ADHD and OCD: Similarities and differences

Attention-deficit hyperactivity disorder (ADHD) is a mental health condition that can create challenges with focus, impulsivity, and hyperactivity. Similarly, obsessive-compulsive disorder (OCD) typically affects a person’s ability to control their thoughts and behavior. It causes a cycle of upsetting, intrusive thoughts called obsessions. Obsessions are followed by unwanted compulsive behaviors that aim to reduce the anxiety caused by the obsessions. 

ADHD and OCD often occur together. Research shows that up to 30% of adults with OCD also have ADHD. This is called having a dual diagnosis or co-occurring conditions. But sometimes, conditions like ADHD and OCD can be mistaken for one another. This is because, on the surface, symptoms of both conditions can look the same. 

This misunderstanding can result in a misdiagnosis, especially in children. But by taking some time to familiarize yourself with the similarities and differences between ADHD and OCD, you can advocate for yourself and help ensure that you get the right treatment for your needs.

Symptom similarities and differences

People with ADHD may have trouble with focus, organization, and impulse control. By contrast, people with OCD experience chronic intrusive thoughts followed by ritualistic, compulsive behaviors or mental processes. Both conditions can impact behavior and daily functioning, but their diagnostic criteria are very different.

ADHD symptoms can include:

• Trouble paying attention to details 
• Frequently making avoidable errors
• Difficulty focusing on tasks
• Seeming not to listen when spoken to directly
• Trouble following instructions
• Avoiding tasks that they dislike or that require sustained effort
• Frequently misplacing personal belongings
• Becoming easily distracted
• Being forgetful in daily activities
• Moving or fidgeting frequently and having difficulty keeping still
• Feeling restless often
• Trouble engaging in leisure activities quietly
• Talking excessively or interrupting others frequently
• Difficulty waiting one’s turn

OCD symptoms can include:

• Experiencing frequent, intrusive thoughts that are inappropriate, uncontrollable, and cause significant anxiety or distress (obsessions)
• Engaging in repeated, unwanted behaviors or mental acts to reduce the anxiety or distress caused by obsessions (compulsions)
• Having obsessions and compulsions that occupy at least an hour each day and significantly interfere with daily life

People can have both ADHD and OCD at the same time, and it’s not uncommon for the symptoms of one to be mistaken for the other. This is because, on the surface, ADHD-induced impulsivity can look the same as OCD-induced compulsivity. 

For example, someone might assume that a person who constantly fidgets is showing symptoms of ADHD. However, upon closer examination, a therapist might find that their fidgeting is actually a compulsive behavior driven by anxiety from intrusive thoughts, a hallmark of OCD.

This distinction is important because ADHD and OCD often require different treatments. To achieve the best outcomes possible, this person’s providers would need to address both conditions at the same time.

Is there a link between ADHD and OCD?

More research is needed to better understand the links between the impulsivity brought on by ADHD and compulsivity brought on by OCD. But both conditions seem to affect the same regions of the brain and stem from similar biological, genetic, and environmental factors, like:

• Having a first-degree relative, like a sibling or parent, who also has ADHD, OCD, or both
• Having differences in brain structure or imbalances in brain chemicals called neurotransmitters
• Experiencing trauma, like childhood abuse or neglect

While these shared risk factors are important to consider, the underlying causes of OCD and ADHD are not entirely the same.

For example, personality traits may play a role in OCD. Being a person with high personal standards who is naturally neat and meticulous may make you more likely to develop OCD. On the other hand, risk factors for ADHD may include premature birth, a history of severe head injury, or epilepsy.

Treatment for co-occurring OCD and ADHD 

If you’re living with OCD and ADHD, know that there are effective treatment options for both conditions. This typically includes a personalized combination of therapy and medication, depending on your specific needs.

Therapy

Cognitive-behavioral therapy (CBT) is often used to treat people living with co-occurring ADHD and OCD. It helps people identify and replace the thought and behavior patterns that cause distress. It’s also used to improve problem-solving, organization, distress tolerance, and other aspects of executive functioning. 

There are other types of therapy that can help reduce symptoms as well, including dialectical behavior therapy (DBT), acceptance and commitment therapy (ACT), and exposure and response prevention (ERP) therapy.

Medication

Medications are sometimes used to lessen certain OCD symptoms. However, the medications commonly used to treat ADHD may make OCD symptoms worse. So if you’re wondering if medication is right for you, talk to your provider, and be sure to let them know about any medications you’re already taking. 

If medication becomes a part of your treatment plan, it’s always important to work closely with your medical and mental health providers to ensure your safety. 

Find care with Rula

ADHD and OCD are two distinct mental health conditions. However, they can sometimes be mistaken for one another because symptoms of ADHD, like impulsivity, can resemble the compulsive behaviors seen in OCD. Conversely, some OCD symptoms might be misinterpreted as impulsivity or hyperactivity associated with ADHD. 

But regardless of the mental health issues you’re facing, getting an accurate diagnosis is one of the first and most important steps in accessing the right care for your needs. 

At Rula, we work with an extensive network of skilled providers who specialize in treating co-occurring conditions of all kinds. When you need support, you can use our therapist-matching services to sift through your options and select a provider who takes your insurance. 

Whether you need individual therapy or psychiatric care (or both), Rula makes it easy to connect with the individualized treatment you deserve from the comfort of home.

Get started with Rula today