OCD Vs. ADHD: What Are The Differences?
Obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD) can be defined as two distinct disorders, but they may share some similarities. While both mental health conditions can share features related to attention, concentration, and executive function, each condition's patterns of brain activity tend to be distinct and may be seen as diametrically opposite. However, there can be potential for a dual diagnosis in some individuals. If you experience symptoms of one or both disorders, seeking professional guidance can be helpful. You can do so by connecting with a therapist in your local area or through an online therapy platform.
OCD and ADHD similarities
According to the APA, OCD is usually “characterized by recurrent intrusive thoughts (obsessions) that prompt the performance of neutralizing rituals (compulsions).” This disorder usually develops in adolescence or early adulthood.
In contrast, ADHD may be defined as a neurodevelopmental and "behavioral condition that makes focusing on everyday requests and routines challenging."
According to the International OCD Foundation, both conditions may exhibit uncommon brain activity in the same neural circuit, potentially affecting motor, cognitive, behavioral, and executive functioning.
White the actual brain patterns may be distinct, the resulting cognitive effects on planning, switching tasks, working memory, and decision-making may be similar. Some researchers suggest that both disorders may be part of a compulsive-impulsive continuum, sometimes corroborated by a dual diagnosis.
Other distinct conditions negatively affecting executive function can include major depressive disorder and post-traumatic stress disorder.
OCD symptoms
Adult OCD may be characterized by a pattern of intrusive thoughts and fears that cause anxiety. Such thoughts may result in compulsive, repetitive behaviors that can cause distress and interfere with daily functioning.
Obsessions may include, but are not limited to, the following:
- A fear of forgetting or losing something, which may result in constantly checking one's keys or locking the door
- Unwanted or taboo thoughts
- A desire for order and symmetry
In general, OCD involves bothersome, obsessive thoughts leading to behaviors that temporarily relieve the anxiety associated with them.
ADHD symptoms
ADHD may be characterized by a pattern of inattention and/or hyperactivity-impulsivity that usually interferes with daily functioning at work and school, as well as in relationships and social spheres. Main adult symptoms can include impulsiveness, restlessness, and challenges with paying attention.
OCD vs. ADHD
Both conditions may show deviations in the same part of the brain. However, OCD is usually linked with increased activity (overactivity) in the frontostriatal circuits, whereas those with ADHD may display decreased activity (underactivity) in the same region.
Moreover, ADHD may be considered an externalizing disorder, whereas OCD can be viewed as an internalizing disorder. Therefore, a person with ADHD may respond to their environment by turning outward, perhaps displaying risk-taking behavior, acting impulsively, and being inattentive. The willingness to take risks may be linked with the perception of achieving positive outcomes by doing so, as opposed to taking risks for their own sake, according to some researchers.
Those with OCD may respond to anxiety by turning inward and avoiding risks. This internalizing feature is typically linked with a display of obsessive/compulsive behavior and thoughts, a more inhibited temperament, and a concern for the consequences of their actions.
Some researchers believe that the "overflow" of obsessive/compulsive thoughts can take up space in a person's brain, potentially leading to an "overload" that can impair executive functioning.
This theory may be likened to a computer running too many programs at once, causing malfunctions in individual programs. For example, a person with OCD who is trying to finish a project but is flooded with intrusive thoughts may find it difficult to complete the task at hand. OCD treatment usually aims to reduce the symptoms affecting a person's executive function, thus reducing the overload of intrusive thoughts.
ADHD dual diagnosis and misdiagnosis
A person can have a dual diagnosis of both OCD and ADHD, which may be partly attributed to the neurological link between the two disorders.
However, there is also potential for a dual diagnosis misdiagnosis by mental health professionals. Some researchers suggest that co-occurrence rates are highly inconsistent in studies that have examined dual diagnoses. These experts note that high rates of an ADHD-OCD dual diagnosis may be due to "possibly transient phenotypical expressions" that appear similar to ADHD symptoms.
Cognitive behavioral therapy (CBT) for OCD and ADHD
In general, CBT is a type of talk therapy that aims to address unhelpful thoughts and behaviors. By changing patterns of thinking and behaving, one may improve their overall psychological state. To do so, a person may have to learn more constructive, helpful coping strategies to manage stress and anxiety.
CBT can be helpful in relieving symptoms of many disorders, including OCD. In fact, CBT is generally considered to be a well-regarded treatment for obsessive–compulsive disorder (OCD), and this is largely supported by numerous meta-analyses and systematic reviews.
This type of therapy can also address ADHD symptoms. One meta-analysis indicates that CBT can improve both core and emotional symptoms of ADHD. Results also suggest that it could reduce depression and anxiety while improving quality of life and self-esteem.
Therapy for addressing challenging symptoms
Managing ADHD and OCD symptoms, whether or not you have a dual diagnosis, can be challenging. While doctor-prescribed ADHD and OCD medication may relieve symptoms for some people, it also tends to have limitations, especially in relation to long-term use.
If you believe you might benefit from mental health support, you may want to consider in-person or online therapy. Online therapy can be a viable and convenient option for many people.
BetterHelp, for example, is an online therapy platform that generally enables you to have sessions with a licensed therapist by phone, video conference, or online chat. This can make it simple to customize the therapy experience to your own comfort level. Many therapists on this platform use principles of CBT, an approach that can effectively address symptoms of OCD and ADHD.
An overview of the effectiveness of internet-based cognitive behavioral therapy (ICBT) suggests that "ICBT is effective in the treatment and management of various psychiatric disorders such as depression, GAD and social anxiety, panic disorders, phobias, addiction and substance use disorders, adjustment disorder, bipolar disorder, and OCD."
Takeaway
Both ADHD and OCD may involve challenges with executive function that can manifest as difficulty planning, switching tasks, and making decisions. Adult OCD usually involves a pattern of intrusive thoughts and compulsions that cause distress and interfere with daily functioning. Meanwhile, adult ADHD may be defined by a pattern of inattention and/or hyperactivity-impulsivity.
The propensity to take risks and act impulsively tends to differ greatly between those with adult obsessive-compulsive disorder and adult ADHD. Those with OCD are usually much less likely to act impulsively and take risks. While the actual brain patterns in these disorders tend to be distinct, cognitive effects may be similar, leading some researchers to suggest that both disorders may be part of a compulsive-impulsive continuum, which is sometimes corroborated by a dual diagnosis. Both OCD and ADHD can be treated with cognitive behavior therapy or CBT, which can be completed online or in person.
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