OCD Vs. ADHD: What Are The Differences?
Obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD) can be defined as two disorders, but they may share similarities. While OCD and ADHD conditions can share features related to attention, concentration, and executive function, each condition's patterns of brain activity tend to be distinct. However, there can be potential for a dual diagnosis in some individuals. If you experience symptoms of OCD or ADHD, 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 to treat OCD and ADHD.
OCD vs. ADHD: What are the similarities between ADHD and OCD?
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."
Uncommon brain activity of ADHD and OCD
According to the International OCD Foundation, both OCD and ADHD conditions may exhibit uncommon brain activity in the same neural circuit, potentially affecting motor, cognitive, behavioral, and executive functioning.
While 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 of OCD and ADHD.
Other distinct conditions negatively affecting executive function can include major depressive disorder and post-traumatic stress disorder.
Obsessive-compulsive 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.
Attention-deficit/hyperactivity disorder (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 ADHD adult symptoms can include impulsiveness, restlessness, and challenges with paying attention.
OCD vs. ADHD: Are there differences between OCD and ADHD?
Both OCD and ADHD 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.
OCD vs. ADHD: Externalizing disorder vs. internalizing disorder
Moreover, both ADHD and OCD are viewed differently. 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 of OCD and ADHD 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 symptoms
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.
CBT for relieving symptoms of OCD and ADHD
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 of ADHD or OCD
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.
Online therapy for ADHD and obsessive-compulsive disorder
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.
Effectiveness of ICBT for OCD or other mental health concerns
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.
Can ADHD be mistaken for OCD?
ADHD is rarely mistaken for OCD. However, OCD is more frequently mistakenly diagnosed as ADHD, especially in children, since people with OCD may exhibit some ADHD like symptoms, such as difficulty concentrating. OCD is a mental health disorder characterized by increased response to perceived threats, and people with OCD exhibit anxious thoughts and compulsive behaviors. People with OCD tend not to engage in the risk taking behavior that is characteristic of people with ADHD. Typically, people with ADHD exhibit impulsive behavior, restlessness, and difficulty focusing.
Therapeutic approaches might differ, and ADHD is often treated with stimulant therapy, while OCD is often treated with SSRIs. Stimulant medication can often exacerbate obsessive compulsive thoughts in a person with OCD.
Can I have both ADHD and OCD?
OCD can be diagnosed with comorbid ADHD or related disorders. According to a study, the prevalence of OCD diagnosed with co occurring ADHD is 11.8% of individuals with OCD. Health care practitioners need to be cautious of an ADHD dual diagnosis misdiagnosis.
Is OCD a form of autism?
No, OCD is not related to autism, although both disorders are thought to be based on abnormal brain development and neurodivergent brain functions.
How is an OCD brain different from a normal brain?
Brains of people with OCD have been shown to be more active in certain regions, leading to an exaggerated response to perceived threats.
Does OCD get worse with age?
OCD symptom severity does not necessarily worsen with age. While some people see their OCD symptoms stay the same or lessen, especially if receiving effective treatment, others might see more severe symptoms with age. How people experience OCD as they age can depend on adult patterns of behavior, treatment efficacy, life stressors, and personality.
Is ADHD curable?
No, ADHD is not curable. However, ADHD can be managed with the right treatment. It is best to treat ADHD with a mix of psychotherapy and stimulant medications.
ADHD is a neurodevelopmental disorder often characterized by lack of impulse control leading to impulsive behaviors and sometimes risky behaviors.
Can OCD be cured?
No, OCD cannot be cured, but OCD can be managed with the right therapy and medications. Therapy may include response prevention, where a person is supported to deliberately not engage in a ritual behavior after experiencing a certain stimulus. Oftentimes selective serotonin reuptake inhibitors (SSRIs) are used to treat OCD.
Is ADHD on the autism spectrum?
ADHD and autism are very different disorders, although both disorders are based on neurodivergent brain functions.
What does OCD look like?
People with OCD often experience unwanted thoughts and/or OCD obsessions. The primary symptoms of OCD behavior include mental acts (compulsive thoughts or internal rituals) and behavioral compulsive rituals. The American Psychiatric Association answers basic questions about OCD and related disorders like ADHD.
Is ADHD medication good for OCD?
In a few cases ADHD medication might be good for someone with OCD, but in general it is not considered good for OCD. The stimulant medication can make people hyperfocus on repetitive thoughts or obsessive intrusive thoughts.
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