Dialectical Behavior Therapy for ADHD and Anxiety to Develop Practical Coping Skills

dialectical behavior therapy for adhd

Do you struggle to focus, or is your mind just anxious? Are you overwhelmed because you have so much to do or because your brain won’t slow down? For many people, ADHD and anxiety don’t exist separately. They overlap in ways that can feel confusing, exhausting, and hard to manage. Dialectical behavior therapy for ADHD offers a different way to work with that overlap. DBT teaches four practical skills: mindfulness to catch yourself before you spiral, distress tolerance to shorten hard moments, emotional regulation so feelings don’t take over, and interpersonal skills to communicate when your brain feels scattered. You learn to accept yourself where you are while making small changes that actually help. The goal is feeling calmer, more in control, and less worn down by the constant tug between anxiety and ADHD.

What is ADHD?

ADHD, or attention deficit hyperactivity disorder, is a brain disorder that hinders the brain’s ability to focus, control impulses, and rest or sit still. It is often diagnosed in early childhood, especially during school years, and has now been identified as one of the most common neurodevelopment disorders in children. Symptoms continue into adulthood, and for some, are not discovered until adulthood. While ADHD is not curable, it can be managed through medication and behavioral therapy.

ADHD Symptoms

The symptoms of ADHD may present differently in everyone depending on the stage of life, gender, setting and other outside factors. However, they typically manifest as:

  • Difficulty concentrating
  • Excessive fidgeting
  • Frequent daydreaming or zoning out
  • Poor listening and recall skills
  • Interrupting others
  • Difficulty remaining calm and quiet

Three Types of ADHD

Doctors can diagnose patients with three recognized forms of ADHD, each presenting differently. However, over time the presentation of ADHD can shift. For example, a child with hyperactive-impulsive ADHD may begin to experience more internal symptoms in adulthood that correspond more with inattentiveness.

The three forms of ADHD are:

  1. Inattentive

Individuals with a predominantly inattentive presentation of ADHD have difficulties with focus and organization, rather than hyperactivity. This form of ADHD can often go overlooked, leading to a late diagnosis, as it doesn’t always lead to disruptive behaviors.

  1. Hyperactive-impulsive

Predominantly hyperactive-impulsive presentation of ADHD often involves more outward physical energy and impulsivity. This type of ADHD is often caught early in life as the behaviors can become disruptive in school settings.

  1. Combined

Individuals with combined ADHD experience both inattentive and hyperactive-impulsive symptoms. This is the most commonly diagnosed form of ADHD.

What is Anxiety?

Anxiety is a feeling of fear, stress, uneasiness, and impending doom. Anxiety is the body’s natural response to stress; however, for some people feelings of anxiety are overwhelming and consistent. People with anxiety disorders have excessive, ongoing anxiety that often cannot be controlled. This can lead to things like anxiety attacks and panic disorders when untreated.

Anxiety Symptoms

  • Rapid heart rate
  • Sweating
  • Difficulty breathing
  • Feelings of impending doom
  • Difficulty resting or sleeping
  • Feelings of fear, nervousness, or tenseness

The Overlap

There is a large overlap in the symptoms between ADHD and anxiety as both present extremely similarly. Common symptoms like restlessness and difficulty concentrating can lead to misdiagnoses between the two.

When ADHD and Anxiety Cooccur

Apart from the overlap in presentation between ADHD and anxiety, both commonly occur. Studies have shown that up to 50% of individuals with ADHD also have anxiety. This co-occurrence is likely due to a combination of factors including:

  • Stigmas and social perception

Negative social perception and stigmas around ADHD and anxiety can lead to feelings of isolation or embarrassment. This can cause individuals to have anxiety around social situations, especially when interacting with people that they do not know.

  • Emotional Dysregulation

Individuals with ADHD often have difficulties regulating their emotions. This can worsen the symptoms of anxiety as individuals struggle to manage anxiety on their own.

  • Daily Life

ADHD causes impulsivity and difficulties focusing, which can lead to further stress and anxiety down the line. Especially for students, when ADHD causes individuals to jump from

task-to-task, anxiety around focusing and completing tasks occurs. Additionally, pressure and anxiety around getting good grades can worsen attention and impulsivity.

Treating Anxiety and ADHD

When ADHD and anxiety cooccur, managing and treating the symptoms can feel impossible. But the reality is, it’s not impossible! Often, a combined approach to managing both can lessen the need for things like medication by simultaneously targeting each disorder. Common treatments include medications, therapy, and lifestyle changes.

Dialectical Behavior Therapy for ADHD

Dialectical behavior therapy for ADHD helps you deal with strong emotions and handle daily life without feeling out of control. It teaches practical skills like staying present, managing stress, and thinking before reacting. For anyone treating anxiety and ADHD, it can calm racing thoughts, help you focus, and give simple tools to cope with both at the same time.

Other approaches like acceptance and commitment therapy for ADHD (ACT) also help you handle intense feelings while learning ways to stay organized and in control. Whether you choose ACT or another form of ADHD anxiety therapy, these methods work together to make daily life feel less overwhelming. They give you a more balanced, steady way to manage attention, impulsivity, and anxiety.

Easing the Back and Forth Between ADHD and Anxiety

If you’re tired of your emotions running the show or getting tangled in the back and forth between focus and worry, ADHD anxiety therapy rooted in DBT can help you respond differently. At Embrace Now, we offer individual therapy in Conshohocken, PA, and across 41 states via telehealth. If you want practical skills you can use every day, we are here to help. Call us today or book a free consultation to see if we’re the right fit.

Reviewed by Dr. Sandra, Licensed Psychologist


Frequently Asked Questions

Q1. What is the difference between anxiety and ADHD?

A1. Anxiety is fueled by worry about things that might happen, while ADHD is driven by a brain that struggles with focus, impulse control, and staying organized. With anxiety, you get distracted because you are stuck in your head with fear; with ADHD, you get distracted because your brain is hunting for something more interesting. The big difference is that anxiety avoids risk, while ADHD runs toward it without thinking.

Q2. Can you have ADHD and anxiety?

A2. Yes, it is common to have both, with studies showing up to half of adults with ADHD also dealing with an anxiety disorder. When you have both, the anxiety can make your ADHD symptoms like inattention worse, and the chaos of ADHD can give you plenty to be anxious about. A good therapist can help you figure out what is driving what, so you can get the right kind of help for both.

Q3. What is behavioral therapy for ADHD?

A3. It is a hands-on approach that teaches you practical skills to manage your symptoms by changing your habits and environment. For kids, this means parents learn to use clear rules and rewards to encourage better focus and behavior. For adults, it involves working with a therapist to break down overwhelming tasks and build routines that actually stick.

Q4. Can a therapist diagnose ADHD?

A4. Only some therapists can. Licensed psychologists and psychiatrists are qualified to give an official diagnosis, but many counselors and social workers are not. A proper diagnosis takes time and involves ruling out other issues like anxiety or depression that can look a lot like ADHD. If your therapist cannot diagnose you, they should be able to point you to someone who can.

Q5. How to Treat ADHD and Anxiety in Adults

A5. The best approach tackles both at once, mixing medication with therapy that gives you real-world tools to cope. Cognitive Behavioral Therapy works well because it helps you calm anxious thoughts while building systems to manage the chaos of ADHD. Simple daily habits like exercise, a steady routine, and enough sleep also go a long way in keeping both conditions in check.

Dialectical Behavior Therapy for ADHD – Free Consultation for Emotional Regulation and Focus

Schedule a free 10 minute consultation call with a DBT therapist for ADHD, Dr. Sandra Ostroff.

Dr. Sandra Ostroff specializes in Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT) for ADHD, emotional dysregulation, impulsivity, anxiety, and related conditions.

This recorded pop-up workshop by Dr. Sandra on panic features 26 minutes of video content and covers:

What panic attacks are

What panic disorder is

Difference between panic and anxiety attacks

Several coping skills for panic

This recorded pop-up workshop by Dr. Sandra on Rumination features 32 minutes of video content and covers:

What rumination is

When rumination happens

How it occurs commonly in OCD, Generalized Anxiety Disorder, and Depression

Steps to cope with rumination when it is not helpful

Exercise to cope with rumination when our focus on something is needed, but the rumination about that thing is taking over/becoming unhelpful.

“Embrace Discomfort” Workshop, is designed to help you understand and overcome avoidance behaviors through the practice of exposure. This workshop consists of four lessons, totaling approximately 39 minutes of video content, complemented by four associated resources with practical strategies to help you embrace discomfort and lead a more fulfilling life.

By the end of this workshop, participants will:

Understand Why Avoidance is Problematic: gain a foundational understanding of avoidance and exposure, feeling more confident in the necessity and benefits of facing discomfort.

Identify Avoidance Patterns: Participants will recognize their avoidance patterns and understand the impact of these behaviors.

Understand How to Use Values to Embrace Discomfort: Participants will develop insight into the value of facing discomfort, realizing what they gain by overcoming avoidance and how it aligns with their core values.

Prepare Action Plan: Participants will leave with a clear plan and practical strategies to start embracing discomfort, using graded exposure techniques to gradually overcome avoidance.

“Embrace Connection: Social Anxiety Skills Workshop,” is designed to help you understand and manage social anxiety through evidence-based techniques and strategies. This workshop consists of five comprehensive lessons, totaling 43 minutes of video content, and includes four associated resources/activities to enhance your learning and application.

By the end of this workshop, participants will:

Understand Social Anxiety: Gain a clear understanding of social anxiety, its causes, and the difference between normal social anxiety and social anxiety disorder.

Manage Anxious Thoughts: Learn to catch, identify, and reframe socially anxious thoughts with evidence-based strategies.

Reduce Social Avoidance: Understand the ineffectiveness of avoidance, learn gradual steps to reduce it, and develop strategies to cope with the process.

Improve Communication Skills: Acquire practical conversation and communication skills to enhance confidence and effectiveness in social interactions.

Adopt a Values-Based Perspective: Learn to reframe social anxiety through a values-based perspective, improving their approach to social interactions and reducing anxiety.

Embrace Uncertainty – Coping with What If Thoughts Workshop”, is designed to help you understand and manage uncertainty and the ineffective “what if” thoughts that often accompany it. This workshop consists of five engaging lessons, totaling 34 minutes of video content.

By the end of this workshop, participants will:

Understand Uncertainty: Gain a clear understanding of what uncertainty is, why it’s common to feel uncomfortable with it, and the ineffectiveness of “what if” thoughts.

Learn the Five Laws of Uncertainty: Understand and accept the fundamental principles of uncertainty to cope more effectively.

Avoid Unreasonable Efforts to Reduce Uncertainty: Recognize why trying to eliminate uncertainty is ineffective and adopt healthier, more reasonable approaches.

Develop Coping Strategies: Acquire practical, evidence-based strategies for enduring and managing uncertainty.

Embrace Uncertainty: Learn to reframe uncertainty positively, find meaning in it, and embrace it as a part of life.

 

“Embrace Now: Mindfulness Skills Workshop” is designed to introduce you to the principles and practices of mindfulness, helping you cultivate a calmer, more centered mind. This workshop consists of five concise lessons, totaling 26 minutes of video content, complemented by four associated resources to support your mindfulness journey.

By the end of this workshop, participants will:

Understand Mindfulness: Gain a clear understanding of what mindfulness is, its benefits, and overcome common myths.

Enhance Present Moment Awareness: Learn and practice mindfulness activities that help stay grounded in the present.

Observe Thoughts Mindfully: Develop skills to observe thoughts without judgment and prevent them from taking over.

Regulate Emotions Mindfully: Learn techniques to notice and balance emotions, reducing impulsive behavior.

Cultivate Gratitude: Foster a positive mindset through regular gratitude exercises, enhancing overall mindfulness.

Embrace Your Values is designed to provide participants with a deep understanding of their values and practical strategies to live in accordance with them, fostering greater fulfillment and resilience in the face of anxiety and stress. This workshop consists of five engaging lessons, totaling 36 minutes of video content, and includes three guided activities to enhance your learning and application.

By the end of this workshop, participants will:

Understand the Importance of Values: Gain insight into what values are and how they influence behavior and well-being.

Explore Personal Values: openly explore their personal values, discovering what truly matters to them through reflective exercises.

Identify Core Values: Clearly identify and articulate their most important core values.

Assess Values-Based Actions: Evaluate current actions in relation to their values, identifying obstacles and areas for improvement.

Plan for Values-Based Action: Develop a practical plan to increase alignment between their actions and values, receiving a step by step guide on how to address obstacles and enhance engagement.

Embrace Calm – Anxiety Skills Workshop is designed to help you understand and manage anxiety effectively through evidence-based teachings provided by Dr. Sandra. This workshop consists of five concise lessons, totaling 41 minutes of video content, complemented by seven associated resources to deepen your understanding and practice.

By the end of this workshop, participants will:

Understand Anxiety: Grasp the “why” behind anxiety, feeling validated in their experiences.

Manage Anxious Thoughts: Utilize effective strategies to catch and cope with anxious thoughts.

Confront Avoidance: Recognize the pitfalls of avoidance and learn how to face anxiety-provoking situations.

Reduce Anxious Feelings: Apply mindfulness, self-compassion and distress tolerance techniques to alleviate emotional and physical sensations of anxiety.

Accept Anxiety: Develop acceptance strategies and cognitive reframes to live more comfortably with anxiety.