ADHD and OCD are two different mental health disorders that can both cause significant disruption to the day-to-day lives of those diagnosed. Because ADHD and OCD share some symptoms, they are often misdiagnosed for one another. In some rarer cases, it is even possible to be diagnosed with both disorders.
What Is ADHD?
Attention-deficit/hyperactivity disorder (ADHD) is a developmental condition that can influence one’s ability to remain attentive, control their impulsivity, and stay overly active. Without appropriate diagnosis, mental health treatment, or medication intervention, individuals with ADHD may have difficulty staying organized and completing tasks. This difficulty may cause problems for the diagnosed individual in academic, professional, or social environments.
ADHD is one of the most commonly diagnosed behavioral health disorders. Approximately 9% of all children and adolescents are diagnosed with ADHD.1 In most cases, ADHD will be diagnosed with a comorbid mental health condition, such as anxiety or other mood disorders. Almost 75% of children and adolescents diagnosed with ADHD will have comorbidity.2 Additionally, ADHD is commonly divided into three distinct categories: inattentive type, hyperactive-impulsive type, and combined type.
Common symptoms that often occur with inattentive ADHD include:3
- Easy distractibility
- Difficulty staying focused on tasks
- Trouble staying organized
- Avoiding tasks that require focus for a longer period of time
- Losing items
- Forgetting to do routine chores
Common symptoms that often occur with hyperactive-impulsive ADHD include:3
- Fidgeting with various items or body parts, taps, or squirms in place
- Talking excessively
- Blurting out an answer before the question has been completed
- Interrupting or intruding on others
- Inability to take part in leisure activities quietly
- Feeling or acting restless
What Is OCD?
Obsessive compulsive disorder (OCD) is a chronic disorder that causes a person to experience intrusive thoughts (obsessions) and behaviors (compulsions) that result in repetitious behaviors. OCD is classified as an anxiety disorder. Those diagnosed will often feel intense anxiety due to how their obsessive-compulsive thoughts and behaviors will often have a significant impact on their daily life.
OCD can be diagnosed from early childhood, but one can be diagnosed into their adulthood. Research has shown that there is a genetic component to developing OCD. A close relative being diagnosed with the disorder more than doubles one’s chances of being diagnosed with the disorder; however, environmental factors also play a part in the development of the disorder.4 Common symptoms of OCD include repetitive behaviors, ruminating thoughts, and anxiety.3
OCD is characterized by:
- Obsessions: Obsessions are persistent, repetitive, and uncontrollable thoughts that the diagnosed individual will experience. Intrusive thoughts may also be considered part of obsessions; however, while anyone may experience an intrusive thought, those with OCD will ruminate on the thought and experience the intrusive thought repeatedly.
- Compulsions: Compulsions are repetitious behaviors that the individual diagnosed with OCD will enact. Compulsions may result from an accompanying obsession or be entirely behavioral in nature. Those with OCD will often state that they comply with compulsions for fear of something bad occurring if they do not enact the behavior.
Similarities Between ADHD & OCD
Although ADHD and OCD are different disorders, there are several similarities between the two diagnoses. Both disorders may affect the diagnosed individual’s day-to-day life by disrupting neurotypical behaviors. Both disorders may influence the way diagnosed individuals act in academic, professional, or social environments, and how they are perceived by others.
Similarities between ADHD and OCD include:
Brain Abnormalities in the Frontostriatal Area
Research regarding ADHD and OCD has indicated that both disorders may involve abnormal activity in the same part of the brain. Both disorders are associated with abnormalities in the frontostriatal system. The frontostriatal system of the brain is responsible for higher order, motor, cognitive, and behavioral functions.5 Impairments of the frontostriatal system can affect executive function and quality of life.
Difficulty Paying Attention
ADHD and OCD can interfere with maintaining attention to a specific person or task. While ADHD may influence how easily one is distracted by external sources, OCD will introduce obsessive thoughts or compulsive behavior that steals the focus.
High Risk of Depression, Anxiety & Anger
Those diagnosed with ADHD and OCD are likely to deal with comorbidities of depression, anxiety, and poor anger management. Frustration with oneself, or the diagnosis, is expected. Without proper intervention, quality of life will suffer, leading to depression or anxiety.
Professional Development Challenges
Both ADHD and OCD have the potential to hinder academic or professional development and success. Much of academic or professional development requires focus, organization, and attentiveness, all of which are impacted by a diagnosis of ADHD, OCD, or both. Developing and maintaining academic or professional success without appropriate coping skills can be a struggle.
Social Relationships Struggles
Those close to people diagnosed with ADHD and/or OCD may have to deal with certain behaviors, such as disorganization, difficulty focusing, or obsessing over other things. It may appear that the relationship is not a priority.
Sleep Disruption
Both disorders can throw mental energy expenditure off balance. Sometimes, a diagnosed individual will deal with focus and rumination at inopportune times, disrupting one’s ability to sleep. 70% of individuals diagnosed with OCD have some form of sleep disorder .6 Those diagnosed with ADHD have been known to also have difficulty sleeping due to restlessness, disrupted circadian rhythms, and insomnia.
Differences Between ADHD & OCD
While ADHD and OCD may share similarities, they are distinct disorders that have drastically different effects on a diagnosed individual’s neurological functioning. ADHD will affect external functioning, while OCD will disrupt internal functioning. Impulsiveness Can compound the difficulties.
Differences between ADHD and OCD include:
Brain Activity
While research has indicated that both ADHD and OCD affect the frontostriatal area of the brain, the ways in which the frontostriatal area is affected are dependent on the disorder. Individuals with ADHD show decreased activity, while those with OCD show increased activity.5
Internal Vs. External Symptoms
Symptoms of ADHD are often external. ADHD can manifest as inhibited social functioning and hyperactivity. The problems stemming from ADHD are often due to the individual’s reaction to external stimuli. This is a major factor in an ADHD diagnosis.
The symptoms of OCD are often internal. OCD manifests as obsessions, ruminations, and intrusive thoughts. Compulsions, while external, function as vessels for an individual to try to control their internal struggles and obsessions.
Impulsivity Differences
OCD and ADHD impulsivity effect people in varying ways. Individuals with ADHD have been shown to engage in more risk-taking or impulsive behaviors for potential benefit.7 Individuals with OCD have been shown to be less likely to engage in risk-taking or impulsive behavior for potential gain, generally engaging in risk-taking or impulsive behaviors when faced with the possibility of loss.8
Presence of Rituals
A common indicator of OCD is “rituals,” or repetitive maladaptive behaviors that impact one’s day-to-day life by being time-consuming, frustrating, or disruptive in other ways. The need to complete rituals is not a diagnostic criterion of ADHD.3 In fact, an ADHD diagnosis often indicates difficulty staying on task, which would preclude a ritual.
Can You Have Both ADHD & OCD?
It is possible to be diagnosed with both ADHD and OCD, but the prevalence of dual diagnoses is a debate among researchers. Certain research indicates that 11.8% of individuals diagnosed with OCD have a comorbidity of ADHD.9 Other research indicates that rates of dual diagnosis may be inflated due to misdiagnosis of the two disorders for one another.10
The Impact of Having Both ADHD & OCD
When diagnosed with both ADHD and OCD, the two diagnoses may worsen one another. Symptoms from one disorder may influence symptoms of the other. As symptoms of one disorder appear to lessen, symptoms of the other disorder may dominate. This pivot between behaviors of ADHD and the compulsions of OCD can be exhausting.
Diagnosis Process for ADHD & OCD
Currently, no laboratory or brain imaging tests can be used to diagnose ADHD or OCD. Both disorders are diagnosed through behavioral observation and psychological assessment. During the observational period, a mental health professional may consider how some symptoms co-mingle.
Treatment for ADHD
ADHD treatment can help with coping with symptoms that impact daily functioning. A combination of medication intervention and psychotherapy will often yield the greatest results. A primary care physician (PCP), a psychiatrist, or a licensed mental health provider may render treatment.
Treatment options for ADHD include:
- Cognitive behavioral therapy (CBT): CBT for ADHD can be a framework for evaluating how the rapid thinking (cognitions) in ADHD may result in maladaptive behaviors.
- Medication: ADHD medicines are not a permanent cure for ADHD; however, medications may help with day-to-day function with improved concentration, lessened impulsivity, and a calmer state of mind.11
- Psychoeducation: Psychoeducation for the individual or the family is a useful tool for improving social dynamics within the home. Those with ADHD will learn more about their condition and how it affects themselves and others. Family members will learn about the condition and how to react best and help.11
- Social Skills Training: Social skills training uses role-playing to give people with ADHD an opportunity to practice the skills learned during psychotherapy. This can help with behaviors and reactions in social situations.11
- Parent Training and Education Programs: For parents of children with ADHD, training and education programs will teach how to reinforce the behavioral skills taught during psychotherapy.11.
Treatment for OCD
Treatment for OCD can help diminish rumination, intrusive thoughts, compulsions, and other symptoms of OCD. OCD is typically treated with psychotherapy; however, in certain instances, medication may also be an option. OCD is a chronic disorder and may continue to cause discomfort during or after treatment.
Treatment options for OCD include:
- Exposure response prevention (ERP): ERP for OCD involves exposing individuals to thoughts, images, objects, or situations that make them uncomfortable and cause obsessions. The objective is to have the diagnosed individual practice making a conscious choice to resist the resulting compulsive behavior.12
- Cognitive behavioral therapy (CBT): CBT for OCD will provide a framework for evaluating how particular obsessions result in specific compulsions. Individuals can readjust their reactions to obsessions or ruminating thoughts and learn strategies to cope with intrusive thoughts and rumination.
- Medication: Medications for OCD that can be used to assist with symptoms of OCD include serotonin reuptake inhibitors (SSRIs) and clomipramine.13
- Psychoeducation: Psychoeducation may help individuals and families to cope with negative emotions regarding their diagnosis. Learning about common challenges, coping mechanisms, and support options may be addressed.
Treatment for Both ADHD & OCD
Similarly to those diagnosed with either ADHD or OCD, cognitive behavioral therapy (CBT), medication intervention, and psychoeducation are the key strategies for understanding, coping with, and overcoming challenges associated with both disorders. A trial of stimulant medication may be attempted. Stimulants are sometimes prescribed for individuals with ADHD; however, stimulant use may worsen symptoms of OCD.14
When to Seek Professional Support
Seeking professional support is an advisable option for those diagnosed with ADHD, OCD, or both. One may use an online therapist directory to find a practitioner specializing in treating either or both disorders. When talk therapy practices do not yield positive results on their own, one may consider finding a psychiatrist who can evaluate whether there is a need for medication.
In My Experience
My experience working with clients with ADHD and OCD has shown me that many people diagnosed with one or both disorders will deal with a significant blow to their self-esteem. The professional, academic, and social challenges associated with both disorders will often affect self-image and hopes for success. Comorbidities of anxiety and depression can worsen the symptoms of their disorder and make it more difficult to overcome their symptoms.
Talk therapy approaches with clients with ADHD, and OCD will often reveal underlying insecurities regarding their diagnosis. Addressing underlying mental health needs, such as anxiety, depression, etc., will leave the client in a more positive frame of mind to address the symptoms of their disorder.
For Further Reading
- LIVING WITH OCD: Triumph over Negative Emotions, Obsessive Thoughts, and Compulsive Behaviors
- Living with ADHD: Simple Exercises to Change Your Daily Life
- Inflow ADHD App Review: Pros & Cons, Cost, & Who It’s Right For
- NOCD Review: Pros & Cons, Cost, & Who It’s Right For
- Best OCD Books
- Best ADHD Podcasts
ADHD & OCD Infographics
