people who know the person well, such as family members or close friends, can be helpful. This is because symptoms of ADHD are often persistent across different settings, including work, home, and social environments. This feedback can paint a fuller picture of how ADHD impacts daily life.
Evaluating for Comorbidities: A comprehensive ADHD assessment also screens for conditions like anxiety and depression. This is important for understanding which symptoms belong to ADHD and which are part of a separate mental health condition.
Benefits of an Accurate ADHD Diagnosis
When ADHD is properly identified, it paves the way for targeted treatments and support. Without an accurate diagnosis, people with ADHD may receive treatments that don’t address their unique needs. Here’s why getting an accurate ADHD diagnosis matters:
Access to Effective Medication: ADHD medications, like stimulants, can be life-changing for those with ADHD. However, if ADHD is mistaken for anxiety or depression, people may be prescribed antidepressants or anti-anxiety medications instead, which are not as effective for ADHD symptoms.
Skill-Building Therapy: Therapy approaches that are designed for ADHD, such as cognitive-behavioral therapy (CBT) or ADHD coaching, focus on skills to improve time management, organization, and emotional regulation. Without an ADHD diagnosis, these tailored approaches are less likely to be recommended.
Rebuilding Self-Esteem: Adults with undiagnosed ADHD often struggle with self-esteem issues, as they may feel “lazy” or “less capable” because of their challenges. A proper diagnosis can provide validation and help people understand that their struggles aren’t due to a lack of effort but rather a different way of thinking.
Getting the Right Support Through ADHD Testing
Because ADHD symptoms can mimic anxiety and depression, ADHD-specific testing can provide valuable clarity. This is especially true for adults who may have masked their symptoms or who experience less noticeable forms of hyperactivity. ADHD testing typically includes detailed questionnaires, direct testing, and observational tools that help distinguish ADHD from other conditions. For example, ADHD testing may reveal patterns like difficulty starting and finishing tasks, getting easily distracted, or a tendency to procrastinate.
An ADHD evaluation should be conducted by a professional experienced with ADHD in adults, as adult ADHD can manifest differently than in children. A proper assessment ensures that any co-occurring conditions like anxiety or depression are also identified and managed appropriately.
Final Thoughts
For adults who have been diagnosed with anxiety or depression but feel that something still doesn’t quite add up, an ADHD evaluation might hold the key. Because ADHD can look similar to other mental health conditions, people often spend years receiving treatments that don’t fully address their needs. A comprehensive ADHD assessment, complete with ADHD testing, can reveal a clearer picture of what’s going on and guide people to the right support.
Whether you’re struggling with organization, easily distracted thoughts, or feeling overwhelmed by everyday tasks, it’s worth considering the possibility of ADHD if anxiety or depression treatments haven’t provided relief. A clear diagnosis can make all the difference, giving people with ADHD a way to understand their brains and access tools that celebrate, rather than suppress, their neurodiversity.
Address Your Unique Neurodivergent Needs With ADHD and Autism Evaluations in Middlesex, NJ
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Other Services Offered at True Reflections
At True Reflections Mental Health Services, I’m here to help you find your true self and help you overcome anything with therapy. So in addition to providing ADHD and Autism Assessments to embrace your unique traits before college, I also offer Autism and Anxiety Therapy, ADHD and Anxiety Therapy, Trauma Therapy for ADHD and Autism, Affirming Therapy for those with ADHD, Affirming Therapy for those with Autism, and Prenatal and Postpartum Therapy. I also offer different treatment modalities such as Play Therapy, Sandtray Therapy, EMDR Therapy, DBT Therapy, and more. My services are offered in both Middlesex, NJ as well as online in the state of New Jersey. Check out my blog for more topics!
Janine Kelly, MSW, LCSW, C-NDAAP, ADHD-CCSP, ASDCS, PMH-C, RPT-S™, C-DBT, CBT-C, CCATP-CA, CATP is a neurodivergent psychotherapist and the Founder of True Reflections Mental Health Services in Middlesex, NJ. She provides support and Neurodiversity Affirming Comprehensive ADHD & Autism Evaluations to children, teens, and adults in-person and virtually in the state of New Jersey. Janine specializes in the diagnosis of ADHD & Autism in girls and women.
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