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 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.
Understanding OCD and ADHD
OCD is a mental health condition marked by a cycle of obsessions and compulsions. Obsessions are undesired and intrusive thoughts, sensations, images, feelings, or urges that cause anxiety or distress. They could be anything from a fear of getting sick, having violent thoughts, or doubting whether or not your partner is “the one.”
OCD compulsions are repetitive physical or mental behaviors you might perform to get rid of or neutralize the obsessions. Examples of common compulsions include rumination, excessive cleaning or organizing, and seeking reassurance.
ADHD, on the other hand, is a mental health condition “categorized by having issues with impulse control,” according to Tracie Zinman-Ibrahim, MA, LMFT, CST, Chief Compliance Officer at NOCD.
The symptoms of ADHD include inattention, or the inability to concentrate, stay on task, or stay organized, hyperactivity, and 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, poor time management and procrastination, or picking an immediate reward without thinking about future rewards or consequences.
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All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
Can you have OCD and ADHD at the same time?
The simple answer is yes. 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 perform compulsions,” she says.“If you’re hyperactive, sometimes you’ll find yourself in a physical compulsion before you even realize that you’ve started compulsing.”
OCD vs. ADHD: Key Similarities and Differences
Both ADHD and OCD can affect the same area of your brain
OCD and ADHD may both 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.
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.”
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 suppression, or ruminating.
On the flip side, Zinman-Ibrahim says ADHD is mostly an “outward” condition, 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 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.
How to treat OCD and ADHD together
If you have both of these conditions, know that you can receive treatment for OCD and ADHD at the same time, but it’s important to find a mental health professional that understands how to care for 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.”
ERP therapy
Exposure response and prevention (ERP) therapy is a specialized form of cognitive behavioral therapy (CBT) that’s been proven to be more effective at managing OCD than traditional talk therapies.
During ERP, a therapist specializing in OCD guides you through exercises that intentionally expose you to your triggers. The key part of ERP is learning response prevention techniques, like sitting with uncertainty without having to perform compulsions.
ADHD treatment
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 conditions or developmental disabilities improve their social skills, such as problem-solving or decision-making.
Although traditional CBT isn’t too beneficial for OCD, research reveals that it is effective for managing ADHD symptoms. CBT is a type 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.
Bottom line
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 get your symptoms under control so you can get back to living the life you deserve.
