Health & Wellness

What If the Anxiety You’ve Been Treating for Years Isn’t the Real Issue?

March 12, 2026

For a lot of women, ADHD doesn’t look like the stereotype. It’s not always bouncing off the walls, failing classes, or being obviously hyperactive. Sometimes it looks like traits often associated with anxiety. Things like overthinking, chronic stress, emotional overwhelm, perfectionism, brain fog—you get the gist.

That is part of why ADHD can be mistaken for anxiety for years.

On SHE MD, psychiatrist Dr. Steven Storage explained that many women are first treated for anxiety or depression when the real issue may be ADHD, or a mix of both. The key difference is that ADHD is not simply an inability to focus. It’s difficulty regulating attention. Someone with ADHD may struggle to stay with boring or routine tasks, while also being able to hyperfocus intensely when something feels interesting or rewarding.

Signs it may be more than anxiety

If your mind feels busy all the time, anxiety may seem like the obvious answer. But according to the episode, ADHD can also create a constant sense of internal pressure. That can show up as:

trouble following through
feeling mentally scattered
chronic procrastination
emotional ups and downs
perfectionism or people-pleasing
feeling restless even when sitting still
forgetting things despite trying hard
being able to focus deeply only when something feels stimulating

In women especially, that restlessness is often more internal than external. Instead of obvious hyperactivity, it may feel like you cannot fully relax, your brain is always “on,” or silence feels uncomfortable.

What anxiety often looks like

Anxiety tends to center more around fear, worry, and a sense of threat. You may feel stuck in overthinking, worst-case-scenario spirals, physical tension, or constant anticipation that something will go wrong.

But Dr. Storage makes an important point: sometimes the answer is not ADHD or anxiety. It can be both. In some people, anxiety becomes a way of compensating for ADHD. Almost as if staying stressed is the only way to stay on top of things.

A simple way to think about the difference

Ask yourself: Do I struggle because my brain feels worried, or because it feels hard to direct and manage my attention?

If the bigger issue is fear, dread, and nervous-system activation, anxiety may be leading the picture.

If the bigger issue is inconsistency, distractibility, procrastination, emotional reactivity, and only being able to focus when something is interesting or urgent, ADHD may be worth exploring.

Why women miss it for so long

Dr. Storage explains that females are less likely to be flagged early because their symptoms often look quieter (that and the sad reality that women are often dismissed in general by medical professionals). Instead of, say, disrupting class, they may daydream, seem disorganized, or even forget things. And over time, that can chip away at self-esteem.

Perimenopause can also make ADHD symptoms much more noticeable, since dropping estrogen can affect dopamine and norepinephrine, two brain chemicals tied to focus and executive function. That can look like brain fog, forgetfulness, low motivation, and feeling suddenly unable to keep up the way you used to.

What to do if you think ADHD might be part of the picture

According to Dr. Storage, the first step shouldn’t be jumping straight to medication. Instead, he suggests starting with foundational habits that support dopamine and brain function. You know, the actual systems that help regulate attention and executive function.

Here are some of the strategies he highlighted:

☐ Prioritize sleep quality
Aim for about 7–9 hours of sleep per night. Try to keep your bed reserved for sleep, limit screens about an hour before bedtime, and wake up at the same time each day.

☐ Get sunlight in the morning
Natural light shortly after waking helps regulate your circadian rhythm, which supports better sleep and overall brain function.

☐ Exercise regularly
High-intensity cardio can increase dopamine and serotonin levels. Even 20 minutes every other day may help improve focus, mood, and mental clarity.

☐ Eat for brain health
Focus on lean protein, healthy fats like avocado or olive oil, fruits and vegetables, and complex carbohydrates such as quinoa or sweet potatoes. Limiting refined sugar and highly processed foods may also help reduce brain inflammation.

☐ Support dopamine naturally
Some people benefit from nutrients that support brain chemistry, including omega-3 fatty acids, vitamin D, and certain amino acids. Always speak with a healthcare provider before starting supplements.

☐ Look at the bigger picture
If symptoms like chronic overwhelm, focus issues, emotional swings, or burnout are interfering with your life, a full evaluation with a qualified clinician can help determine whether ADHD, anxiety, or a combination of both may be involved.

To hear all of Dr. Storage’s insights on anxiety and ADHD in women, listen to SHE MD wherever you get your podcasts.