Could It Be Autism/ADHD? Don’t Worry, It’s An Anxiety Disorder.

Could It Be Autism/ADHD, Truly?

Have you found yourself deep diving into TikTok videos about neurodivergence, suddenly recognizing traits that seem eerily familiar? Do you feel in your heart that something deeper is going on, or that your struggles are NOT just anxiety?

I’ve been there! Trust me, you’re not just making things up. For countless neurodivergent individuals, the path to proper diagnosis is paved with frustrating misdiagnoses. Especially, if someone labels it as an anxiety disorder, when autism or ADHD is the true underlying condition.

The reality is heartbreaking but important to acknowledge — neurodivergent individuals, especially women, girls, and those from marginalized communities, frequently endure years (or sometimes even decades!) of incorrect diagnoses before someone finally recognizes their neurodivergence. This is a truly shocking reality, for many.

This isn’t just a minor medical oversight; it’s a life-altering experience that can delay proper support, create identity confusion, and even lead to harmful treatments for an individual.

This experience can be incredibly isolating and invalidating. When doctors categorize your sensory issues and/or emotional regulation challenges as anxiety, self-doubt creeps in. But, always remember, you truly know yourself best! Your anxiety symptoms could actually be the result of undiagnosed autism or ADHD.

You deserve to properly understand yourself. You deserve validation. We’ll deep dive into the reasons behind misdiagnosis, in this post. We’ll discuss the harmful impacts of misdiagnosis. Most importantly, we’ll continue learning how to best advocate for appropriate assessment and support. Now and in the future!

The Prevalence of Misdiagnosis

Studies have actually shown that women tend to receive an autism diagnosis on average 4-5 years later than men (Source here.) With ADHD, the gap on average is also roughly about 4 years (Source here.)

Many healthcare providers are also likely to misdiagnose women, people of color, LGBTQ+, and adult individuals. Black children are 5.1 times more likely to be misdiagnosed with conduct disorders, than white children that present completely identical symptoms (Source here.) Gender diverse/LGBTQ+ individuals have also significantly self reported an increased risk of adverse experiences and outcomes, when treating and/or understanding their ADHD/Autism. (Source here.)

Both autistic and ADHD individuals have an increased risk for other conditions, including depression, bipolar, OCD, PTSD, and anxiety (Source here.) Misdiagnosis can cause so much confusion and misunderstanding in an individuals life.

When healthcare providers continually ignore autism/ADHD, they only increase an individual’s self-doubt and further ignite self-resentment. It makes it incredibly hard to trust your own potential and limitations. A person’s life can feel incredibly chaotic and coping in the world may be increasingly difficult without correct diagnoses.

The Historical Bias Problem

It’s also important to note that diagnostic models for Autism and ADHD have troubled histories. Most of early autism research only really focused on boys. Hans Asperger’s original studies? They were all based on male subjects. The diagnostic criteria that developed from this research naturally reflects male presentation patterns.

ADHD had similar issues. The hyperactive, young boy that can’t sit still became the stereotype. There wasn’t much, if any information on how traits could present in young girls. The inattentive girl daydreaming quietly at her desk? She was me. Completely overlooked.

Most of the time, while I was at school, I couldn’t pay attention in actual class. I thought that everyone was experiencing school like this, that they would pretend to pay attention, and then just go home and teach themselves the information later.

That’s exactly how I went through school, most of the time. Daydream in class, then learn later. Imagine my surprise, realizing that this was actually not everyone’s experience while in school! Complete shock.

That’s common in inattentive ADHD. I masked heavily, all through school. I masked (or pretended) to fit in and completely internalized all of my hyperactiveness. Which, is a common presentation for a lot of women. As a girl, you commonly mask heavily, especially if providers continually misdiagnose your neurodivergence and overlook you all throughout adolescence.

Social Anxiety vs, Autism Social Differences

I was told that I had social anxiety when I was in fourth grade, and started seeing a child psychologist for my social difficulties. A child psychologist officially diagnosed me with a generalized anxiety disorder (GAD), soon after. I’ve realized now, in adulthood, that GAD never fully explained my experience. I believe that I could very likely be AUDHD (autistic + ADHD).

Both social anxiety and autism can make social situations difficult, but for very different reasons. With social anxiety, a person understands social rules but fears judgment. With autism, the social rules themselves may be unclear or overwhelming. An autistic person can struggle reading non-verbal cues and miss some implied meanings. For autistic individuals, small talk can be confusing and exhausting. (I have truly always hated small talk, it makes absolute no sense to me).

Here is the key difference: Social anxiety tends to improve when the person feels safe from judgement. Autistic social challenges normally persist even if the environment is completely accepting.

Many autistic individuals develop social anxiety as a secondary condition. Imagine years of misunderstandings and negative social experiences combining together — you would most likely learn to fear interaction. This can make diagnosis even more confusing. Anxiety can definitely be present, but it is not always the root cause.

Rejection Sensitivity Dysphoria vs. Social Anxiety

Autism can be mistaken for social anxiety, but can certain aspects of ADHD also be mistaken for social anxiety? Most Definitely!

Rejection Sensitivity Dysphoria (or more commonly known as RSD), is an ADHD symptom that could be misinterpreted as social anxiety. This misinterpretation can influence the treatment approaches that clinicians use, and can often influence how symptoms may present. Both RSD and social anxiety have similar characteristics, but they are also distinctly different;

Rejection Sensitivity Dysphoria Characteristics

• Involves intense, immediate emotional responses to perceived rejection or criticism
• Reactions can feel overwhelming and disproportionate
• May appear as sudden anger, shame, or withdrawal
• Typically episodic, in the moment, rather than chronic worry
• Usually does not prevent social engagement beforehand
• Often accompanied by an impulsive response in the moment
• May develop compensatory behaviors, such as; perfectionism, people pleasing or avoiding even trying
• Often present since childhood alongside other ADHD symptoms
• May respond well to ADHD medication

Social Anxiety Characteristics

• Fear and worry primarily focused on potential future judgment or rejection
• Anticipatory anxiety before social situations
• Persistent worry about how one is perceived by others
• Continuous mental rehearsal of potential negative outcomes
• Gradual building of anxiety rather than sudden emotional flooding
• Focus on preventing rejection by carefully monitoring ones own behavior
• Significantly limits social engagement due to anticipatory anxiety
• Responds to anxiety-specific treatments, such as exposure therapy and CBT

The main significant difference between the two is when the person experiences the emotional response, and whether or not the response is resulting from actual perceived rejection or the anticipatory/potential possibility of rejection. My RSD has always been bad, it’s always been something that I’ve struggled to fully manage.

Growing up, people told me that my intense fear of any type of rejection was social anxiety. They only saw social anxiety and my treatment only involved exposing myself to more social situations/experiences and cognitive restructuring. Likely because I have RSD, not just social anxiety, there wasn’t a whole lot of improvement from those treatments.

What I really most likely needed was to understand and learn how to implement emotional regulation techniques. It would have helped to know what skills I could use to cope with my intense emotional reactions when they occurred. I would have likely learned a lot earlier, in my life, how to navigate and work through my RSD.

Stimming Interpreted as Nervous Habits

Stimming (self-stimulatory behavior), helps autistic and ADHD individuals regulate. Rocking, finger-tapping, shaking legs, or fidgeting can all be forms of stimming. Stimming helps neurodivergent individuals process emotions, maintain focus, or manage sensory input. All things that would be incredibly hard to process and manage without stimming.

Clinicians can misinterpret stimming as anxiety. They may just see nervous energy, rather than sensory regulation. They can miss the reasoning and function behind the behavior entirely. Rather than engaging in treatments/therapies that try to eliminate stimming movements, we should be focusing on providing proper support. We should create safe spaces that not only understand stimming, but also accept it.

I learned pretty early on how to suppress my stims, to appear to be improving. I knew deep down that things were never truly improving, but I would pretend nonetheless. Really, I was only increasing my distress levels and teaching myself to not trust myself or my own body movements. That has honestly caused a lot of damage over time, that I am just now learning to undo. It’s hard. Stimming is important, it’s not just nervous anxious energy.

Meltdowns Labeled as Anxiety Attacks

For years, I went through my life believing that I was just experiencing anxiety attacks. But, I’ve come to realize that what I was most likely experiencing were meltdowns (I believe that I have experienced both). There are distinct differences between what are meltdowns and what are anxiety attacks. A lot of healthcare professionals don’t understand, or don’t pick up on those differences.

Meltdowns can be confusing and terrifying. Growing up, I thought that everyone likely experienced them, but that they were just better at managing and controlling them. I thought I was overdramatic and never understood why my meltdowns (or even shutdowns) happened. But there are definitely differences between meltdowns and anxiety attacks, which are important to distinguish and fully understand.

Anxiety Attack Characteristics

• Often has an identifiable trigger that’s related to a perceived threat or worry
• Typically involves fear thoughts (“What if something terrible happens?”
• Features physiological symptoms: racing heart, sweating, trembling, shortness of breath, etc.
• May respond to grounding techniques and/or breathing exercises
• It resolves, once the threat has passed, or anxiety-reducing strategies are used
• Often includes worrying about the attack itself (fear of losing control)
• Person may seek reassurance or safety behaviors

Autistic Meltdown Characteristics

• Often triggered by accumulated stress, change in routine, or sensory overload rather than a specific threat
• More focused on overwhelm than future-oriented worry
• May involve stimming behaviors, shutdown, or outward emotional expression
• Standard anxiety management techniques may be ineffective or make things worse
• Resolution requires reduction of demands and sensory input
• Recovery period afterwards is necessary
• Not typically accompanied by fear of the meltdown itself
• Person may seek escape rather than reassurance

Key Differences

• Anxiety Attacks normally center around fear responses; meltdowns around system overload
• Anxiety Attacks are part of the body’s threat response; meltdowns are more so related to processing capacity
• The experience during recovery differs significantly between the two

Without understanding or having the ability to pick up on the differences, healthcare providers can completely miss the mark, and treatment implemented can be more harmful than helpful. When autistic meltdowns are continually misidentified as anxiety attacks, people may feel broken when anxiety interventions fail.

They will not learn or know of the environmental accommodations that can help prevent/manage their meltdowns. It can cause a lot of hardship and confusion in someone’s life. Understanding the difference allows for self compassion and understanding. I may not of felt so broken for so long, if only one provider had been able to pick up on the difference. Truthfully.

Racing Thoughts: ADHD or Anxiety?

How exactly does one know the difference between anxious racing thoughts, and ADHD hyperactive racing thoughts? Unless a healthcare provider is specifically asking detailed questions when getting more information (which, honestly, is something they should be doing), it can be difficult to distinguish between the two. Both conditions can involve minds that just won’t slow down, but the experience and nature of the thoughts are often very different;

ADHD Racing Thoughts Characteristics

• Thoughts tend to be varied and random, jumping between unrelated topics
• Usually not inherently negative or worry-based
• Can include creative ideas, observations, and random associations
• May involve hyperfixation on topics rather than worries
• Present regardless of a person’s emotional state
• Often worse when under-stimulated
• May be accompanied by verbal impulsivity (blurting out words/phrases)
• Medication (stimulants) may significantly improve symptoms

Anxiety Racing Thoughts Characteristics

• Thoughts typically follow worry patterns of thinking and “what if” scenarios
• Usually focused on specific themes of concern
• Predominantly negative context revolving around perceived threats
• Often involves replaying past situations or anticipating future problems
• Often worsens when in specific anxiety-triggering situations
• May develop during particular life periods rather than being lifelong
• Responds to anxiety-specific interventions, like mindfulness and CBT

I have experienced racing thoughts all of my life, from my intertwining ADHD and anxiety. Normally, I can tell the difference between the two. With ADHD racing thoughts, I’m in more of a hyperactive state. I feel excited and energized, and there is not really anything specific that the thoughts are focusing on. The thoughts are bouncing off one another, at an incredibly fast speed. And they’re normally more creative in nature, for me.

I get anxious racing thoughts, that are normally triggered by a specific situation/environment. In these situations, I don’t feel energized or excited, like I do when I experience hyperactive ADHD racing thoughts. The thoughts are more organized and specific.

Sometimes, repetitive loops of the same distressing anxious thoughts can trap me. Over and over again, stuck on repeat. It can be difficult for me to snap out of my racing anxious thoughts, or even realize that I’m in the loop. It can cause a lot of distress, and can even lead to a shutdown. These anxious loops can overwork my brain, and I eventually will just check out — That’s a shutdown. Forming any sentence feels like trying to walk through quicksand. I’m barely keeping my head above ground. Everything takes a lot of energy and my brain feels like an overworked computer that’s smoking and about to catch on fire.

It’s important to understand and be able to recognize the difference between anxious and ADHD racing thoughts. On the outside, they can seem incredibly similar. But, they are not and it’s always important to have more information. Racing thoughts are not always the result of anxiety!

The Comorbidity Factor

The relationship between anxiety disorders and neurodevelopmental conditions is complex and bidirectional. Understanding this relationship helps explain why symptoms overlap and why proper diagnosis requires carful assessment.

For many individuals with autism or ADHD, anxiety disorders can develop as a secondary condition. The daily challenges of navigating a world that is not designed for your neurodivergent mind can create chronic stress. Sensory sensitivities, social communication differences, and repeated experiences of not meeting expectations, can all contribute to the development of anxiety over time.

Neurodevelopmental conditions can also create unique types of anxiety that don’t typically fit the standard diagnostic categories. An autistic person might develop intense anxiety around unpredictable changes or specific experiences, while someone with ADHD might develop anxiety around task performance or social rejection based on past experiences of criticism. I completely believe that the interaction between all of those formed my anxiety.

The presence of anxiety can dramatically alter how neurodevelopmental conditions may manifest. When I have heightened anxiety levels, I can act more withdrawn socially and my inattention/ability to stay focused can become significantly worse. This “anxiety overlay” can sometimes mask the underlying neurodevelopmental conditions or make its presentation even more complex.

Importantly, treating anxiety in neurodivergent individuals often requires adapted approaches. Standard anxiety interventions may need modification to better account for different cognitive styles and sensory needs. Conversely, providing appropriate supports for autism or ADHD can sometimes reduce anxiety levels by addressing root causes of stress.

The diagnostic journey can also be further complicated by developmental timing. Many adults that grew up without identification of their neurodivergence developed coping mechanisms and compensatory strategies — often at a significant psychological cost. By adulthood, anxiety can become the most visible condition, obscuring the underlying neurodevelopmental differences that contribute to it.

For these reasons, comprehensive assessment that considers both present symptoms and developmental history are key! Understanding the relationship between anxiety and neurodivergence allows for more targeted interventions that actually address both the anxiety and the underlying neurodevelopmental needs.

Conclusion

Truthfully, trust yourself. If your experience doesn’t seem to be fully explained by anxiety, then you very likely could be right. The path to discovering your neurodivergent identity is often long. Our brains aren’t well-suited for the healthcare system that exists.

Getting a proper diagnosis after years of misdiagnosis can feel incredibly validating. Suddenly, your life makes a whole more sense, and the struggles you’ve experienced all throughout your life aren’t character flaws. It’s not just simple anxiety. Your brain just works differently.

Please be gently with yourself around the lost time. Allow yourself to feel any grief or anger. But, also celebrate knowing! You can connect to a community and now live your life more authentically.

Past misdiagnoses do not define your future. You deserve healthcare providers that see not just anxiety, but your whole neurodivergent self. We deserve support and understanding, and the ability to access those supports to live a happier, more authentic life!

Love, Kaitlin

All About Me

Recommended Books To Learn More!

• Neurotribes: The Legacy of Autism and the Future of Neurodiversity, by Steve Silberman
• Unmasking Autism: Discovering the New Faces of Neurodiversity, by Devon Price
• Now It All Makes Sense: How An ADHD Diagnosis Brought Clarity To My Life, by Alex Partridge
• Different, Not Less: A neurodivergent’s guide to embracing your true self and finding your happily ever after, by Chloe Hayden

Other Helpful Resources!

• The Society for Neurodiversity (S4Nd) — Information, community, and support
• The Neurodiversity Alliance — Community and Nonprofit, supports colleges/schools grow acceptance/inclusion of neurodivergence.
• Tips for Finding a Diagnostician or Other Mental Health Professional
• Prosper Health Adult diagnosis resource
• The Neurodivergent Experience Podcast
• Divergent Conversations Podcast