Kids with ADHD often have issues with working memory, organization and time management that make it hard to follow daily routines. This can lead to chronic stress. Kids with ADHD may also have more trouble managing stress than kids who don’t have ADHD.

That’s because ADHD can affect how kids manage their emotions. Kids with ADHD may get so flooded with emotion—in this case, anxiety—that they have trouble thinking clearly about how to deal with the situation.

For example, a child with ADHD who finds it difficult to pay attention for most of his math class may panic when he learns there will be a quiz the next day. Instead of thinking about solutions, like asking for help after class or getting notes from a friend, he may come home and get so anxious that he spends the afternoon playing a video game—and forgets to do his history report. And the cycle can go on from there.

Kids with ADHD are at higher risk for anxiety disorders than kids who don’t have ADHD. Because ADHD and anxiety disorders often occur at the same time, some researchers think many kids may be pre-wired to be both anxious and inattentive.

Why Anxiety Can Sometimes Be Misdiagnosed as ADHD

Sometimes kids with anxiety disorders can be misdiagnosed with ADHD, or vice versa. On the surface, the two issues may look similar. Here are some of the ways a child with either issue may act—but for very different reasons:

  • Be inattentive. A child with anxiety may seem tuned out or preoccupied because he’s distracted by worries. A child with ADHD is inattentive because he has a brain-based issue with sustaining focus.
  • Fidget constantly. A child with anxiety may tap his foot nonstop during class because he has a lot of nervous energy. A child with ADHD fidgets because of brain-based issues with hyperactivity or impulse control.
  • Work slowly. A child with anxiety may work slowly because he feels compelled to be a perfectionist. A child with ADHD takes a long time to get things done because of difficulties starting tasks and sustaining focus.
  • Fail to turn in assignments. A child with anxiety may get stuck on a task and be too anxious to ask for help. A child with ADHD doesn’t turn in assignments because of brain-based issues that involve poor planning and forgetfulness.
  • Struggle to make friends. A child with social anxiety may have emotional outbursts that alienate peers. A child with ADHD who’s inattentive can struggle socially because he doesn’t pick up on social cues. Or he may have issues with impulse control that annoy or alienate other kids.

There are several overlapping symptoms. But there are also key differences. Kids with anxiety disorders often show compulsive or perfectionist behavior. This is not as common in kids with ADHD.

Kids with ADHD tend to have issues with organization. This is not as common in kids with anxiety disorders.

Kids with anxiety tend to worry more about socializing than kids with ADHD. Kids with anxiety may also develop physical symptoms like sweaty palms, rapid breathing and stomach aches.