Obsessive-compulsive disorder (OCD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are two different mental health conditions that affect many people worldwide, yet they can cause some confusion due to overlapping symptoms. While one features intrusive thoughts and repetitive behaviors, the other presents difficulties with attention, impulsivity, and hyperactivity. Both disorders, however, can wreak havoc in multiple areas of a person’s life, including their work, relationships, and social obligations.
Here’s an in-depth look at OCD vs. ADHD, their symptoms, and how each condition is treated.
Obsessive-compulsive disorder is a mental health condition that involves recurrent behaviors and mental acts that an individual feels driven to perform. These behaviors are done to reduce the anxiety that’s related to intrusive thoughts or to prevent perceived negative outcomes. OCD can have an overwhelming impact on a person’s everyday responsibilities and social interactions.
OCD is categorized into various subtypes due to its ability to present in different ways depending on the person. The primary subtypes include:
OCD symptoms can be broken down into obsessions and compulsions. Obsessions are intrusive recurring thoughts, images, or urges that cause significant distress or anxiety. These thoughts are persistent and irrational, taking over a person’s mental space despite efforts to ignore or suppress them. Common obsessions include:
Compulsions, on the other hand, are repetitive behaviors or mental acts that a person feels compelled to do in response to an obsession. While these behaviors are done to help reduce anxiety or ease fears related to obsessions, relief is temporary, which perpetuates a cycle. Common compulsions include:
These compulsions can become so demanding that they consume hours of the person’s day.
Attention-Deficit/Hyperactivity Disorder is a neurodevelopmental disorder that typically begins in childhood and can continue into adulthood. This disorder can present in three different ways: Predominantly Hyperactive-Impulsive Presentation, Predominantly Inattentive Presentation, and Combined Presentation, which features symptoms of both of the other two types.
ADHD symptoms are categorized into three main types: inattention, hyperactivity, and impulsivity. Here’s a breakdown of how symptoms might look in each of these categories:
Inattention:
Hyperactivity:
Impulsivity:
These symptoms can not only vary depending on the person, but they can also present differently in adults and children. In children, hyperactivity is more pronounced, while adults may experience more subtle symptoms. For example, a child with hyperactive symptoms might constantly climb and move around instead of staying seated, whereas an adult might simply feel restless while doing tasks that require sitting for long periods.
Diagnosing OCD and ADHD is a multi-step process as there is no single test to diagnose these disorders. Their symptoms can mimic other mental health conditions, and there’s a possibility that a patient with OCD or ADHD may have other mental health issues, such as depression or anxiety. To ensure they give patients a proper diagnosis, doctors will:
While OCD and ADHD share some common features like familial links, disturbances in attention, and executive function issues, they are each their own disorder with unique characteristics. Here’s a closer look:
In OCD, there’s typically a ramp-up in activity within the brain’s fronto-striatal regions. This hyperactivity is tied to the intrusive thoughts that define the disorder. On the other hand, ADHD shows underactivity in these same areas. This can negatively affect one’s ability to maintain attention and control their impulses.
When it comes to behavior, those with ADHD partake in spontaneous actions that seem to happen without much thought, like blurting out an answer in class. This impulsiveness can make staying focused or following through on tasks really challenging.
In contrast, OCD involves very deliberate actions. These compulsions, like excessive hand washing, are attempts to soothe anxiety. Although both disorders involve repetitive behaviors, the nature and intent behind them are different.
Since each disorder is different in terms of how the brain is affected, treatment will look a little different in some ways. However, therapy, medication, or a combination of both is typically prescribed for the treatment of each.
For OCD, the first line of pharmacotherapy is selective serotonin reuptake inhibitors (SSRIs). These medications target the serotonin system in the brain, specifically the fronto-striatal circuits which are overactive in OCD. If SSRIs don’t fully alleviate symptoms, doctors may add antipsychotics.
Exposure and Response Prevention (ERP) is a type of cognitive behavioral therapy (CBT) that exposes patients to their fear triggers in a controlled environment. This teaches them strategies and ways to refrain from doing compulsive behaviors. Studies have shown that between 42-52% of patients see symptom improvement with ERP therapy.
In addition to therapy and medication, regular exercise, adequate sleep, and mindfulness practices like meditation can help improve symptoms. Mindfulness practices, especially, teach individuals to observe their thoughts without judgement and have been shown to reduce obsessions and compulsions seen in OCD.
Treatment for ADHD may include FDA-approved medications like methylphenidate or amphetamine. New and repurposed drugs are also continually being evaluated in clinical trials. Besides pharmaceuticals, non-medication treatments like CBT, neurofeedback, and cognitive training have been shown to be effective in managing ADHD symptoms.
Physical activities and dietary changes may also help. Eliminating artificial food colors and supplementing with free fatty acids have been shown to reduce ADHD symptoms. Additionally, social skills training may be beneficial for children and adolescents to teach them how to handle various social interactions.
Transcranial magnetic stimulation (TMS) uses magnetic fields to stimulate nerve cells in the brain areas that are related to mood regulation and cognitive control. For OCD, targeting the dorsolateral prefrontal cortex (DLPFC) on the right side of the brain has proven to be effective in reducing symptoms.
In ADHD, TMS has shown potential in improving cognitive functions like attention and processing speed by stimulating the right prefrontal cortex. TMS treatments are especially helpful for those who do not respond well to traditional treatments like medications.
Yes, it is possible to have both OCD and ADHD at the same time. Studies that have looked at the prevalence of OCD in adults with ADHD suggest rates from 1% to 13%.
Treating comorbid OCD and ADHD can be complicated. Medications used for ADHD, such as stimulants, are not effective in managing OCD symptoms, and treatments for OCD, like SSRIs, do not address the core symptoms of ADHD. Despite this, it is generally recommended to treat both disorders simultaneously.
Whether you have OCD, ADHD, or a combination of both, help is available. Here at Cura Behavioral Health, we specialize in evidence-based treatments and personalized care for a wide range of mental health conditions. Our team is here to guide you through diagnosis and develop a treatment plan that’s right for you. If you’re ready to take the next step, contact us today.
Determining if TMS therapy suits your mental health journey should involve consultation with a qualified professional. At Cura Behavioral Health, we provide comprehensive assessments to help you make informed treatment decisions.
Don’t let a mental health condition hold you back any longer. Schedule a consultation with Cura Behavioral Health today. Our experienced team is ready to answer your questions and create a personalized treatment plan tailored to your unique needs.
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Dr. Kevin Simonson, an esteemed Medical Director at Cura Behavioral Health, brings over 15 years of experience in psychiatry. A graduate from a top medical school, he specializes in the treatment of mood disorders and anxiety, employing a patient-centered approach. His dedication to evidence-based care and his commitment to advancing mental health practices have made him a respected figure in the field. Dr. Simonson’s leadership ensures the highest standard of care for the community at Cura Behavioral Health.
