Hacking Your ADHD – Understanding the ADHD and Anxiety Overlap with Dr. Mona Potter
Host: William Curb
Guest: Dr. Mona Potter
Date: February 2, 2026
Episode Overview
This episode of Hacking Your ADHD delves into the nuanced relationship between ADHD and anxiety. Host William Curb welcomes Dr. Mona Potter, Harvard-trained child and adolescent psychiatrist and Chief Medical Officer at InStride Health. Together, they explore how ADHD and anxiety often overlap, methods to distinguish their symptoms, how to approach treatment, and the additional considerations when OCD or other comorbidities come into play. The discussion focuses on using a biopsychosocial model for comprehensive support, the role of medication, and the importance of skill-building alongside symptom management.
Key Topics & Insights
Differentiating ADHD & Anxiety [02:13–09:14]
- Similar Symptoms, Different Roots:
- ADHD and anxiety often look similar on the surface, but have different underlying causes and require distinct interventions.
- Dr. Potter: "When you’re having a hard time focusing...think about inattention like a fever. There can be a lot of different causes." [04:17]
- How Distraction Manifests:
- Dr. Potter: "With ADHD, oftentimes it’s external...the world is tapping you on the shoulders...With anxiety, oftentimes it’s more of an internal distraction...all the side commentary of what could go wrong." [05:48]
- Three Diagnostic Buckets:
- Misdiagnosis of ADHD as anxiety, or vice versa
- ADHD leading to secondary anxiety due to poor management
- Genuine comorbidity: having both ADHD and anxiety
- Dr. Potter: "It is important to be able to say which bucket is this person in, so that I can make sure the intervention...is actually matching the needs of this individual." [08:05]
The “Optimal Zone” of Anxiety & Its Effects [09:14–11:41]
- Anxiety as Motivation vs. Hindrance:
- A certain level of anxiety can help motivate and mask ADHD symptoms.
- William: "I was very good at being on time, but it was just all anxiety driven...the medication helped with that and suddenly I was late all the time again." [09:14]
- Dr. Potter: "There’s that zone of optimal anxiety...it helps us know what's important to us, and it helps drive behaviors that matter. When it’s in its optimal zone, it can almost sometimes even mask some of the symptoms of ADHD." [09:42]
- When Anxiety is Unhelpful:
- Too much anxiety becomes overwhelming and counterproductive, even paralyzing behavior.
Physiological and Emotional Toll of Chronic Anxiety [11:41–14:24]
- Physical Symptoms:
- Anxiety often presents somatically, especially in children, but also adults (stomach aches, headaches, chest pain, tension).
- Dr. Potter: "Anxiety is a very both physical and emotional and cognitive experience...the first thing that somebody notices is actually a physical symptom." [11:41]
- When Anxiety Becomes Exhausting:
- Chronic anxiety floods the system, leading to long-term health consequences.
- William: "My friend Brenda describes anxiety as being the only emotion that you can burn for energy that creates more anxiety." [13:28]
- Dr. Potter: "It can be really helpful in the short run. It becomes problematic when it just becomes chronic, unrelenting." [13:45]
Building Skills: Executive Functioning & the 'Crutch vs. Tool' Debate [14:24–16:22, 31:47–33:06]
- Fostering Independence in Children:
- Dr. Potter: "It is so much easier for me to just rescue you...It's faster...But...how am I coaching you to learn to do this eventually on your own?" [16:34]
- Medication as a Tool, Not the Crutch:
- Both host and guest emphasize skills must be built—medication simply opens opportunities to do so by lowering the 'volume' of symptoms.
- Dr. Potter: "Medication does not build skills, it doesn't build brain muscles...use the quiet provided by medication as a window to practice." [26:32]
- Dr. Potter: "I want to reduce that feeling of 'I'm using a crutch if I use medication.' ...Why is a crutch even bad? A crutch allows you to be able to do the things that are important to you." [31:47]
Biopsychosocial Model of Treatment [02:13, 26:32–28:01, 29:46]
- Broad Approach to Care:
- Biological: Medications, sleep, exercise, diet
- Psychological: Therapy, coping strategies, behavioral skills
- Social: Environmental supports, routines, relationships
- Dr. Potter: "Know your body and know what your threshold is for being more vulnerable...when you're not getting those basic biological needs." [26:32]
- Risks of Not Treating:
- Not using all available tools (meds, skills, environmental support) risks worsening symptoms and self-concept.
- Dr. Potter: "You're living in the world and interacting with the world in a way that's not completely...you almost have goggles on." [28:24]
Medication: Considerations and Myths [17:47–24:06; 28:01–30:43]
- Recent Medication Shortages:
- Due to increased diagnosis and reduced stigma, especially among adults and women, demand for stimulants rose beyond production.
- Dr. Potter: "Adult ADHD diagnoses have gone up...so what we’ve had is a supply and demand issue where the demand for medications went up." [18:25]
- Navigating Anxiety About Medication:
- Openly discuss feelings and experiences with a provider; describe symptoms in detail and note their impact.
- Dr. Potter: "It makes me sad to hear you say that [about stigma around asking for medication]...as a doctor it's our responsibility to be open-minded and collaborative." [24:45]
- Medication Plus Skills:
- Medications can reduce anxiety or ADHD symptoms so that skills can be practiced more successfully; sometimes both stimulant and anxiety medications are appropriate.
- Dr. Potter: "Every individual is different...I don’t think it's fair to have a blanket statement that stimulants raise anxiety, therefore don't prescribe if you have anxiety." [21:48]
ADHD, Anxiety, and OCD: Rituals, Structure, and Accommodations [33:06–39:03]
- What is OCD?
- Intrusive thoughts (obsessions) lead to compulsions (actions/rituals). Relief is temporary, creating a self-perpetuating loop.
- Dr. Potter: “It can show up in a lot of different ways...What separates little rituals from OCD is: how important are they and how much time do they take up? In OCD, that thought is so sticky...not being able to do whatever OCD tells you is incredibly distressing.” [33:34]
- Structure Helps ADHD, But Not OCD:
- Dr. Potter: "Adding rituals...is incredibly helpful for ADHD. Feeding into rituals can actually feed the OCD. With OCD, we want to break the accommodation." [36:13]
- Exposure & Response Prevention (ERP):
- Gold-standard OCD therapy; gradually exposes individuals to distress without performing the ritual.
- Dr. Potter: "ERP is the gold standard for OCD and also for avoidance-directed anxiety...approach, rather than avoidance, is what's going to help you get back to living the life you want to live." [37:25]
When To Seek Help and Final Thoughts [41:28–44:42]
- When to Reach Out:
- When symptoms are interfering with functioning or have become unmanageable with self-help, or when distress is influencing choices more than values/goals.
- Dr. Potter: "Help is along a spectrum...If there’s something that’s on your mind, if you’re worried, ask for help. When symptoms are driving your decisions, rather than your decisions being driven by what matters to you...that’s a good time to get help." [42:03]
- Parting Advice:
- Dr. Potter: "Accept yourself for all of the wonderfulness and the messiness that makes you you...but keep challenging yourself to build on your strengths and manage vulnerabilities." [43:57]
Notable Quotes & Timestamps
-
Differentiating Distractions:
"With ADHD...the world is tapping you on the shoulder...with anxiety...it’s more of an internal distraction." — Dr. Mona Potter [05:48] -
On Masked ADHD by Anxiety:
"Anxiety...can sometimes even mask some of the symptoms of ADHD, because it kind of counters or protects against some of that distractibility." — Dr. Mona Potter [09:42] -
Medication as an Opportunity:
"Medication does not build skills, it doesn't build brain muscles...being very open to saying, 'hey, here are non-medication things I’m trying'" — Dr. Mona Potter [26:32] -
Avoidance and OCD:
"Adding rituals is incredibly helpful for ADHD. Feeding into rituals can actually feed the OCD...with OCD, we’re breaking the accommodation." — Dr. Mona Potter [36:13] -
Medication Stigma:
"I want to reduce that feeling of, 'I'm using a crutch if I use medication.'...Why is a crutch even bad?" — Dr. Mona Potter [31:47] -
Seeking Help:
"We’re not built to worry alone. If there's something that’s on your mind...ask for help...When your symptoms are driving your decisions...that’s a good time to get help." — Dr. Mona Potter [42:03] -
Final Thought:
"Accept yourself for all of the wonderfulness [and] the messiness that makes you you...but keep challenging yourself to build on your strengths..." — Dr. Mona Potter [43:57]
Important Timestamps & Segments
| Timestamp | Topic/Segment | |-----------|--------------------------------------------------------------------| | 02:13 | William introduces the topic and Dr. Potter | | 04:17 | Dr. Potter describes diagnostic complexity between ADHD/anxiety | | 05:48 | Key differentiation: internal vs. external distraction | | 09:14 | Anxiety sometimes masks ADHD, “optimal zone” concept | | 11:41 | The physical side of anxiety | | 14:24 | Executive function & not being a permanent 'external EF' | | 18:25 | ADHD medication shortage context | | 21:48 | Approaching stimulant use with comorbid anxiety | | 26:32 | Biopsychosocial model for treatment | | 33:34 | Dr. Potter defines OCD & overlap with ADHD | | 36:13 | The problem with structure/rituals for OCD vs. ADHD | | 37:25 | ERP: gold standard for OCD & avoidance anxiety | | 42:03 | Signs it’s time to seek help | | 43:57 | Dr. Potter’s parting advice for sensitive brains |
Resources & Where to Learn More
- Dr. Mona Potter: Chief Medical Officer and co-founder at InStride Health
- Hacking Your ADHD: Show notes for this episode
- Newsletter: Any and All Distractions (William Curb’s newsletter)
Tone & Style
The conversation is warm, validating, and practical—balancing clinical expertise with lived experience. Dr. Potter brings empathy to her explanations, and William's self-reflective humor and openness help listeners relate, making complex mental health topics accessible and actionable.
This summary provides an in-depth yet concise overview for anyone interested in the connections—and distinctions—between ADHD and anxiety, practical advice for addressing both, and thoughtful guidance on when and how to seek further support.