Are you misplacing your keys—or losing hours to unwanted thoughts? Forgetting appointments—or feeling stuck in mental loops?
Both obsessive-compulsive disorder (OCD) and attention-deficit hyperactivity disorder (ADHD) can impact your attention, memory, and emotions, making it hard to tell where one condition ends and the other begins. And when intrusive thoughts enter the picture, the confusion only grows.
In this guide, we’ll break down what OCD and ADHD look like, how they overlap, and how you can find the right support, especially if you’re dealing with both.
What are OCD and ADHD?
Here’s a brief overview of both mental health conditions:
Obsessive-compulsive disorder (OCD)
OCD is a mental health condition marked by a cycle of obsessions and compulsions:
- Obsessions: Intrusive thoughts, images, urges, feelings, or sensations that cause significant distress
- Compulsions: Repetitive physical behaviors or mental acts done to neutralize those thoughts or reduce anxiety
Examples include:
- Fear of harming others → mentally reviewing every interaction
- Fear of contamination → excessive cleaning
- Relationship doubts → constantly seeking reassurance
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
Attention-deficit hyperactivity disorder (ADHD)
ADHD affects how your brain manages focus, activity levels, emotional regulation, and self-control.
Core symptoms include:
- Inattention: Forgetting details, trouble organizing, easily distracted
- Hyperactivity: Restlessness, excessive talking, or fidgeting
- Impulsivity: Interrupting, risky choices, trouble with delay of gratification
Can ADHD cause intrusive thoughts?
Yes, but they’re very different from OCD obsessions.
People with ADHD often describe their thoughts as rapid, scattered, or overwhelming. These thoughts may arise unexpectedly, making it difficult to concentrate.
However, they usually don’t come with the same level of fear, guilt, or compulsive urges seen in OCD.
Think of it this way:
- ADHD = “brain won’t slow down”
- OCD = “brain won’t let go of a specific intrusive thought”
That said, if you’re unsure whether your thoughts are ADHD-related or obsessive, an evaluation from a licensed mental health professional can help you sort it out.
Can you have both ADHD and OCD?
Yes—and it’s more common than you might think.
Studies show that 8% to 25.5% of people—particularly children—may have both ADHD and OCD.
When both conditions are present, it can be difficult to manage symptoms. ADHD may make it harder to notice when compulsions start. “We’re asking you to be mindful, pause, and make a choice not to perform compulsions,” says Tracie Ibrahim, LMFT, CST, Chief Compliance Officer at NOCD. “If you’re hyperactive, sometimes you’ll find yourself in a compulsion before you even realize what’s happening.”
OCD vs. ADHD: What’s the difference?
While ADHD and OCD can overlap, there are important distinctions:
They affect the same brain region, but in opposite ways
Both impact areas are responsible for executive functioning (planning, memory, and impulse control)
- OCD: Overactive in this region
- ADHD: Underactive in this region
Both affect focus, but for different reasons
- OCD: Focus problems due to obsessive thoughts that hijack attention
- ADHD: Focus problems due to distraction, stimulation, or impulsivity
Both can impact social life
- OCD: May avoid people due to fear of harm, judgment, or contamination
- ADHD: May interrupt, overshare, or struggle with social cues
OCD = internal distress; ADHD external disorganization
- OCD: Driven by internal anxiety (What if I harm someone? What if I’m contaminated?)
- ADHD: Driven by external challenges (I forgot the deadline. I lost track of time.)
OCD involves compulsions; ADHD does not
People with OCD perform rituals or behaviors to reduce anxiety. In contrast, people with ADHD may repeat mistakes or distractions, but not as a form of relief from distress.
OCD avoids risk; ADHD may seek it
- OCD: Overestimates risk and avoids harm
- ADHD: Underestimates risk and acts impulsively
How to treat both conditions
The good news is that it is possible—and effective—to treat ADHD and OCD at the same time. However, treatment should be tailored to both conditions.
OCD: Exposure and response prevention (ERP) therapy
ERP is a specialized form of cognitive behavioral therapy (CBT) proven to be effective for OCD. General CBT, if not tailored for OCD, can sometimes be unhelpful or even worsen symptoms. ERP helps you gradually face your fears head-on without resorting to compulsions.
With a trained ERP therapist, you’ll:
- Identify your obsessions and triggers
- Learn how to tolerate uncertainty
- Practice resisting compulsions with support
ADHD: Medication and practical strategies
For ADHD, medication is often the first line of treatment. Stimulants help improve focus by activating underused areas of the brain.
Other options include:
- CBT: Helps with time management, organization, and thought reframing
- Social skills training (SST): Supports communication and problem-solving in daily life
If you have both conditions, you may benefit from working with two providers: an ADHD-focused clinician and an OCD specialist trained in ERP.
Bottom line
If your mind feels like it’s spinning in every direction—or getting stuck on distressing thoughts—you’re not alone. OCD and ADHD are both common, treatable, and manageable with the right support.
Reach out to a licensed mental health provider who can help you sort through your symptoms and create a personalized treatment plan. With the right care, you can feel more focused, present, and in control.
Key takeaways
- ADHD can cause intrusive thoughts, but they’re typically fast-moving and distracting rather than distressing and compulsive, like in OCD.
- OCD and ADHD often overlap, and as many as 1 in 4 people with OCD may also have ADHD.
- While both conditions impact focus and behavior, OCD is driven by internal anxiety and compulsions, whereas ADHD is driven by impulsivity and inattention.
- Treating both OCD and ADHD is possible, often involving ERP for OCD and a combination of medication and CBT for ADHD.
