The Overlap Between OCD and ADHD
Research indicates that obsessive-compulsive disorder (OCD) and attention-deficit hyperactivity disorder (ADHD) frequently co-occur, with studies suggesting that up to 30% of people with OCD also have ADHD (Abramovitch et al., 2015). While these conditions have different diagnostic criteria, they share some overlapping features that can complicate diagnosis and treatment.
Signs of OCD and ADHD
OCD is characterized by persistent, unwanted, and intrusive thoughts (obsessions), along with repetitive behaviors or mental acts (compulsions) aimed at reducing anxiety or distress produced by those intrusive thoughts. Common obsessions include fears of contamination, disorder, harm, or asymmetry, while compulsions might involve excessive cleaning, checking, or organizing. A child’s compulsions often provide limited or no relief from their obsessions, increasing the risk that the obsession/compulsion cycle will begin again.
In contrast, ADHD is marked by symptoms of inattention, hyperactivity, and impulsivity. Individuals with ADHD may struggle with sustaining attention, following through on tasks, and controlling impulses. These core symptoms can manifest in ways including forgetfulness, difficulty organizing activities, or fidgeting and restlessness.
Despite the differences in their diagnostic criteria, both OCD and ADHD can involve difficulties with executive functioning, such as planning, decision-making, and impulse control. This overlap can make it challenging to distinguish between the two conditions, particularly when they co-occur.
How OCD and ADHD Can Interact
When OCD and ADHD co-occur, the impulsivity and distractibility of ADHD can interfere with the ritualistic behaviors of OCD, leading to increased frustration and anxiety. Conversely, the obsessive thoughts and compulsive behaviors of OCD can consume time and attention, which can worsen the focus and organizational challenges experienced by a person with ADHD.
Children with both conditions might find it particularly challenging to complete tasks, manage time, and maintain attention. This can impact academic performance, family and social relationships, and daily functioning, creating a cycle of stress and difficulty.
Treatments and Therapies for OCD and ADHD
A comprehensive, individualized approach can effectively support those with both OCD and ADHD. Here are some treatments and therapies that may help:
Cognitive-Behavioral Therapy (CBT): CBT is an evidence-based intervention for both OCD and ADHD. For OCD, a specific form of CBT called exposure and response prevention (ERP) is used to help children confront and manage their obsessions and compulsions. For ADHD, CBT can help improve organizational skills, time management, and impulse control (Szymanski & Henin, 2021).
Medication Management: Medications can be effective in managing symptoms of both OCD and ADHD. Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for OCD, while stimulant medications are often used to treat ADHD. A qualified healthcare professional can help to identify the right combination and dosage for each person (Bloch et al., 2009).
Behavioral Interventions: Behavioral strategies can help manage the symptoms of both conditions. For example, establishing structured routines, using visual schedules, and breaking tasks into smaller, more manageable steps can be beneficial for children with OCD and ADHD.
Support Groups and Education: Support groups can provide a sense of community and understanding for children and families living with OCD and ADHD. Additionally, educational materials can empower families to advocate for appropriate care and accommodations for their children.
Navigating life with co-occurring OCD and ADHD can be complex, but with the proper personalized strategies and support, families can help children manage their symptoms and thrive.
Sources:
Abramovitch, A., Dar, R., Mittelman, A., & Wilhelm, S. (2015). Comorbidity Between Attention Deficit/Hyperactivity Disorder and Obsessive-Compulsive Disorder Across the Lifespan: A Systematic and Critical Review. Harvard Review of Psychiatry, 23(4), 245-262. doi: 10.1097/HRP.0000000000000050
Bloch, M. H., McGuire, J., Landeros-Weisenberger, A., Leckman, J. F., & Pittenger, C. (2009). Meta-analysis of the dose-response relationship of SSRI in obsessive-compulsive disorder. Molecular Psychiatry, 15(8), 850-855. doi: 10.1038/mp.2009.50
Szymanski, J., & Henin, A. (2021). Cognitive-Behavioral Therapy for OCD and ADHD. Journal of Cognitive Psychotherapy, 35(2), 97-111. doi: 10.1891/0889-8391.35.2.97
