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Friday, 28 Aug 2020

ADHD and OCD: When Do They Co-Occur and How to Tell Them Apart

By Dr Becky Spelman
How to Tell Apart ADHD and OCD? | Private Therapy Clinic

Although you might not associate attention-deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD) as being related to one another, they are both categorised as being neuropsychiatric disorders. Because of this and the fact that there is often so much ‘overlap’ between conditions, it can sometimes be hard to make an accurate diagnosis.

This is especially true in the case of ADHD, as around thirty to fifty per cent of individual’s who suffer from the condition also present signs of learning disabilities, anxiety, anger and of course, OCD. If each of these conditions is to be managed and properly treated, it’s vital that they’re identified so the individual can receive the appropriate care.

ADHD Overview

Symptoms of ADHD tend to vary from person to person, as they are multiple types of ADHD that can also present differing manners. It’s also important to remember that ADHD isn’t a static condition; it can change with the person as they mature. So a child who receives a diagnosis will likely have a vastly different set of symptoms later on in adulthood. These can also be affected by the situation or environment the person is in, gender, and also increase in intensity during times of stress. There are, in fact, three main types of ADHD which are:

  • Predominantly inattentive
  • Predominantly hyperactive-impulsive
  • Inattentive and hyperactive-impulsive combined

Inattentive ADHD

For those people who fall with this category of the spectrum, they will often find it difficult remaining focused on tasks which might be perceived as mundane. This means that when they’re required to engage in work that demands their mental energy, their mind will wander. They’ll procrastinate and find themselves easily distracted by their environment, jump from one task to another and getting bored of them quite easily. They may seem forgetful like they’re living in their own world and often-times like they’re not listening when speaking with someone.

Hyperactive-Impulsive ADHD

When people think of ADHD, this is the variation that most often comes to mind, partly because it so often portrayed in media. Individuals who fall into this category have excessive levels of energy that they must use up, which can present either as a tendency to speak incessantly or else as the need to physically move their body. But however this hyperactivity manifests, it promotes a constant state of inertia. This person will have a hard time sitting still and will readjust their position and fidget involuntary.

OCD Overview

“OCD is a neurological disorder that is characterised by recurrent and unwanted thoughts (obsessions) and/or repetitive behaviours.” It an internalising disorder, which means those who suffer from it will take on anxiety that’s produced by their environment and turn it inwards. Generally speaking, those with OCD tend to exhibit a more inhibited temperament and will go out of their way to avoid situations that may place them in harm. Another defining factor is that people with OCD tend to be concerned with the consequences of their actions, which also feeds into this sense of inhibition.

Obsessions

Obsessions are characterised as unwanted thoughts, images, beliefs or any other thought-constructs that will present themselves persistently causing the person extreme levels of distress. This is due to the fact that these mental processes are simply out of the experiencer’s control. And it’s this inability to regulate their own thoughts that can lead to heightened states of anxiety. This can be even further exacerbated if the individual is cognizant of their obsessions. The fact they recognise this short-coming yet are unable to do anything about it can add their anxiety.

Compulsions

Compulsions, on the other hand, are associated with the behaviour of an individual. These are the self-created habits that someone feels an intense drive to complete in order to maintain a sense of order in their life. They are often carried out repeatedly and will cause great distress if these behaviours or rituals aren’t able to be carried out. It can lead to extreme debilitation, as the affected person must carry out these tasks. Some of the most common include cleaning, counting, checking, organising and hand washing. 

How and When Do ADHD & OCD Co-Occur with One Another?

It’s actually not uncommon for someone to have a combined diagnosis of both ADHD and OCD. In fact, comorbidity between ADHD and OCD has been found to have a co-occurrence rate ranging between 25% – 50%. As we mentioned in the beginning, since both are neurological disorders acting on the same part of the brain, there can be some cross-over between how symptoms present in both conditions. The way that OCD can manifest in those with ADHD is by acting as a coping mechanism and/or strategy to help be more efficient in their day-to-day tasks. So, for example, a child who has difficulty getting organised may spend an excessive amount of time arranging and planning their workflow so they can get be productive. And while this is obviously a proactive way of trying to manage the issue, it can lead to an over-reliance on these behaviours which can become entrenched habits – obsessive and compulsive.

Treatment

It’s not unusual for those with ADHD to have co-occurring disorders such as anxiety and OCD. It should be noted that those who have both problems with low dopamine and/or norepinephrine, as well as high levels of serotonin, may have both ADHD and OCD. When this is the case, it’s important to know that both conditions will need to be treated separately. Unfortunately, there is no a one-purpose fits all therapeutic approach that can speed up this process. It will take time and patience. But recovery can absolutely be accomplished. You should also be aware that stimulant medications have often been known to exacerbate OCD symptoms. And so a general recommendation in a case of dual diagnosis where you’re suffering from both ADHD and OCD is that you’d treat the OCD first. This would then open up the possibility of using certain medications should the need arise.

About the author:

Dr Becky Spelman is a leading UK Psychologist who’s had great success helping her clients manage and overcome a multitude of mental illnesses.

***If you’re struggling confused about whether you’re suffering from ADHD or OCDand think you might benefit from speaking to someone, we offer a FREE 15-MINUTE CONSULTATION with one of our specialists to help you find the best way to move forward. You can book yours here

References

Internal OCD Foundation. (2013)Is It BPD or cPTSD?Retrieved on 20thJuly, 2020 from, https://iocdf.org/expert-opinions/expert-opinion-ocd-and-adhd-dual-diagnosis-misdiagnosis-and-the-cognitive-cost-of-obsessions/#:~:text=Individuals%20with%20ADHD%20may%20exhibit,producing%20environments%20by%20turning%20inward.

Very Well Mind. (16thApr 2020)How OCD and ADHD Similarities Can Cause Misdiagnosis. Retrieved on 20th July, 2020 from, https://www.verywellmind.com/ocd-and-adhd-2510596

ADDitude. (16thApr 2020)OCD and ADHD: The Polar Opposites That Are Not. Retrieved on 20th July, 2020 from, https://www.additudemag.com/ocd-and-adhd-are-the-polar-opposites-that-are-not/

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