ADHD vs Anxiety vs Depression: How to Tell the Difference
Estimated Reading Time: 6–7 minutes
Do you ever feel restless, distracted, and mentally exhausted—yet also weighed down, unmotivated, or worried all the time?
If so, you’re not alone. Many adults live with overlapping symptoms of ADHD, anxiety, and depression, often unsure which one is really at play.
These conditions share similar features—trouble focusing, fatigue, irritability—but the root cause and best treatment differ. Let’s unpack the distinctions and how to know what’s actually driving your symptoms.
1. The Shared Confusion
It’s easy to see why people mix them up:
All three can cause concentration issues.
All three can lead to low motivation.
All three can make you feel overwhelmed by simple tasks.
The difference lies in what’s causing those struggles and how your brain processes motivation, emotion, and reward.
2. ADHD: The Brain’s “Interest-Based” Operating System
ADHD isn’t a lack of willpower—it’s a difference in how your brain regulates attention, motivation, and reward.
Common adult ADHD signs:
You can focus intensely on things you enjoy but not on things you “should” do.
You forget deadlines, misplace items, or start multiple projects without finishing.
You crave stimulation and get restless or bored easily.
Your emotions feel big and fast-changing.
In ADHD, the core problem is executive dysfunction—difficulty managing time, focus, and transitions. It’s not sadness or fear; it’s a dopamine imbalance that makes consistency hard, even when motivation is high.
3. Anxiety: The “What If” Loop That Never Stops
Anxiety is the brain’s alarm system stuck in the “on” position. It creates constant anticipation of threat, judgment, or failure—even when nothing is wrong.
Common anxiety features:
Racing thoughts about future outcomes (“What if I forget something?”)
Physical tension, tight chest, heart racing
Difficulty relaxing or sleeping
Fear-driven avoidance or perfectionism
People with anxiety usually know what they’re afraid of. Their restlessness stems from worry, not boredom or distraction.
When anxiety and ADHD overlap, the anxious brain amplifies every missed deadline or impulsive mistake, creating a feedback loop of stress and guilt.
4. Depression: The Energy Drain and Emotional Fog
Depression slows everything down. Instead of racing thoughts, you may feel mentally heavy—like your brain and body are running through mud.
Common depression indicators:
Persistent sadness or loss of interest in previously enjoyable things
Low energy, slowed speech, or appetite changes
Difficulty getting out of bed or starting the day
Thoughts of hopelessness or guilt
Unlike ADHD, which fluctuates by interest level, depression causes a more global loss of motivation and pleasure. Even things that used to excite you feel flat.
5. How These Conditions Overlap (and Confuse Doctors Too)
Many people have both ADHD and anxiety, or ADHD and depression—one often triggers the other.
ADHD can cause chronic stress and self-criticism → leading to anxiety or depression.
Anxiety can cause avoidance and distraction → mimicking ADHD.
Depression can reduce motivation and focus → also resembling ADHD.
That’s why professional evaluation matters. A brief questionnaire or online test can’t always accurately separate them.
6. What the Brain Science Shows
Each condition affects the brain’s chemistry and energy in distinct ways. Here’s a simple breakdown:
ADHD
Core Neurochemicals: Dopamine and norepinephrine
Primary Challenge: Difficulty regulating focus, motivation, and executive function
Typical Energy Pattern: Fluctuating — bursts of energy followed by burnout
Anxiety
Core Neurochemicals: GABA and serotonin
Primary Challenge: Excessive worry, fear, and mental hyperarousal
Typical Energy Pattern: High-strung and tense — the brain feels “always on”
Depression
Core Neurochemicals: Serotonin and glutamate
Primary Challenge: Low mood, loss of motivation, and reduced reward processing
Typical Energy Pattern: Low, flat, and fatigued — everything feels slowed down
Understanding this helps guide treatment: stimulants and skill-building for ADHD, calming or serotonergic medications for anxiety, and mood-focused therapy or ketamine-based interventions for depression.
7. Real-World Clues That Point Toward ADHD
You might be dealing primarily with ADHD (not just anxiety or depression) if:
You’ve felt this way since childhood, but learned to mask it.
You function best under pressure or deadlines.
You thrive in crisis but struggle with routine.
Your mood lifts immediately when engaged in something stimulating.
You’ve tried SSRIs or therapy for years with little change in focus or follow-through.
If that sounds familiar, it’s worth exploring an ADHD-specific assessment.
8. Why Getting the Diagnosis Right Matters
Treating anxiety or depression without recognizing underlying ADHD often leads to partial improvement—symptoms come back, or new ones appear.
When ADHD is correctly identified and treated, anxiety often decreases naturally as structure, focus, and control return.
9. How Six States ADHD Can Help
At Six States ADHD, we specialize in the evaluation and treatment of adult ADHD for patients across New Hampshire and Massachusetts.
Our process includes:
Comprehensive assessment and history review
Evidence-based testing to rule out anxiety and depression overlap
Individualized treatment plans with medication, coaching, and behavioral strategies
We also coordinate with your therapist or prescriber to ensure continuity of care.
10. You Don’t Have to Keep Guessing
If you’ve been told “it’s just stress” or “you just need to try harder,” but nothing seems to click—there’s a better explanation.
ADHD, anxiety, and depression can look alike, but the proper diagnosis changes everything.
Schedule an evaluation or call (857) 256-1487 to talk with a clinician who understands adult ADHD.
Getting clarity could be the most empowering step you take this year.
