Understanding ADHD and Social Anxiety

Table of ContentsView AllTable of ContentsUnderstanding ADHD and Social AnxietyComplicationsDiagnosisTreatmentCoping

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Table of Contents

Understanding ADHD and Social Anxiety

Complications

Diagnosis

Treatment

Coping

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Though any anxiety disorder can coexist with ADHD,social anxiety disorder(SAD) is one of the most common. While estimates vary, research suggests that 60 to 70% of people with ADHD also experience social anxiety disorder.

Learning the differences between the two conditions is important in the management and treatment of both. In this article, we discuss the connection between ADHD and social anxiety disorder, including how one condition affects the diagnosis and treatment of the other.

The Connection Between ADHD and Social Anxiety

It’s entirely possible that anxiety disorders occur much more frequently in people with ADHD than they do in the general population. However, more research is needed to understand why ADHD and SAD co-occur in some people and not in others.

Although experts don’t know for certain why ADHD and SAD tend to occur together, some think that thefactors that play a role in ADHD—genetics, environmental toxins, or premature birth—may also influence anxiety disorders.

Still, others believe that ADHD symptoms, themselves, contribute to anxiety. Often, ADHD symptoms—such as inattention, hyperactivity, and impulsivity—put a person at greater risk of being teased, bullied, or otherwise socially rejected. Fearing further rejection, many withdraw into themselves,avoiding any social settingthat they find threatening.

A person with ADHD might be more likely to develop social anxiety if:

Complications of ADHD and Social Anxiety

When ADHD and social anxiety occur together, a number of complications may result.

Overlapping Symptoms

On the surface, SAD and ADHD can sometimes look alike. The following are just a few ways symptoms of ADHD and SAD overlap:

Misdiagnosis

Having both conditions at the same time can also contribute to misdiagnosis.Unfortunately, some symptoms of SAD can be misinterpreted as ADHD symptoms, and it isn’t until outward behaviors—such as weight loss, sleeplessness, or refusal to attend social settings—that the social anxiety becomes more apparent. As a result, SAD often goes undiagnosed in those who also have ADHD.

When to See a DoctorIf symptoms of social anxiety are causing severe distress and affecting your ability to function in daily life, it is important to talk to a health professional. If you are experiencing panic attacks or are avoiding school, work, or other social obligations due to social anxiety, talk to your doctor or mental health professional.

When to See a Doctor

If symptoms of social anxiety are causing severe distress and affecting your ability to function in daily life, it is important to talk to a health professional. If you are experiencing panic attacks or are avoiding school, work, or other social obligations due to social anxiety, talk to your doctor or mental health professional.

Diagnosis of ADHD and Social Anxiety

In order to diagnose ADHD and social anxiety, a doctor or mental health professional will ask questions about symptoms, conduct psychological assessments, and collect a medical history.

ADHD

ADHD can be categorized intothree subtypes: inattentive type, hyperactive type, and combined type. To be diagnosed, children and adults must exhibit symptoms of inattention or hyperactivity for six months or longer. Such symptoms may include:

Symptoms must begin before age 12, be present in two or more settings, and interfere with the individual’s ability to function in daily life. Such symptoms must also not be the result of another mental disorder or medical condition.

Social Anxiety

In order to be diagnosed with social anxiety disorder, a person must:

Additionally, symptoms of social anxiety must be present for six months or longer and must not be due to substance use, a medical condition, or another mental health condition.

Treatment of ADHD and Social Anxiety

There are no clear or published guidelines on how to treat co-occurring ADHD and SAD. Only after your doctor determines how your anxiety functions can they develop the best treatment plan to meet your needs.

For instance, if your anxiety and ADHD are functioning independently of one another, your doctor may decide to treat both conditions simultaneously. Or they may choose to treat whichever condition is causing you the most problems first before moving on to the other condition.

Medications

If your anxiety is the result of ADHD, your doctor may decide to treat your ADHD first with medications as this may reduce your anxiety symptoms. Common medications used to treat ADHD include:

Psychotherapy

While medication has historically been the first line of treatment for ADHD, many people also benefit from non-medication therapies, and that is especially true of people who are also living with an anxiety disorder.

Approaches such ascognitive behavioral therapy (CBT)can address many of the underlying challenges of both ADHD and SAD—as well as the complicated symptoms that overlap between them. The goal of CBT is to provide techniques and practice for managing anxiety so that those with SAD.

A specific technique your therapist might recommend isexposure therapy, a type of CBT most often used when treating SAD, in which you and your therapist work together to gradually expose you to anxiety-provoking situations so you can develop healthy coping mechanisms and, over time, the situations elicit less fear. In other types of CBT, you can learn and practicesocial skillsandrelaxation techniques.

Coping With ADHD and Social Anxiety

If you have ADHD and social anxiety, there a many coping methods that can make your life easier to manage.

Lifestyle Changes

There are several lifestyle changes that may help make disruptive ADHD characteristics easier to cope with. Such strategies may also offer relief from feelings of social anxiety. Some you might try include:

Support Groups

Support groups can be a great source of encouragement, resources, and advice. You’ll be able to talk to people who have had similar experiences and get advice about how to manage different aspects of your condition.

Of course, the idea of participating in a support group can be intimidating for many people with social anxiety disorder. One way to deal with this is to consider joining anonline support group. This will allow you to gradually practice interacting with others in an online format. Over time, you may find that attending in-person support meetings can also be helpful.

How to Find an ADHD Support Group

Summary

It is not uncommon for people with ADHD to have co-occurring conditions, including social anxiety disorder. The exact reasons why they often co-occur are not clear, but genetics and environmental factors may play a part. Characteristics of ADHD may also make it more likely for people to feel anxious in social situations.

While having both conditions can lead to complications and make diagnosis more difficult, treatments are available that can help. Medications, psychotherapy, and lifestyle changes can help people manage the traits and symptoms of both conditions in order to function better in daily life.

A Word From Verywell

A co-occurring diagnosis of SAD can be a lifelong reality for someone with ADHD. It’s OK to feel overwhelmed. Learning more about the connection between these two conditions is the first step toward lessening the impact they have on your life. Just take a deep breath and know that with the right support, you can manage both ADHD and SAD, and thrive in life.

Conditions That Can Produce ADHD-Like Symptoms

8 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Koyuncu A, İnce E, Ertekin E, Tükel R.Comorbidity in social anxiety disorder: diagnostic and therapeutic challenges.Drugs Context. 2019;8:212573. doi:10.7573/dic.212573Koyuncu A, Alkın T, Tükel R.Development of social anxiety disorder secondary to attention deficit/hyperactivity disorder (the developmental hypothesis).Early Interv Psychiatry. 2018;12(2):269-272. doi:10.1111/eip.12372American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders(5th Ed.). Washington, DC. 2013Centers for Disease Control and Prevention.Symptoms and diagnosis of ADHD.American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Golubchik P, Sever J, Weizman A.Methylphenidate treatment in children with attention deficit hyperactivity disorder and comorbid social phobia.Int Clin Psychopharmacol. 2014;29(4):212-215. doi:10.1097/YIC.0000000000000029Koyuncu A, Çelebi F, Ertekin E, Kök BE, Tükel R.Extended-release methylphenidate monotherapy in patients with comorbid social anxiety disorder and adult attention-deficit/hyperactivity disorder: Retrospective case series.Ther Adv Psychopharmacol. 2017;7(11):241-247. doi:10.1177/2045125317714193Adler LA, Liebowitz M, Kronenberger W, et al.Atomoxetine treatment in adults with attention-deficit/hyperactivity disorder and comorbid social anxiety disorder.Depress Anxiety. 2009;26(3):212-221. doi:10.1002/da.20549

8 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Koyuncu A, İnce E, Ertekin E, Tükel R.Comorbidity in social anxiety disorder: diagnostic and therapeutic challenges.Drugs Context. 2019;8:212573. doi:10.7573/dic.212573Koyuncu A, Alkın T, Tükel R.Development of social anxiety disorder secondary to attention deficit/hyperactivity disorder (the developmental hypothesis).Early Interv Psychiatry. 2018;12(2):269-272. doi:10.1111/eip.12372American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders(5th Ed.). Washington, DC. 2013Centers for Disease Control and Prevention.Symptoms and diagnosis of ADHD.American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Golubchik P, Sever J, Weizman A.Methylphenidate treatment in children with attention deficit hyperactivity disorder and comorbid social phobia.Int Clin Psychopharmacol. 2014;29(4):212-215. doi:10.1097/YIC.0000000000000029Koyuncu A, Çelebi F, Ertekin E, Kök BE, Tükel R.Extended-release methylphenidate monotherapy in patients with comorbid social anxiety disorder and adult attention-deficit/hyperactivity disorder: Retrospective case series.Ther Adv Psychopharmacol. 2017;7(11):241-247. doi:10.1177/2045125317714193Adler LA, Liebowitz M, Kronenberger W, et al.Atomoxetine treatment in adults with attention-deficit/hyperactivity disorder and comorbid social anxiety disorder.Depress Anxiety. 2009;26(3):212-221. doi:10.1002/da.20549

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Koyuncu A, İnce E, Ertekin E, Tükel R.Comorbidity in social anxiety disorder: diagnostic and therapeutic challenges.Drugs Context. 2019;8:212573. doi:10.7573/dic.212573Koyuncu A, Alkın T, Tükel R.Development of social anxiety disorder secondary to attention deficit/hyperactivity disorder (the developmental hypothesis).Early Interv Psychiatry. 2018;12(2):269-272. doi:10.1111/eip.12372American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders(5th Ed.). Washington, DC. 2013Centers for Disease Control and Prevention.Symptoms and diagnosis of ADHD.American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Golubchik P, Sever J, Weizman A.Methylphenidate treatment in children with attention deficit hyperactivity disorder and comorbid social phobia.Int Clin Psychopharmacol. 2014;29(4):212-215. doi:10.1097/YIC.0000000000000029Koyuncu A, Çelebi F, Ertekin E, Kök BE, Tükel R.Extended-release methylphenidate monotherapy in patients with comorbid social anxiety disorder and adult attention-deficit/hyperactivity disorder: Retrospective case series.Ther Adv Psychopharmacol. 2017;7(11):241-247. doi:10.1177/2045125317714193Adler LA, Liebowitz M, Kronenberger W, et al.Atomoxetine treatment in adults with attention-deficit/hyperactivity disorder and comorbid social anxiety disorder.Depress Anxiety. 2009;26(3):212-221. doi:10.1002/da.20549

Koyuncu A, İnce E, Ertekin E, Tükel R.Comorbidity in social anxiety disorder: diagnostic and therapeutic challenges.Drugs Context. 2019;8:212573. doi:10.7573/dic.212573

Koyuncu A, Alkın T, Tükel R.Development of social anxiety disorder secondary to attention deficit/hyperactivity disorder (the developmental hypothesis).Early Interv Psychiatry. 2018;12(2):269-272. doi:10.1111/eip.12372

American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders(5th Ed.). Washington, DC. 2013

Centers for Disease Control and Prevention.Symptoms and diagnosis of ADHD.

American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.

Golubchik P, Sever J, Weizman A.Methylphenidate treatment in children with attention deficit hyperactivity disorder and comorbid social phobia.Int Clin Psychopharmacol. 2014;29(4):212-215. doi:10.1097/YIC.0000000000000029

Koyuncu A, Çelebi F, Ertekin E, Kök BE, Tükel R.Extended-release methylphenidate monotherapy in patients with comorbid social anxiety disorder and adult attention-deficit/hyperactivity disorder: Retrospective case series.Ther Adv Psychopharmacol. 2017;7(11):241-247. doi:10.1177/2045125317714193

Adler LA, Liebowitz M, Kronenberger W, et al.Atomoxetine treatment in adults with attention-deficit/hyperactivity disorder and comorbid social anxiety disorder.Depress Anxiety. 2009;26(3):212-221. doi:10.1002/da.20549

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