Understanding ADHD And Social Anxiety Disorder

Medically reviewed by Nikki Ciletti, M.Ed, LPC
Updated October 24, 2024by BetterHelp Editorial Team

If you have attention-deficit/hyperactivity disorder (ADHD), you might notice that it can sometimes affect the way you communicate. You might be more likely to interrupt others, talk excessively, or “zone out” during conversations. Depending on how others react, this can make social situations stressful or even anxiety-provoking. In some cases, people with ADHD may also show signs of social anxiety disorder, which can be seen as a form of anxiety triggered by social interactions. While it’s possible to live with both disorders, a licensed mental health professional can provide you with an accurate diagnosis. Treatment for both disorders often involves a combination of lifestyle adjustments, therapy, and doctor-prescribed medication.

A woman in a tan shirt isolates herself from the other people in the room while sitting in a chair and gazing down sadly.
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ADHD and social anxiety can be challenging to manage

What is ADHD? 

ADHD is a disorder that can affect your ability to make plans, focus, stay organized, and control your impulses. It’s often diagnosed during childhood, although some people may not be diagnosed until later in life. While we don’t yet know exactly what causes it, research has found differences in the brains of people with ADHD. These usually include differences in levels of brain chemicals, as well as structural changes in the parts of the brain responsible for motivation, planning, and memory. 

Symptoms of inattentive ADHD

To understand how ADHD can affect social skills, it may help to learn about the different forms of this disorder. People can be diagnosed with one of three types: inattentive, hyperactive-impulsive, and combined. Each of these usually has its own symptoms, although some may overlap. Below are several potential signs of inattentive ADHD:

  • Struggling to concentrate for long periods
  • Having trouble completing tasks
  • Getting distracted, even in the middle of conversations
  • Frequently forgetting or losing things
  • Struggling to make plans and stay organized

Signs of impulsive ADHD

In contrast, signs of hyperactive or impulsive ADHD may include the following:

  • Struggling to control your urges
  • Fidgeting or having trouble sitting still
  • Frequently interrupting others
  • Talking excessively
  • Acting without thinking

Combined type of symptoms

People with ADHD often have symptoms of mainly one type or the other, but some people may also have the “combined” type with symptoms of both hyperactivity and inattentiveness. In general, boys tend to have the hyperactive-impulsive type more than girls, who tend to be more likely to have the inattentive type. 

Challenges of people with ADHD

ADHD can cause challenges with daily life, work, and relationships. People with ADHD may be more likely to experience other mental health challenges as well. In a 2021 review of existing data on 8,310 people, researchers found that childhood ADHD was usually associated with a higher risk of developing depression later in life

A man in a blazer sits alone on a bench ouside of a glass building and gazes off.
Getty/Manuel Arias Duran

Understanding social anxiety disorder

Social anxiety disorder sometimes referred to as “social phobia” or SAD, can be defined as an anxiety disorder centered around social situations. 

While it can be natural to experience some discomfort when talking to someone new or speaking in front of a crowd, social anxiety is usually more than just nerves. Like other anxiety disorders, it can cause a level of anxiety that’s so intense, it can get in the way of daily life. SAD can make it hard to do things like talk to strangers, attend meetings, go on dates, and make phone calls. Over time, this can lead to isolation, panic attacks, low self-esteem, and trouble at work or school.

Social anxiety disorder symptoms 

  • Intense fear of judgment or humiliation
  • Avoidance of situations that might lead to embarrassment
  • Expecting the worst possible outcome in every social situation
  • Replaying interactions over and over in your mind
  • Physical symptoms, like muscle tension, stomachaches, dizziness, or a racing heart, that arise during social situations

Risk factors for developing SAD

People may develop SAD due to genetics, brain chemistry, or negative experiences, such as trauma or embarrassing childhood events. 

Is there a link between social anxiety disorder and ADHD? 

The answer may be a bit complicated. This is because ADHD and social anxiety disorder can often cause overlapping symptoms. For example, both ADHD and SAD can make it harder to concentrate in social settings. ADHD can also make social interaction more challenging in general, due to the tendency to interrupt, blurt things out without thinking, or “space out” during conversations. Over time, these challenges may contribute to low self-esteem, fear of judgment, and avoidance of socializing, which can also be symptoms of SAD. 

Overlapping symptoms can make ADHD and SAD diagnoses challenging

These overlapping symptoms can sometimes make it hard to tell if a person is living with ADHD or SAD. Complicating things further is the fact that both ADHD and SAD are often diagnosed early in life.

Comorbidity between ADHD and social anxiety

All that said, it can be possible to have both ADHD and SAD at the same time. In a 2015 study, researchers evaluated 130 people who had been diagnosed with social anxiety disorder for ADHD symptoms. They found that there tended to be a high rate of comorbidity between the two disorders. Because challenging social experiences can sometimes contribute to social anxiety, ADHD may even play a role in its development. 

Getty/Halfpoint Images
ADHD and social anxiety can be challenging to manage

Getting help with managing SAD and ADHD

Because ADHD and SAD can be tricky to tell apart, it can be important to get an expert opinion if you’re having symptoms that are negatively affecting your daily life. A licensed professional may be able to determine whether they’re being caused by ADHD, SAD, or a combination of both disorders. They may also be able to recommend treatments to help you manage your symptoms for a better quality of life. For example, ADHD treatments may include those listed below:

  • Medication
  • Social skills training
  • Lifestyle changes, like setting routines to improve organization and productivity 

SAD can also often be managed with a combination of treatments

  • Medication
  • Self-care strategies, like getting regular exercise and eating nutrient-dense foods
  • Reducing caffeine intake
  • Mindfulness and meditation

Therapy for improving symptoms of ADHD and social anxiety

Therapy is another type of treatment that may improve symptoms of ADHD and SAD. By working with a therapist, you may be able to develop coping strategies for managing social stress and reframe negative thought patterns that might be contributing to your symptoms. 

However, if social situations are stressful for you, attending in-person therapy might be uncomfortable. Online therapy may make it easier by empowering you to meet with a therapist from the comfort of your home. The option to choose between in-app messaging, voice calls, and video calls may also make it easier to find a format that’s comfortable for you. 

Online therapy for treating ADHD and social anxiety disorder 

Online therapy can improve the symptoms of both ADHD and SAD. In a 2022 study of 44 individuals with social anxiety disorder, researchers found that internet-based therapy typically led to remission in 86% of participants

In a different study from 2022, researchers analyzed the results of six existing ADHD studies, finding that online ADHD treatments usually led to improvements in attention and social function

Takeaway

ADHD and social anxiety disorder (SAD) can each make social situations challenging. ADHD can make it hard to pay attention in conversations, avoid interrupting others, and control impulses. This can make socializing stressful. It may even contribute to SAD, which can cause an intense fear of embarrassment and the avoidance of social interactions. While it’s possible to have both SAD and ADHD, it can be important to get a professional diagnosis, as the symptoms of these disorders often overlap. Both SAD and ADHD can often be managed with proper treatment, which may include online or in-person therapy, doctor-prescribed medication, and lifestyle changes.
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