Are you unable to focus, or could something else be going on in the background—like a cycle of obsessive thoughts that’s stealing your time and attention? Are you forgetful—misplacing your keys, forgetting that your sunglasses are on top of your head—or could your absentmindedness be a sign of a bigger mental health issue?
These behaviors typically align with obsessive-compulsive disorder (OCD) and attention-deficit hyperactivity disorder (ADHD). Both OCD and ADHD are often misunderstood and even confused with one another because they share similar symptoms and can be debilitating if left unmanaged.
If you believe you have OCD, ADHD, or a combination, continue reading to better understand their similarities and differences and what treatment can look like for getting your symptoms under control.
What is OCD?
While you likely have a good idea of what OCD and ADHD are, it probably wouldn’t hurt to get a quick refresher before we compare the two conditions.
Obsessive compulsive disorder (OCD) is a mental health disorder characterized by a cycle of obsessions and compulsions. Obsessions are undesired and intrusive thoughts, images, urges, and feelings that can cause anxiety. They could be anything from a fear of getting sick, having violent thoughts, or doubting whether or not your partner is “the one.” Compulsions are repetitive physical or mental behaviors you might perform to get rid of or neutralize the obsessions. Examples of compulsions include seeking reassurance that your obsessions are valid, excessive cleaning or organizing, or physically distancing yourself from others to avoid hurting them.
What is ADHD?
ADHD is a mental health condition that affects around 1 in 10 children and 1 in 20 adults. According to Tracie Zinman-Ibrahim, MA, LMFT, CST, Chief Compliance Officer at NOCD, ADHD is “categorized by having issues with impulse control.” She explains that you could experience hyperactivity, inattentiveness, or a mixture of both.
The symptoms of ADHD include:
- Inattention: Inability to pay attention, stay on task, or stay organized
- Hyperactivity: Excessive activity or restlessness
- Impulsivity: Doing things without thinking or having difficulty with self-control
These symptoms can affect your day-to-day life, possibly leading to:
- Difficulty remembering responsibilities
- Procrastination
- Poor time management, organization, or planning
- A constant need for stimulation or activity
- Picking an immediate reward without thinking about future rewards or consequences
What are the similarities between OCD and ADHD?
Although ADHD and OCD are totally different mental health conditions, they do have a few things in common.
Both ADHD and OCD can affect the same area of your brain
Both OCD and ADHD may be partly caused by a dysfunction in the same area of the brain. Specifically, they’re associated with abnormal activity in an area that’s involved in executive functions such as short-term memory, planning, and behavioral control. This region of the brain is often in overdrive for people with OCD, but it tends to be less active in people with ADHD.
Brain chemicals can also play a part in both disorders. With ADHD, though, the issue tends to be a dopamine dysfunction, whereas the neurotransmitter serotonin is often out of whack for people with OCD. This plays a role in determining which treatments are best for each condition.
OCD and ADHD can make it hard to focus
These mental health conditions can affect your ability to pay attention, as you can be distracted by your intrusive thoughts or impulsiveness. “Somebody with ADHD can struggle with the ability to pay attention and sit still,” says Zinman-Ibrahim. “When you have OCD, it can be difficult to focus because you may be distracted by your intrusions.”
ADHD and OCD symptoms can affect how you interact with others
These conditions can also impact your social life. “Both can cause you to avoid social interactions,” says Zinman-Ibrahim. “Some of the social skills deficits, especially in younger people with ADHD, can cause social impairments. My first two kids have ADHD and OCD, and they found it very difficult in school because people were giving them a hard time for talking a lot, not waiting for somebody to answer, or not allowing time for someone else to converse with them.”
OCD can also cause some issues with socializing, but it is more of an internal issue. You might think, “‘I’m afraid to be around people because maybe I’ll harm them, or maybe they’ll know what I’m thinking,’” says Zinman-Ibrahim. “Or, ‘I can’t go outside my house because it’s not safe.’ You might see some of the same behaviors [between OCD and ADHD] but for very different reasons.”
How are OCD and ADHD different?
Among the similarities, there are several differences between OCD and ADHD. Here are comparisons of OCD vs ADHD.
OCD is internal and external, while ADHD is more external
With OCD, the obsessions you experience are entirely internal. “Your intrusive thoughts, images, urges, and all those things are going on in your head,” says Zinman-Ibrahim. However, she adds that the compulsions you might do to relieve distress from your obsessions could be physical or mental—such as mental reviewing, thought-blocking, or ruminating.
On the flip side, Zinman-Ibrahim says ADHD is completely an “outward disorder,” as it focuses on how you manage the external world around you. “It’s how you navigate the outside world, how you try to organize, and how you try to go about your day,” she explains.
OCD can cause compulsive behaviors, but ADHD doesn’t
Compulsions are one of the key parts of OCD that are driven by intrusive thoughts. People with ADHD typically won’t perform compulsions to get rid of or alleviate anxiety or uncertainty or to prevent something awful from happening—that’s more of an OCD thing.
OCD tends to avoid risk, and ADHD goes toward it
The levels of risk heavily differ between ADHD and OCD. According to a 2016 study, people with certain OCD symptoms, like doubting or checking, were less likely to take risks because they were concerned they could actually cause harm.
On the contrary, there’s research suggesting that people with ADHD are more likely to engage in risky behaviors—which is more than likely tied to their impulsiveness. This might be because they’re underestimating the consequences, believe that the rewards outweigh the risks, and enjoy the feelings or sensations that come with it.
Can you have OCD and ADHD?
The simple answer is yes. In a 2014 research article, researchers discovered that between 8% and 25.5% of people—particularly young children—may have a dual diagnosis of ADHD and OCD.
So, what exactly would having ADHD and OCD together look like? According to Zinman-Ibrahim, managing the two conditions can be challenging, as the symptoms can intertwine. “Often, it’s hard for people because we’re asking you to be mindful, pause, and make a choice not to compulse,” she says.“If you’re hyperactive, sometimes you’ll find yourself in a physical compulsion before you even realize that you’ve started compulsing.”
How are OCD and ADHD treated?
If you have one or both of these conditions, know there’s treatment available to manage your symptoms. Here’s a look into OCD and ADHD treatments.
Treatment for OCD
Zinman-Ibrahim recommends exposure and response prevention (ERP) therapy for treating OCD. ERP is the gold standard OCD treatment that’s been proven to be more effective than traditional talk therapies like cognitive behavioral therapy (CBT).
During ERP, a therapist specializing in OCD guides you through exercises that intentionally expose you to your triggers. Then, during the second part of ERP, response prevention techniques, you learn to sit with the anxiety your obsessions can bring and move on with your life.
In addition to therapy, medications, such as selective serotonin reuptake inhibitors (SSRIs), may be recommended to manage symptoms of OCD. “If you have a severe presentation of OCD, you might need medications to bring it down a notch so that you can take part in your therapy more effectively,” says Zinman-Ibrahim. “There’s a combination of certain doses you can take to reduce symptoms.”
Treatment for ADHD
In contrast to OCD, Zinman-Ibrahim says medication is usually the first-line treatment for managing ADHD. “Because there’s an underactive part of your brain, you get stimulants, or things that work as stimulants to speed that up so you can slow down—which sounds backward, but that’s how it works,” she explains.
Supplemental treatments for ADHD may include behavioral therapies like social skills training (SST) and CBT. SST can help people with mental health disorders or developmental disabilities improve their social skills, such as problem-solving or decision-making. “When I work with kids with ADHD, I do social skills training,” says Zinman-Ibrahim.
Although CBT isn’t too beneficial for OCD, research reveals that it is effective for managing ADHD symptoms. CBT is a form of talk therapy that helps you address and change negative thoughts and behaviors that are disrupting your life. As a therapist, Zinman-Ibrahim performs CBT for adults with ADHD to help them learn how to navigate the world. “[In CBT] you can give more concrete ideas on how to stay on track, like setting alarms, writing notes, and color-coding things,” she says.
Can OCD and ADHD be treated at the same time?
You can receive treatments for OCD and ADHD at the same time, but it’s important to find a mental health professional that understands how to treat them simultaneously. “You just need somebody who knows how to tell the difference and knows how to work with both,” says Zinman-Ibrahim. “You may need to work with one person to help you with your ADHD and someone else who’s an ERP specialist.”
Managing multiple mental health conditions may seem overwhelming, but it doesn’t have to be. If you believe you’re showing symptoms of OCD and ADHD, reach out to a licensed mental health professional for a proper assessment, diagnosis, and treatment. Getting treatment can help you overcome these conditions and get back to living the life you deserve.
You just need somebody who knows how to tell the difference and knows how to work with both. You may need to work with one person to help you with your ADHD and someone else who’s an ERP specialist.
Tracie Zinman-Ibrahim, MA, LMFT, CST
Not sure if you have OCD, ADHD, or both? Work with an OCD specialist to find out what’s going on. Book a free call.
