Exploring The Possible 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 ADHD and OCD. 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 OCD and ADHD and other ways they may be linked.
Understanding OCD symptoms
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 from OCD may include:
- Fear of contamination and 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 and disturbing thoughts of harming yourself or others
- Unwanted thoughts about aggression, sexual subjects, religion, and other topics
Symptoms of compulsions from OCD may include:
- Undeniable impulses to wash and 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
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 OCD have other existing psychiatric diagnoses. Other anxiety disorders are the most common.
Understanding ADHD symptoms
ADHD typically manifests first in childhood with symptoms commonly continuing through adulthood and beyond. ADHD has a 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 ADHD symptoms, or a combination of both: inattentive, or hyperactive/impulsive. Either ADHD or OCD or both can impact daily functioning and performance at work and school. ADHD symptoms may include:
- Trouble focusing and a short attention span
- Difficulty controlling impulses and resisting temptation
- Forgetfulness
- Difficulty following through on tasks and commitments
- A lack of attention to detail
- Mood swings
- Difficulty keeping organized
- Fidgeting, squirming, and restlessness
- Impulsivity and risk-taking
What’s the link between OCD and ADHD?
Both ADHD and OCD likely have a heritable, genetic component. Recent research has estimated the heritability of ADHD to be 70-80% and OCD to be 40-65%.
Both OCD and ADHD can also significantly impact daily functioning and brain development, 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 ADHD and OCD 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, and OCD is an internalizing disorder, which means that the individual tends to turn inward in response to their environment.
Dual diagnosis or misdiagnosis
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 claims 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 ADHD misdiagnoses could be part of the reason. For example, someone who has trouble paying attention at work and school because of a preoccupation with an obsession might be assumed to have ADHD when they are actually managing severe OCD in anxiety producing environments.
Treatment for OCD and ADHD
Treatment for both ADHD and OCD typically involve 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 patients. If you have comorbid ADHD and OCD, you may benefit from speaking to an expert in adult or adolescent psychiatry to assess effective treatment options for both ADHD and OCD.
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 and learn to practice response inhibition. 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, especially if your adult ADHD patterns are severely impacting your life.
The option of online therapy
Those experiencing mild to moderate symptoms of many different mental health conditions, like ADHD, generally have the option to pursue therapy in person or online. For those who are seeking a 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 and anywhere you have an internet connection. Costs associated with this service are comparable to most insurance co-pays. 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.
Takeaway
While they tend to present quite differently, research suggests that OCD and ADHD may have some links, including heritability and the part of the brain affected. Symptoms of both conditions can be effectively treated; reaching out to a healthcare provider if you’re experiencing any is typically recommended.
What happens if you have OCD and ADHD at the same time?
Obsessive-compulsive disorder can make ADHD symptoms worse, and vice versa. Although seeing a mental health professional may lead to a dual diagnosis, misdiagnosis is also possible. There can be some overlap in symptoms, but sometimes with different motivation. For example, a person with an attention disorder may seem to obsess over their environment, but this may be because they prefer a specific environment for focus and productivity. To get an accurate diagnosis, it may help to seek a therapist who has experience treating people with both obsessive-compulsive disorder and attention disorders.
Can people with attention disorders lead a normal life?
People with attention disorders can lead normal lives with fulfilling relationships and success at school and work, but it may help to receive treatment in the form of medication and/or therapy. A health care provider may be able to treat attention-deficit hyperactivity disorder in a way that’s tailored to the specific symptoms they experience, whether they’re related to inattention, hyperactivity, or both.
Can people with attention disorders have OCD as well?
People with attention-deficit hyperactivity disorder can also have obsessive-compulsive disorder. Both conditions can be related to differences in brain activity and can cause similar symptoms in some people. Obsessive-compulsive disorder and ADHD treatment may involve medication and/or therapy, such as cognitive behavioral therapy.
What is the best ADHD coping mechanism?
The best coping mechanism may depend on the type of attention disorder a person experiences. A person with hyperactive ADHD may benefit from calming strategies, such as use of sensory toys. They may also benefit from scheduled breaks that allow for movement in between tasks.
For those who experience problems with focus (inattention), it may help to find the ideal environment for them to concentrate. For example, some people don’t focus well on tasks when they’re in a quiet environment. Instead, they may thrive in an environment with background noise. It may also help to break down their tasks into smaller, more manageable objectives.
How do you live with OCD and ADHD?
It is possible to live a fulfilling life with attention-deficit hyperactivity disorder and OCD with the right treatment and coping strategies. It may help to speak with a licensed mental health professional who has knowledge about how to treat obsessive-compulsive disorder and ADHD.
Does attention-deficit hyperactivity disorder cause obsessive behavior?
It may seem like a person with attention-deficit hyperactivity disorder has some obsessive thoughts and behavior, with or without an OCD diagnosis, but the motivation behind these thoughts and behaviors may be different from those involved in OCD. Also, a person with OCD may have ADHD-like symptoms. For example, if a person with OCD gets distracted, some people could mistake this for a sign of progress against obsessions. In these cases, they could also be experiencing undiagnosed ADHD.
If individuals with attention-deficit hyperactivity disorder exhibit certain behaviors related to OCD, they may not necessarily have OCD. Likewise, if individuals with OCD exhibit ADHD-related symptoms, they may not necessarily have ADHD. A mental health professional may use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to determine if they meet enough criteria to be diagnosed with both disorders.
Can attention-deficit hyperactivity disorder cause intrusive thoughts?
Attention-deficit hyperactivity disorder can lead some people to experience intrusive thoughts, regardless of whether they have enough OCD symptoms to be diagnosed. A person may end up dwelling on these thoughts, which can create anxiety, leading a person to make unhelpful choices and misinterpret social cues. However, there is help available for attention disorders and intrusive thoughts, including through online cognitive behavioral therapy.
Do people with attention-deficit hyperactivity disorder have a lot of hobbies?
People with attention-deficit hyperactivity disorder can have many hobbies. Some people living with OCD tend to enjoy activities that serve as an outlet for their creativity. They may also enjoy activities that involve exercise, which may help reduce symptom severity.
Is attention-deficit hyperactivity disorder a mental illness or coping mechanism?
Attention-deficit hyperactivity disorder is a mental illness listed in the DSM-5. A mental health professional may diagnose ADHD if a person meets enough of the criteria in the DSM-5. If you believe you are experiencing symptoms that seem like a coping mechanism, it may help to explore this with a licensed counselor who understands ADHD and coping mechanisms.
Is attention-deficit hyperactivity disorder a learning disability or mental illness?
Attention-deficit hyperactivity disorder is not considered a learning disability but a mental disorder. However, many people with ADHD also have a learning disability. The Learning Disabilities Association of America states, “Although ADHD is not considered a learning disability, research indicates that from 30-50 percent of children with ADHD also have a specific learning disability, and that the two conditions can interact to make learning extremely challenging.” Some people with symptoms of ADHD experience improvement with therapy and/or a stimulant medication. However, a doctor may prescribe a non-stimulant depending on the person’s symptoms and medical needs.
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