Adult ADHD vs. High-Functioning Anxiety: Why You Can't Focus

You look successful on paper. You hit your deadlines (mostly), you show up to meetings, and you keep the wheels turning. But inside, you feel like you're constantly scrambling.

You sit down to work, and your brain feels like a browser with 50 tabs open. You lose hours to scrolling or "busy work," only to panic at 4 PM and hyper-focus to get the real work done.

You've probably asked yourself (or Google): "Do I have adult ADHD?"

It's a valid question. But for many high-performing professionals, the answer isn't always ADHD. Often, it's a nervous system on fire—what we often call High-Functioning Anxiety.

The Key Difference: The "Why" Behind the Behavior

While the behaviors look the same, the internal driver is usually different. Understanding this distinction is the first step to getting the right support.

1. The Experience of ADHD (Executive Function)

With ADHD, the struggle is often about initiation and regulation. It’s an issue with the brain's executive functions.

• The Thought: "I want to do this task, I know I need to do it, but I literally cannot make my body start."
• The Feeling: A sense of paralysis or "under-stimulation." You might need high pressure (deadline adrenaline) just to turn your brain on.
• The Focus: Once you break through, you might hyper-focus on the wrong things (like reorganizing your email folders instead of writing the report).

2. The Experience of Anxiety (Fear & Safety)

With High-Functioning Anxiety, the struggle is often about perfectionism and fear. Your nervous system perceives the task as a "threat."

• The Thought: "I want to do this, but what if it's not good enough? What if I mess up? I need to figure out the perfect plan before I start."
• The Feeling: A physical tightness in the chest, racing heart, or a buzz of "doom." You avoid the task to avoid the feeling of anxiety.
• The Focus: You are distracted because your brain is scanning for threats (checking emails, worrying about a comment your boss made) rather than focusing on deep work.

The "Burnout" Mimic

There is a third player in this equation: Burnout.

When you have been running on high-octane stress for years (common in law, tech, and finance), your frontal cortex—the part of the brain responsible for focus—starts to go offline. This is a survival mechanism.

Chronic stress can create "acquired ADHD-like symptoms." Your sleep suffers, your memory slips, and your ability to concentrate evaporates. You haven't suddenly "developed" ADHD in your 30s; your battery is just empty.

How Therapy Helps (Without a Diagnosis)

You don't need a label to start feeling better. In fact, waiting for a diagnosis can sometimes delay the relief you need right now.

In therapy, we focus on calming the nervous system first.

If your focus issues are driven by anxiety or burnout, regulating your stress response will often bring your focus back online. We work on:

• Uncoupling productivity from self-worth: Learning that you are safe even if you aren't "doing" 24/7.
• Taming the Inner Critic: reducing the perfectionism that causes procrastination.
• Nervous System Regulation: Practical tools to move you from "Fight or Flight" back to "Rest and Digest."

What if it really is ADHD?

If we reduce the anxiety and the focus issues persist, that gives us clarity. You now have a much clearer path to take to a psychologist or doctor for a formal assessment. And even with an ADHD diagnosis, therapy remains a crucial tool for managing the emotional regulation and "shame spirals" that often come with neurodivergence.