Raising Awareness of Co-occurring OCD and ADHD

By Jonathan Hoffman, Ph.D., ABPP

OCD Awareness Week was celebrated the week of October 8-14, 2023. October also happens to be ADHD Awareness Month. As far as I know, however, there is nothing on the calendar set aside to increase awareness of OCD and ADHD as co-occurring conditions. But maybe there should be.

The intersection of obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD) is well-trafficked and needs to be approached with as much knowledge as possible. While we do not have a great statistic for how many people have both OCD and ADHD, it is definitively not uncommon. Unfortunately, it seems that OCD accompanied by ADHD is associated with more severe and persistent OCD symptoms.

At first, it might seem like OCD and ADHD are an odd couple. However, it starts to make more sense if you think of these conditions as sharing an underlying dimension covering the spectrum from compulsiveness and harm avoidance at one end to impulsivity and risk-proneness at the other end. Some experts suggest that OCD and ADHD have much in common genetically and neurobiological, and difficulties in executive functioning may be found in both populations. Interestingly, many people with OCD have uncharacteristic moments of random impulsivity and those with ADHD might be surprisingly perfectionistic in certain respects.

Having ADHD complicates the understanding and treatment of OCD, and vice versa. It is also easy to mistake one condition for the other. Even highly skilled clinicians can have difficulty differentiating when OCD symptoms per se are compromising attention versus when a separate ADHD diagnosis is warranted. Importantly, failure to diagnose or treat ADHD effectively is often a reason why OCD treatment is not working. Therefore, screening for ADHD in those diagnosed with OCD and the other way around would be the ideal.

Finding the right medication approach for individuals with OCD and ADHD can be tricky business, so working with a prescriber who is familiar with the intricacies is always a good idea, especially because other diagnoses, such as tic disorders, are often present and require thoughtful consideration as well. Healthy lifestyles in terms of getting enough sleep, exercising regularly, eating nutritious meals, and avoiding alcohol and other substances can also make a big difference regarding a person’s ability to overcome this dual challenge.

In mental health conditions, having more than one disorder can be daunting, but since it is very common, do not be discouraged if this is what you or someone you love is dealing with. Early intervention is always advantageous, but it’s never too late to seek help, even for adults. Recognizing the difficulties that many encounter in accessing resources, it is essential to keep trying to find effective treatment. Great resources to learn more about the OCD-ADHD connection and its treatment include iocdf.org and CHADD.org. You can learn more about services available for OCD/ADHD at NBI at nbiweston.com.