Understanding the Difference Between Anxiety and ADHD in Teen Girls

Teenage girl appearing overwhelmed with studying, demonstrates how therapy at La Jolla Therapy Center can help your family support and manage your daughter's ability to focus and get tasks completed.

“She says she’s trying, but I just don’t see it.”

“She forgets things constantly, her room is a mess, she waits until the last minute to do everything, and then has a meltdown."

"I don’t know if she’s overwhelmed, anxious, lazy, or what.”

If you find yourself having these thoughts about your tween or teenager, you are not alone.

This is a conversation I have had over and over again—with parents trying their best, and teenage girls feeling defeated and confused. Often, the behaviors look the same: forgetfulness, messy rooms, missed deadlines, emotional meltdowns. But beneath the surface, the reasons can be very different. What looks like procrastination may be fear. What looks like "just being lazy" may be mental overload.

So how do you tell the difference between anxiety and ADHD in preteen or teen girls? And more importantly, how can you support your daughter when even she doesn’t fully understand what’s happening in her brain?

Let’s get into it.

Anxiety vs ADHD: Why It’s So Hard to Tell the Difference

Anxiety and ADHD are two of the most commonly misunderstood mental health challenges for teens—especially girls. They can both lead to:

• Trouble focusing or finishing tasks

• Forgetting things or losing track of time

• Avoiding things that feel hard or overwhelming

• Big emotional reactions

• Sleep problems or restlessness

• Feeling “too much” or “not enough”

And here’s the kicker: it’s not unusual for a teen to have both ADHD and anxiety.

But they’re not the same thing, and they don’t need the same kind of support. So understanding the difference matters.

ADHD in Girls: The Under-the-Radar Struggles

When people think of ADHD, they often picture an energetic, impulsive boy who can’t sit still. But many girls with ADHD don’t look like that at all.

Teen girls with ADHD are often:

• Daydreamy and easily distracted

• Struggling with organization and time management

• Prone to starting things and not finishing them

• Overwhelmed by multi-step tasks

• Hard on themselves for not meeting expectations

These girls aren’t usually “acting out”—they’re “spacing out.” They might try really hard to stay on top of things, but their executive functioning (the brain’s organizing and planning center) is working differently. And because they’re often well-behaved or quiet in class, their struggles go unnoticed for years.

By the time they hit high school, they’re exhausted from trying to keep up. That’s when parents and teachers start to notice: she’s smart, but inconsistent. She’s capable, but always behind. She’s trying, but still falling short.

Anxiety in Girls: The Hidden Perfectionism

Now, let’s look at anxiety. Anxious teen girls often seem responsible, conscientious, and driven. But beneath that is a fear of messing up, failing, or being judged.

Teen girls with anxiety often:

• Procrastinate because they’re scared it won’t be perfect

• Avoid things that feel unpredictable

• Overthink and over-prepare

• Get stuck in worry loops about school, friends, or the future

• Seek constant reassurance

• Cry or panic when something feels “too much”

With anxiety, the issue isn’t a brain that can’t focus—it’s a brain that’s working overtime. Everything feels high-stakes. Even simple tasks can feel like a minefield.

Same Behavior, Different Reasons

Let’s say your daughter hasn’t started her science project, due in two days.

If she has ADHD, she may have forgotten about it, or tried to start and gotten sidetracked. She might want to begin but feel mentally blocked by all the steps.

If she has anxiety, she may have spent hours thinking about how to start but feels paralyzed by fear that she won’t do it right. She might avoid it because facing it makes her feel like she’s going to panic.

If she has both, she may put it off due to distractibility and panic when the deadline gets close. That panic might lead to a flood of tears, self-criticism, and “I can’t do anything right.”

This is why looking only at the behavior doesn’t give the full picture.

Anxiety vs ADHD: What Parents Can Look For

So how can you tell what’s really going on? Here are a few things to notice:

Signs of ADHD:

• Gets easily distracted even with interesting tasks

• Often loses things (keys, phone, assignments)

• Starts tasks with good intentions but doesn’t finish

• Doesn’t seem to register time passing

• Frequently misses steps or instructions repeatedly

Signs of Anxiety:

• Overthinks simple decisions or outcomes

• Constantly worries about doing things perfectly

• Avoids tasks because of fear or overwhelm

• Over prepares, asks “what if” questions

• Melts down after small setbacks or feedback

Of course, these can overlap, and your daughter might not fit neatly into one category. But understanding why the struggle is happening helps shift the approach from frustration to support.

How to Talk to Your Teen About It

Start with curiosity, not criticism. You might say:

• “I’ve noticed school has been tough lately. How’s it feeling for you?”

• “When you say you’re trying, what does that actually look like during the day?”

• “Do you feel like your brain gets stuck, or like it bounces all over?”

• “Are you more worried about forgetting, or more worried about doing things wrong?”

These questions aren’t about diagnosing—it’s about helping her reflect and feel heard.

Many teens don’t have the language yet to explain what’s happening inside. Your role is to create space for discovery, not pressure for answers.

Anxiety vs ADHD: When to Seek Help

If your daughter is constantly overwhelmed, falling behind in school, emotionally distressed, or starting to doubt herself—that’s a sign to reach out. A therapist or psychologist who works with teens can help assess whether anxiety, ADHD, or both are part of the picture.

And no, this isn’t about labeling her. It’s about understanding how her brain works so she can stop feeling broken—and start feeling capable.

Final Thoughts

Your teen girl isn’t lazy, broken, or dramatic. Whether she’s dealing with anxiety, ADHD, or a mix of both, her brain is doing its best under pressure. What she needs most is understanding, not judgment.

Recognizing the difference between anxiety and ADHD can help her get the tools she needs—whether it’s learning how to structure her time in ways that work for her brain, or calming the fear voice that tells her she has to be perfect to be okay.

So the next time you catch yourself saying, “Why can’t she just focus?”—try shifting to, “What’s making it hard to focus right now?” That simple change opens the door to support, connection, and growth.

Because every overwhelmed teenage girl deserves to feel seen—and to learn that she is not the problem. Her brain just speaks a slightly different language. And together, you can learn how to translate It.

Our San Diego, California based counseling practice specializes in helping teens and adults who struggle with anxiety. Through counseling, we help kids and young adults overcome the negative thought cycles, the constant comparison game, and worst-case scenarios that accompany the anxious brain. Additionally, we offer other mental health services, primarily for perfectionists, overachievers or others who don’t feel like they 100% fit in. More specifically we offer treatment for anxiety/OCD, and depression at La Jolla Therapy Center. If you don’t live around San Diego or the commute makes in-person therapy impossible, all of our services are available via online therapy to anyone physically located in California. Therefore, we work with clients from Sacramento to Palo Alto or even Mountain View. You and your family deserve to finally feel less overwhelmed. Get started today by scheduling your free phone consultation with a member of our team here.