Dear Therapist:

I have always struggled in several areas such as concentration, inability to complete projects, and too much talking. I have read articles about this and some seem to suggest that this is about anxiety while others indicate that it is ADHD related. How do I differentiate between these two possibilities?

Response:

There are many symptoms that can apply to various disorders. Sometimes it can be difficult to ascertain which problems are associated with which diagnosis. People who have certain anxiety disorders certainly can have trouble with concentration and other issues commonly associated with ADHD. However, the symptoms that you mention are not typically the primary symptoms of an anxiety disorder. Without primary symptoms of anxiety, an anxiety disorder is not usually diagnosed. For instance, according to the DSM-5 in order to arrive at a diagnosis of generalized anxiety disorder (perhaps the most commonly diagnosed anxiety disorder), a person must present with “excessive anxiety and worry…occurring more days than not for at least 6 months, about a number of events or activities.”

Obviously I don’t have all the information necessary to make a diagnosis. There are many factors that need to be taken into account in order to do so. You didn’t mention any symptoms of anxiety or depression. Although the issues that you mentioned are associated with ADHD, this doesn’t necessarily mean that you meet the criteria for that either. Additionally, people with ADHD often feel anxious and/or depressed. This doesn’t necessarily mean that they have anxiety or depressive disorders.

It’s important not to get too caught up in diagnoses and labels. Diagnoses are simply collections of symptoms that are grouped together to indicate a particular problem. It’s not the diagnosis that is treated; symptoms are treated. If someone has a certain number of symptoms and qualifies for certain other criteria, he can be diagnosed with a disorder. This allows us to refer to the problem in a more concise way. It helps us to focus on treatment, but the focus of treatment is on the symptoms rather that the diagnosis itself.

If you have anxiety as well as attention-related problems like those you mentioned, it’s possible that you have an anxiety disorder or ADHD. It’s also possible that you have both or neither. Regardless, if you feel that you have issues that you would like help dealing with, you should see a mental health professional. Psychotherapists and psychiatrists are trained to identify and parse out symptoms in order to arrive at a diagnosis—and more importantly to establish an appropriate treatment.

Yehuda Lieberman, LCSW

 psychotherapist in private practice

 Brooklyn, NY   |   Far Rockaway, NY

 author of Self-Esteem: A Primer

 www.ylcsw.com / 718-258-5317

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