If you’ve been treated for anxiety for years and the tools have only ever taken you so far, you may have started wondering whether something else is going on underneath. Medication may have helped in parts, and therapy may have given you some understanding of yourself. Even so, the mental noise doesn’t fully settle, the focus doesn’t fully return, and certain patterns keep repeating in a way that anxiety alone doesn’t quite explain.
Before going further, one framing point is worth naming. Anxiety and ADHD often present together in adults, and what was originally identified as anxiety in your case may well still be accurate. The question this article is exploring is whether ADHD might be another part of the picture that hasn’t been assessed.
The Divergent Edge is a neurodivergent-led telehealth practice for neurodivergent adults across Australia. This article walks through why ADHD often gets missed in adults, how anxiety and ADHD traits can look similar from the outside while feeling different underneath, who tends to slip through the cracks, and what a considered next step could look like.
Why ADHD Gets Missed, and Anxiety Gets Named Instead
There are a few structural reasons this happens, and they show up consistently across Australian primary care.
Most GPs and older-trained psychiatrists received minimal training in adult ADHD, and what they were taught tends to reflect the paediatric literature where the recognisable picture is a hyperactive boy who can’t sit still in a classroom. Adults with inattentive or internalised presentations don’t fit that mental model, and the assessment often ends before it begins.
Anxiety is the more familiar clinical language in general practice as well. When someone arrives describing racing thoughts, poor sleep, restlessness, difficulty focusing and a general sense of being overwhelmed, anxiety is the framework most clinicians reach for, because it’s the one they know how to treat inside a 15-minute consultation.
There’s also the Australian access reality. Adult ADHD assessment is expensive, waitlists can run to a year or longer in some states, and the pathway most immediately available for a busy GP is often an SSRI script and a mental health care plan for CBT. That reflects a system doing what it can with the time and referral options it has.
Research suggests a significant proportion of adults with ADHD in Australia remain undiagnosed, particularly women and those who developed strong masking strategies in childhood. If you’ve been treated for anxiety for years and it never fully resolved, you’re in familiar company.
What Anxiety Symptoms Look Like When They’re Actually ADHD
Five of the most commonly overlapping experiences, and how each one tends to feel different depending on which pattern is driving it.
Racing Thoughts
Anxiety racing thoughts are usually worry-content, cycling through fears, catastrophes and “what if” scenarios with a threat driver underneath them. ADHD racing thoughts tend to be content-jumping, cycling through ideas, random memories, song lyrics and unrelated tasks, often positive or neutral in tone and without any fear driver behind them.
Restlessness
Anxiety restlessness tends to come with physical tension and a sense of dread, as the body braces against a perceived threat. ADHD restlessness tends to come with under-stimulation and a need to move, shift tasks, or seek input, as the body looks for engagement to settle itself.
Difficulty Concentrating
Anxiety pulls concentration toward threat monitoring, so the mind keeps returning to what could go wrong. ADHD concentration works on interest and novelty, so boring or low-stakes tasks don’t get the neurochemical support to sustain focus, while things that genuinely grip you can hold your attention for hours without effort.
Sleep Issues
Anxiety keeps you up with worry loops. ADHD can keep you up through revenge bedtime procrastination, delayed sleep phase patterns that often trace back to adolescence, or a brain that finally has enough quiet in the evening to start thinking properly.
Perfectionism and Avoidance
Anxiety perfectionism runs on fear of failure. ADHD “perfectionism” is often pre-emptive shame from rejection sensitivity combined with task paralysis, where the task feels impossible to start because the standard in your head is impossible to meet and the shame of getting it wrong feels bigger than the shame of never doing it at all. The behaviour can look similar from the outside, though the emotional texture underneath tends to be quite different.
When It’s Both (Which Is More Often Than People Realise)
For a lot of adults, the honest answer is that anxiety and ADHD are both part of what’s happening, and there are three common versions of this.
In the first version, what has been named as anxiety is largely being driven by unsupported ADHD, with no separate anxiety presentation underneath, and the anxiety piece tends to ease considerably once ADHD is understood and supported properly.
In the second version, a genuine anxiety presentation sits alongside ADHD as a distinct co-occurring presentation, and treating one without the other tends to leave half the picture unaddressed, which is often what people mean when they say therapy helped up to a point.
In the third version, anxiety developed as a downstream effect of undiagnosed ADHD, where years of underfunctioning, missed deadlines, social confusion, chronic stress and rejection sensitivity built a real anxiety presentation on top of the ADHD. The anxiety piece is genuine here, and it typically won’t fully settle until the ADHD piece is also being supported.
Prevalence data reflects how common this overlap is. Around 50 per cent of adults with ADHD also meet criteria for an anxiety presentation, and around 28 to 32 per cent of adults with a generalised anxiety diagnosis meet criteria for ADHD.
Who Gets Missed Most Often
Some groups are particularly likely to end up with an anxiety diagnosis while the ADHD piece stays invisible for years.
- Women, especially those with an inattentive presentation, whose ADHD traits are internalised rather than externalised
- High-masking adults across genders, who have spent a lifetime compensating so effectively that clinicians often don’t see what’s underneath
- Adults with academic or professional achievement, where the assumption that a degree rules out ADHD tends to block further investigation
- AuDHD adults, whose autistic traits are frequently read as social anxiety
- People from cultural backgrounds where mental health carries stigma and ADHD isn’t part of the vocabulary
- Adults whose ADHD traits were internalised as personality flaws in childhood rather than named as anything
If you’re recognising yourself in more than one of these, that’s worth paying attention to.
Signs Worth Considering
Rather than functioning as a self-assessment checklist, what follows is a set of patterns that suggest ADHD might be part of what’s happening and worth exploring with a clinician who knows what they’re looking for.
The “since when?” test is a useful starting point. If what you’re experiencing traces back to childhood, that pattern tends to point toward ADHD, while a clearer onset in adult life often points toward anxiety or something else worth naming.
Response to previous treatment is another signal. SSRIs may have helped without fully resolving things, and CBT may have given you insight without shifting day-to-day functioning, which is often what happens when the treatment is working on one layer while another layer sits underneath it.
The energy and interest pattern is also worth noticing. If you can focus intensely on things that grip you and lose focus entirely on things that bore you, that’s how ADHD attention works, and it doesn’t fit an anxiety framework cleanly.
Sensory or emotional intensity that sits outside an anxiety picture, along with a family history of ADHD or the quiet recognition that everyone in your family is a bit like this, can add further texture. Any one of these on its own can be inconclusive, though several appearing together can be worth taking to a clinician.
What to Do From Here
There’s a practical pathway in Australia if you want to explore this further.
Talking to your GP is usually the starting point, and a useful framing to bring is something like: “I’ve been treated for anxiety, and I’d like to explore whether ADHD might also be part of what’s happening for me.” Bringing examples from childhood, along with a short summary of the traits that have been persistent across your whole life rather than tied to a specific stressful period, tends to make that conversation more productive.
Getting properly assessed involves either a psychiatrist referral, which is required for diagnosis and medication, or a registered psychologist for assessment where medication isn’t the immediate priority. Waitlists and costs are real, and worth planning around honestly.
A mental health care plan can fund therapy sessions with a Medicare-registered practitioner while formal assessment is being pursued separately, which means the therapeutic work doesn’t have to wait for the assessment queue to clear.
Working with a neuroaffirming practitioner matters here. That means someone who understands ADHD as a neurotype rather than behaviour to be corrected, who holds the co-occurring picture rather than treating anxiety in isolation, and who adapts therapy for how ADHD nervous systems actually process emotion, memory and regulation.
This is where our team at The Divergent Edge fits in. Our counselling team, led by neurodivergent clinicians including Accredited Mental Health Social Workers and registered counsellors and psychologists, works with the therapeutic side of anxiety, complex trauma, OCD, depression and the chronic stress that builds up over years of misdiagnosis. Our therapeutic ADHD coaching supports the practical daily-functioning piece once the ADHD picture is clearer. Sessions are online, structured to reduce overwhelm, and available Australia-wide.
A Gentle Next Step
Getting a fuller picture is about making sure the support you’re receiving matches the brain you’re actually working with, and everything you’ve learned through years of anxiety treatment can still form part of that picture. If any of this has landed and you’d like to talk it through with a clinician who understands both sides, our counselling team can help.
