Exploring The Connection Between OCD And ADHD

Obsessive-compulsive disorder (OCD) and attention-deficit hyperactivity disorder (ADHD) are two separate mental health conditions with distinct symptoms and differing treatment methods. Nevertheless, research over the years has suggested that there may be a link between the two. Some people experience them concurrently, and the abnormal neural activity that causes symptoms in both disorders is related to the same area of the brain. Read on for a deeper dive into both of these conditions and other ways they may be linked.

Understanding OCD And Its Symptoms

Obsessive-compulsive disorder is a type of anxiety disorder. People with OCD experience recurring thoughts that are unwanted and often distressing, and they feel compelled to take repetitive actions in order to rid themselves of the thoughts. For example, a person might cope with the intrusive thought of something bad happening to a loved one by repetitive counting, checking, or cleaning objects around them. In order to receive a clinical diagnosis of OCD, an individual’s compulsions usually must cost them an hour or more of time each day, cause significant distress, and affect daily functioning.

Symptoms of obsessions may include:

• Fear of contamination or getting dirty, such as an unwillingness to touch things others have touched
• Frequent doubt and trouble tolerating uncertainty, like being unsure you turned off the oven and needing to turn around to check
• Needing an orderly, symmetrical environment and having trouble with disorganized things 
• Aggressive or disturbing thoughts of harming yourself or others
• Unwanted thoughts about aggression, sexual subjects, religion, or other topics

Symptoms of compulsions may include:

• Undeniable impulses to wash or clean, such as hand washing until skin becomes raw
• Checking things over and over, like circling the house to ensure that doors and windows are locked
• Counting things multiple times, often with specific patterns
• A need for strict routines
• Frequently demanding reassurance, often repeatedly

According to a 2022 article published by the National Library of Medicine, it’s estimated that OCD affects around 1.6–2.3% of adults, with 19.5 being the average age of onset. OCD commonly appears in conjunction with other mental health conditions; in fact, it’s estimated that 90% of those with obsessive-compulsive disorder have other existing psychiatric diagnoses. Other anxiety disorders are the most common.

Understanding ADHD And Its Symptoms

Attention-deficit hyperactivity disorder typically manifests first in childhood with symptoms commonly continuing through adulthood. Its lifetime prevalence among US adults is 8.1%, according to the National Institute of Mental Health. An individual with ADHD may present with one of two main categories of symptoms, or a combination of both: inattentive, or hyperactive/impulsive. Either or both can impact daily functioning and performance at work or school. Symptoms may include:

• Trouble focusing and a short attention span
• Difficulty controlling impulses and resisting temptation
• Forgetfulness
• Difficulty following through on tasks or commitments
• A lack of attention to detail
• Mood swings
• Difficulty keeping organized
• Fidgeting, squirming, or restlessness
• Impulsivity and risk-taking

What’s The Link Between OCD And ADHD?

Both can also significantly impact daily functioning, especially when symptoms are untreated. Otherwise, the way they manifest typically seem quite distinct from each other. However, the areas of functioning that are affected can be similar. Both disorders relate to issues with executive functioning, especially in terms of planning, making decisions, and switching between tasks. That said, an article published by the International OCD Foundation points out that ADHD is an externalizing disorder, which relates to how a person relates outwardly to their environment, while OCD is an internalizing disorder, which means that the individual tends to turn inward in response to their environment.

The article also notes that both conditions seem to be characterized by abnormal brain activity in the same region, but that it’s overactive in those with OCD and underactive in those with ADHD. Finally, it shares that “over 35 studies have reported that an average of 21% of children and 8.5% of adults with OCD actually have ADHD as well”. Researchers are still examining exactly why this is, but misdiagnoses could be part of the reason. For example, someone who has trouble paying attention at work or school because of a preoccupation with an obsession might be assumed to have ADHD if the underlying cause of their attention issues is not uncovered. 

Treatment For OCD And ADHD

Treatment for both of these conditions typically involves a combination of medication and psychotherapy. In terms of medication, selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for OCD, while stimulants, antihypertensives, or cognition-enhancing medications are commonly recommended for ADHD. 

When it comes to psychotherapy, cognitive behavioral therapy (CBT) is one modality that’s commonly recommended for both disorders. CBT can help an individual learn to become aware of and shift flawed or unhelpful thought patterns that may be leading to distressing feelings and behaviors. Other types of therapy that may be suggested include exposure and response prevention (ERP) for OCD and interpersonal and social rhythm therapy (ISRT) for ADHD. You can speak with your mental health care provider for insight into which type might be best for your specific situation.

The Option Of Online Therapy

Those experiencing mild to moderate symptoms of many different mental health conditions generally have the option to pursue therapy in person or online. For those who are seeking a more convenient and affordable option, virtual therapy may be worth considering. With an online therapy platform like BetterHelp, you can get matched with a licensed therapist who you can meet with via phone, video call, and/or in-app messaging, all from the comfort of home or anywhere you have an internet connection. Costs associated with this service are comparable to most insurance co-pays, making it more accessible for those experiencing financial difficulties. Research suggests that both online and in-person therapy can offer similar benefits in many cases, so there are options available depending on your needs and preferences.