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Anxiety disorders

It is completely normal to feel worried or stressed during difficult situations. However, when those feelings of intense fear, dread or unease become constant, overwhelming and begin to interfere with daily life, it may be an anxiety disorder.

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For many people, anxiety isn't just 'in their head'. It is a physical experience that triggers the body's 'fight, flight, freeze or fawn' response. This can lead to symptoms like a racing heart, shallow breathing, muscle tension, exhaustion and panic attacks.

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While anxiety is incredibly common in the general population, it is disproportionately high among neurodivergent individuals. For someone with ADHD or autism, anxiety is rarely just about 'worrying too much'; it is often a direct result of living with a differently wired brain in a world designed for neurotypical people.

The link to ADHD and autism

Research shows that up to 50% of adults and children with ADHD or autism also experience an anxiety disorder. But why is the connection so strong?

  • Sensory overload

    • For many autistic individuals and those with ADHD, the world is physically louder, brighter, and more overwhelming. Chronic sensory overload puts the nervous system in a constant state of high alert, naturally breeding anxiety.

  • Executive dysfunction

    • ADHD traits like chronic forgetfulness, time-blindness, and struggling to start tasks can lead to a lifetime of missed deadlines, lost items, and letting people down. Over time, this creates a state of chronic, anticipatory anxiety (waiting for the next mistake to happen).

    • Masking and camouflaging

    Many neurodivergent people – especially those who go undiagnosed for years – spend a huge amount of energy 'masking' their natural traits to fit in. Constantly monitoring your own behaviour to appear 'normal' is exhausting and highly anxiety-inducing.

    • Rejection sensitive dysphoria (RSD)

    A common trait of ADHD is RSD, which causes extreme emotional pain linked to perceived or actual rejection. The fear of triggering this pain can cause severe social anxiety.

    • Social confusion

    Navigating neurotypical social cues, unwritten rules, and expectations can feel like taking a test you haven't studied for, leading to intense social anxiety.

    What anxiety looks like in ADHD and autism

    Anxiety in neurodivergent individuals doesn't always look like traditional panic. It can present differently, which is why it is often missed or misdiagnosed:

  • Increased 'stimming' or restlessness

    • Pacing, hand-flapping, skin-picking or severe fidgeting.

  • Pathological demand avoidance (PDA)

    • Experiencing everyday requests or demands as an intense threat to autonomy, triggering severe anxiety and resistance.

    • Physical symptoms

    ​Frequent stomach aches, headaches, nausea or profound fatigue (autistic/ADHD burnout).

    • Hyper-focus as an escape

    Retreating completely into a screen, video game or special interest to block out an overwhelming environment.

    • Meltdowns or shutdowns

    What looks like an angry outburst or complete withdrawal is often the result of an anxiety-fueled nervous system crash.

    Coping strategies and support

    Managing anxiety when you have ADHD or autism requires a neurodiversity-affirming approach. Traditional anxiety advice (like 'just face your fears') can sometimes cause more harm if sensory or executive functioning needs aren't addressed first.

    Accommodate the environment (sensory regulation)

    Anxiety often starts in the body. If the environment is overwhelming, the brain will feel anxious.

    • Use noise-cancelling headphones or earplugs (like Flare or Loop).

    • Create a low-demand, quiet 'safe space' at home to decompress after work or school.

    • Identify and reduce sensory triggers (harsh lighting, scratchy clothing, overwhelming crowds).

    Reduce the need to 'mask'

    Encourage unmasking in safe environments. Allowing a person to stim, avoid eye contact or communicate differently without judgment heavily reduces the anxiety of having to 'perform'.

    Externalise executive functions

    Take the pressure off the working memory. Use visual timers, whiteboards, body-doubling (having someone sit with you while you work) and phone alarms to manage tasks. Reducing the fear of forgetting reduces anxiety.

    Somatic and nervous system tools

    • Deep pressure therapy: weighted blankets or tight compression clothing can signal to the nervous system that the body is safe.

    • Movement: regulate nervous energy through gross motor movements (swinging, jumping, heavy lifting or brisk walking).

    Seek neuro-affirming professional help

    • If anxiety is taking over, seek out a therapist who specifically understands the ADHD and autistic profiles. Traditional cognitive behavioural therapy (CBT) may need to be adapted, as neurodivergent anxiety is often based on real systemic struggles, not just irrational thoughts.

    • Medication can also be a highly effective tool when discussed with a psychiatrist who understands comorbidities.

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    Timely detection matters

    Just like ADHD, early identification of an anxiety disorder can change a person's life trajectory. When we understand why someone is struggling, we can provide the right tools to prevent them from turning to harmful coping mechanisms, such as addiction.

    Lived experience: ADHD and anxiety

    "My anxiety isn't worrying about the future; it's the exhaustion of trying to act 'normal' all day."

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    "My anxiety isn't always a panic attack. Sometimes it's the paralysing dread of having an appointment at 3PM, so my brain goes into 'waiting mode' at 9AM. I can't start anything else because I'm terrified that if I relax for even a second, I'll lose track of time and let someone down."

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    "People tell me to just 'take a deep breath' when I'm anxious, but they don't realise my anxiety is physical. It's the buzzing of fluorescent lights, too many conversations happening at once, and a world that just feels too loud. My nervous system isn't overreacting; it's overwhelmed."

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    "Social anxiety with ADHD is exhausting. I spend the whole interaction trying to filter my thoughts and act 'normal,' and then I spend the next three days replaying the conversation in my head, completely convinced I was 'too much' and that everyone is mad at me."

    Source references

    The relationship between ADHD and ODD is well substantiated across multiple expert analyses.

    (Please note: this information is not a substitute for professional medical advice. Always seek the advice of your doctor.)

    Anxiety and Depression Association of America (ADAA)

    Statistic supported: About 50% of adults with ADHD also suffer from an anxiety disorder.

    Reference detail:

    ADAA, "Adult ADHD (Attention Deficit Hyperactivity Disorder) and Anxiety."

    Journal of Attention Disorders / Neurodivergent Insights

    Fact supported: Co-occurrence rates of anxiety with ADHD are frequently estimated at up to 50%, and anxiety in ADHD often stems from executive functioning burnout rather than just generalised worry.

    Reference detail:

    Katzman, M.A., et al. (2017). "Adult ADHD and comorbid disorders: clinical implications of a dimensional approach." BMC Psychiatry, 17(1), 302.

    MDPI: International Journal of Molecular Sciences

    Fact supported: Mood and anxiety disorders represent the most common comorbidities in adult ADHD, affecting ~50% and 20–50% of adults with ADHD, respectively.

    Reference detail:

    "ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives" (2024).

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