Exploring The Possible Connection Between ADHD And OCD

Medically reviewed by Andrea Brant, LMHC and Laura Angers Maddox, NCC, LPC
Updated October 30, 2024by BetterHelp Editorial Team

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 ADHD and OCD symptoms concurrently, and the abnormal neural activity that causes 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.

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Understanding Obsessive-Compulsive Disorder (OCD) Symptoms

People with obsessive-compulsive disorder (OCD) may 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. 

These two functions of OCD are called obsessions and compulsions. For example, a person might cope with the obsessive 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 obsessive-compulsive disorder (OCD)

  • 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:

  • 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

OCD and anxiety

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.

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Understanding attention-deficit/hyperactivity disorder (ADHD) symptoms

Attention deficit/hyperactivity disorder (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. People 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.

Attention-deficit/hyperactivity disorder (ADHD) symptoms

  • 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 ADHD and OCD?

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 may seem quite distinct from each other. However, the areas of functioning that are affected can be similar. Both OCD and ADHD 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: A link between OCD and ADHD

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 for ADHD and OCD treatment, cognitive behavioral therapy (CBT) is one modality that’s commonly recommended. 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.

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The treatment 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.

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