OCD and ADHD: Understanding the Differences and How They Overlap

nicolemarzt
Oct 17
3 min read

Obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD) are two conditions that, on the surface, seem almost opposite. ADHD often involves distractibility, impulsivity, and difficulty focusing, while OCD is characterized by themes of rigidity and compulsive rituals. Yet, these two conditions can and often do coexist.

ADHD symptoms and OCD symptoms often blur together, resulting in confusion or frustration. You may oscillate between feeling out of control and overly controlling, rotating between themes of chaos and perfectionism. That said, understanding where these two conditions differ and how they overlap can help you or your loved one find more clarity and the right support.

Understanding OCD

Obsessive-compulsive disorder is an anxiety-related condition marked by unwanted, intrusive thoughts (obsessions) and repetitive behaviors or mental rituals (compulsions) performed to relieve distress. Obsessive thoughts range in type and may include fears of contamination, losing control, harming others, or making mistakes. Compulsive behaviors often involve repetitive checking, cleaning, counting, or seeking reassurance.

OCD can be particularly distressing because people know their thoughts and behaviors are irrational. Yet, they feel powerless in stopping them. Engaging in compulsions offers temporary relief, but they also reinforce the anxiety symptoms, strengthening the OCD cycle.

It's important to hold that OCD maintains a sense of control and predictability in a world that can feel unsafe. OCD rituals help manage uncertainty or perceived threat, even if danger isn't actually present.

Understanding ADHD

ADHD is a neurodevelopmental disorder that affects attention, executive functioning, and impulse control. People with ADHD may struggle with organization, time management, emotional regulation, and follow-through.

Symptoms typically appear in childhood but often persist into adulthood, showing up as:

Difficulty sustaining attention or finishing tasks
Forgetfulness, misplaced items, or missed details
Impulsivity or “acting before thinking”
Inner restlessness or physical hyperactivity
Trouble prioritizing and maintaining routines

While ADHD is not rooted in anxiety, it's not uncommon for those with ADHD to experience chronic stress or shame. Over time, people with ADHD may internalize the belief that they’re lazy or incapable due to their brain processing information differently.

Key Differences Between OCD and ADHD

Although OCD and ADHD can share overlapping symptoms, the underlying motivations are distinct. As a broad stroke, OCD pulls focus toward control and prevention while ADHD scatters attention outward toward stimulation and distraction.

Understanding these differences can offer more clarity into each presentation:

Source of Behavior

OCD: Actions are rooted in fear or the need to neutralize distressing thoughts
ADHD: Actions are driven by impulse, novelty-seeking, or difficulty sustaining focus

Internal Experience

OCD: The mind feels “stuck," looping with intrusive thoughts and repetitive urges that can feel like an anxiety spiral
ADHD: The mind feels scattered or constantly jumping from one idea to another

Emotional Regulation

OCD: Individuals may feel anxious, hypervigilant, or trapped in mental rigidity
ADHD: Emotions tend to fluctuate quickly, often resulting in frustration or restlessness

Cognitive Patterns

OCD: People with OCD tend to focus on overcontrolling and overthinking. They default to double-checking or overanalyzing their decisions.
ADHD: Under-control and forgetfulness are common, and people may rush decisions or skip details entirely.

Co-Occurring ADHD and OCD

OCD and ADHD share important neurobiological and behavioral intersections. However, co-occurring OCD and ADHD can perpetuate a complicated inner conflict. ADHD brains crave stimulation and novelty, while the OCD brain seeks control and certainty. Therefore, it can feel like being pulled in opposite directions.

For example, ADHD executive dysfunction can exacerbate OCD symptoms around control and certainty. Both conditions may coincide with task paralysis, as ADHD shows up with disorganization, and OCD compulsions often come with perfectionism and fears of making mistakes. Furthermore, in both cases, it's common to struggle with emotion regulation.

When both conditions are present, getting an accurate diagnosis can be hard. Someone with

ADHD, for example, might appear to have obsessive thoughts when they're actually hyperfocusing. Or, someone with OCD obsessions may look inattentive because they're distracted by their intrusive thoughts.

This push-pull dynamic can lead to feelings of shame and self-criticism. You might question why you can’t “just focus” or “just stop worrying.” Without proper diagnosis and treatment, the emotional burden can be immense and may impact multiple areas of functioning.

ADHD and OCD Treatment at Resurface Group

At Resurface Group, we specialize in helping individuals navigate the complex intersection of neurodivergence, trauma, and mental health. Our integrative approach combines evidence-based therapies with lifestyle changes that promote lasting change. We are here to help you strengthen your distress tolerance and enhance your ability to function effectively in daily life.

You don’t have to manage these overlapping challenges alone. If you’re seeking clarity about your diagnosis and needing effective treatment, our team can help you build balance, confidence, and connection to both yourself and others.