Racing Thoughts, Trouble Focusing: Is It ADHD or Anxiety?
You've been scrolling through social media, and suddenly a video stops you mid-scroll: "Signs you might have undiagnosed ADHD." You watch it, and something clicks. The difficulty focusing. The racing thoughts. The sense that you're always behind, always forgetting something, always struggling to keep up with life in a way that seems to come easily to everyone else.
But then you pause. Because you've also wondered if what you're experiencing is anxiety. Maybe both. Maybe neither. The truth is, ADHD and anxiety share a surprising number of symptoms, and if you're a high-achieving adult who has spent years pushing through, the overlap can feel impossibly tangled.
If you've found yourself asking "Do I have ADHD or anxiety?" you're not alone. And in my experience, anxiety is often the more likely culprit, especially for driven, high-achieving people who've spent years pushing themselves hard.
Why Are ADHD and Anxiety Hard to Differentiate?
Both ADHD and anxiety can cause racing thoughts, difficulty concentrating, restlessness, and trouble relaxing. Both can leave you feeling overwhelmed, scattered, and exhausted by the end of the day. It makes sense that people confuse them, or wonder if they have both.
But the why behind these symptoms is different, and understanding that difference matters for getting the right support.
With anxiety, difficulty focusing is usually driven by worry. Your mind isn't wandering aimlessly; it's preoccupied. You might be replaying a conversation from yesterday, anticipating what could go wrong in tomorrow's meeting, or mentally running through your worries for the hundredth time. The thoughts feel sticky and repetitive, circling back to the same fears or concerns. Your attention is hijacked by threat, not boredom. This is one of the hallmarks of anxiety: the mind narrows and fixates rather than scatters. With anxiety, it may feel scattered but when you take inventory of the types of thoughts that are racing around your mind, they’re negative in emotional tone.
With ADHD, the mind tends to wander more freely. Thoughts jump from topic to topic, not necessarily landing on anything negative. The challenge isn't worry; it's that the brain struggles to stay anchored to one thing.
Of course, there's significant overlap, and modern life doesn't make the distinction any easier. We're all contending with constant notifications, endless tabs, and a culture that rewards busyness. Building sustained attention is a skill, and in many ways, technology has eroded our collective capacity for it. Feeling distracted doesn't automatically mean something is clinically wrong.
Anxiety can make it hard to stay with one task at a time. You may find yourself jumping between tasks, checking multiple things at once, or struggling to finish what you start because your mind is constantly scanning for what needs attention next.
How Anxiety Shows Up in High-Achieving Adults
In my practice, I work with a lot of high-achieving professionals who look successful on the outside but feel like they're barely holding it together internally. Anxiety in this population often doesn't look like what you'd expect.
Common signs of anxiety in high-achievers include:
Chronic self-doubt, even with a track record of success
Perfectionism that leads to overchecking or overpreparing
Avoidance of anxiety-provoking tasks like presentations, cold calls, or projects outside your comfort zone
The overwhelm spiral: anxiety makes it hard to focus, which lowers productivity, which increases the sense of falling behind, which fuels more anxiety
Difficulty "turning off" after work or on weekends
Sleep problems, neglected self-care, or increased conflict in relationships
Brain fog or feeling disconnected from your body
If you've ever described yourself as "running on fumes" or feeling like you're watching your life from a distance, that's worth paying attention to. These are often the clearest signals that stress has crossed into something more significant.
Is Overthinking a Sign of Anxiety or ADHD?
This is one of the most common questions I hear, and the answer depends on what you're overthinking and how it feels.
Signs your overthinking may be anxiety:
Thoughts are repetitive and fear-based
Your mind keeps returning to the same worries: What if I mess this up? What do they think of me?
You find yourself "mind-reading," assuming you know what others think about you (usually something negative)
You replay conversations looking for evidence you said something wrong
Symptoms improve when you feel safe, soothed, or reassured
Signs your overthinking may be ADHD:
Thoughts are scattered and jump quickly between topics
The content isn't necessarily negative or fear-based
You struggle to organize or prioritize the many ideas in your head
Symptoms improve with novelty, movement, or a change of environment
If you notice that your racing thoughts calm down when you feel safe or supported, that points toward anxiety. If your focus sharpens when a task becomes genuinely interesting or when you're allowed to move around, that may point toward ADHD.
The Burnout Connection
Burnout is common among anxious, driven people, and it's worth understanding how anxiety specifically contributes to exhaustion.
Anxiety adds an invisible layer of effort to everything you do. When you're constantly second-guessing yourself, anticipating problems, or mentally rehearsing conversations, you're expending energy that others don't have to spend. It's like swimming upstream. You might be covering the same distance as everyone else, but you're working twice as hard to get there.
Social anxiety, in particular, can make work environments feel emotionally draining. You might take feedback more personally than intended, spend hours analyzing a brief interaction, or spiral into self-doubt after a minor critique. This tendency to personalize and ruminate is inherently exhausting, even when it's invisible to everyone around you.
Perfectionism plays a role here too. It can push you toward overworking: staying late, checking one more time, never quite feeling like something is good enough. But perfectionism can also lead in the opposite direction, toward procrastination and avoidance. If you can't do something perfectly, part of you would rather not do it at all. Either way, the internal pressure wears you down.
How Does Anxiety Show Up Differently in Men and Women?
Anxiety can look different depending on gender, though there's more variation within genders than between them. In my experience, people-pleasing, perfectionism, fear of negative judgment, and avoidance of confrontation show up across the board. These patterns aren't exclusive to women, as stereotypes might suggest. I see them frequently in men as well.
That said, some general patterns tend to emerge.
Anxiety in women often looks like:
Excessive worry about relationships, caregiving roles, or social dynamics
Perfectionism and overfunctioning as coping mechanisms
Somatic symptoms like headaches, GI distress, or fatigue
Rumination rather than impulsive reactions
Anxiety in men often looks like:
Irritability, restlessness, or anger
Overworking or distraction as coping strategies
Substance use or risk-taking to manage internal tension
Describing feelings as "stressed" or "on edge" rather than anxious
Seeking help only when symptoms begin affecting work or relationships
These differences aren't about biology so much as socialization. We learn to express distress in the ways our environment permits, and that shapes how symptoms show up and whether they get recognized.
When to Seek Support
If you've been wondering whether what you're experiencing is ADHD, anxiety, or something else entirely, the most important step is to talk to someone who can help you sort it out. Self-reflection is valuable, but self-diagnosis has its limits, especially when you're relying on social media content that's designed to be relatable rather than clinically accurate. If you want to learn more on your own, seek out reputable sources rather than TikTok videos.
A thorough conversation with a therapist can help you understand what's actually driving your symptoms. For many people, the core issue is anxiety that has been building for years, and that's something therapy can meaningfully address. If ADHD remains a consideration after exploring anxiety, formal testing with a psychologist or psychiatrist can provide clarity.
The goal isn't to find a label. It's to understand yourself well enough to get the support that actually fits.
Frequently Asked Questions
How do I know if I have ADHD or anxiety?
The clearest distinction is often in the quality of your thoughts. Anxiety tends to produce sticky, repetitive thoughts centered on worry or fear. The mind narrows and fixates. ADHD tends to produce scattered thoughts that jump between topics without necessarily being negative. A clinician can help you look at your history, symptoms, and functioning to clarify what's going on.
Is it normal to have anxiety? When does it become clinical?
Anxiety is a normal human emotion. Everyone experiences it. It becomes clinical when it's persistent, disproportionate to the situation, and interferes with your ability to function in daily life. If anxiety is affecting your sleep, relationships, work performance, or overall well-being on a regular basis, it's worth exploring with a professional.
What are the most common types of anxiety?
The most common anxiety disorders include:
Generalized anxiety disorder (persistent, excessive worry about many areas of life)
Social anxiety disorder (intense fear of social situations and judgment)
Panic disorder (recurrent panic attacks)
Specific phobias (intense fear of particular objects or situations)
Many people experience anxiety that doesn't fit neatly into one category but still significantly impacts their lives.
Do you treat ADHD or anxiety first?
It depends on the individual. If anxiety is significantly impairing your daily functioning, relationships, or quality of life, addressing it first often provides relief and clarity. In some cases, treating anxiety reveals that attention issues were secondary to the worry all along. A therapist can help you determine what makes the most sense for your situation.
How do I know if I need an ADHD evaluation or anxiety treatment?
Start by exploring your symptoms with a therapist who can help you understand what's driving them. If anxiety seems like the primary issue, therapy can address that directly. If attention and focus difficulties persist even after anxiety is managed, or if your history suggests longstanding attention issues unrelated to worry, an ADHD evaluation may be a helpful next step. While I don't conduct ADHD assessments in my practice, I can help you find appropriate resources if that feels like the right next step.
If you're navigating anxiety, overwhelm, or burnout and want to understand what's going on beneath the surface, I'm here to help. Schedule a free consultation to see if we'd be a good fit to work together.
About the Author: Sage Grazer, LCSW
I am a licensed psychotherapist providing online therapy to adults struggling with anxiety, burnout, trauma, low self-esteem, and relationship issues. I help clients develop the insight, skills, and resilience to cope with whatever life stresses come their way. I specialize in helping high-achieving young professionals overcome anxiety and burnout to feel more confident, empowered, and effective in their lives. If you’re a resident of California or Hawaii, schedule a free consultation to learn more.