Obsessive-Compulsive Disorder (OCD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are two distinct mental health conditions that often present similarly, as both disorders impact focus, routine, and impulse control.
ADHD is characterized by chronic inattention, hyperactivity, and impulsivity that disrupt daily functioning, while OCD includes intrusive obsessions and compulsive rituals driven by intense anxiety and the need for certainty.
Up to 30% of individuals with ADHD also meet criteria for OCD, often caused by shared genetic factors, which can complicate diagnosis and treatment [1]. Read on to learn more about each disorder, their overlap, and the importance of accurate diagnosis.
What is OCD?
Obsessive-Compulsive Disorder (OCD) is characterized by obsessions and compulsions. Obsessions are recurrent, intrusive, and distressing thoughts that often create intense anxiety.
These thoughts cause the individual to engage in compulsions (rituals or behaviors) which attempt to “neutralize” the anxiety associated with the obsessions. OCD is the fourth most common mental health disorder, affecting around 3% of the entire population, with symptoms typically emerging during childhood or adolescence [2].
Common Symptoms of OCD
Obsessive and intrusive thoughts tend to cluster around certain themes. Common obsessions include:
- Worries about leaving appliances on or doors unlocked.
- Fear of acting in shameful or humiliating ways.
- Discomfort with things out of order.
- Intrusive sexual imagery.
- Hypochondriac or health anxiety.
- Excessive religious thoughts, guilt, shame, or concerns about purity.
Common compulsions include:
- Excessive cleaning or handwashing
- Checking doors, locks, and appliances repeatedly
- Arranging or rearranging things in particular orders
- Hoarding
- Using prayer or chants to prevent bad things from happening
What is ADHD?
Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by executive dysfunction in the brain, primarily affecting attention, impulse control, and energy regulation. It causes persistent patterns of inattention, hyperactivity, and impulsivity that interfere with daily functioning, often appearing in early childhood.
ADHD impacts millions worldwide, with recent 2025 estimates indicating about 16 million U.S. adults are diagnosed. It often emerges early due to genetic, environmental, and neurological factors and can heighten risks for co-occurring issues like substance abuse, depression, or anxiety [3].
Common Symptoms of ADHD
- Inattention
- Fidgeting or restlessness
- Hyperactivity
- Impulsivity
- Disorganization
- Forgetfulness
- Jumping quickly between tasks or topics
Co-Occurrence of OCD and ADHD
ADHD is the most common co-occurring condition among early-onset OCD, affecting around 10% to 25% of individuals. One study found that 11% of OCD participants also met criteria for ADHD, and those with ADHD were 41% more likely to have a hoarding disorder (a kind of obsessive-compulsive and related disorder) [1].
Other studies in children and teens with OCD found that nearly 25% had co-occurring ADHD. Experts cite strong genetic links between the two, where relatives affected by ADHD had an increasingly high risk for OCD compared to relatives without [4].
Overlapping Traits of OCD and ADHD
OCD and ADHD have several overlapping traits and, to the untrained eye, can often resemble each other, making it hard to distinguish between the two.
Work and School Difficulties
Both conditions affect daily functioning, such as work attendance, organization, and task completion. In ADHD, this is often due to executive functioning problems such as regulating attention and time blindness (keeping track of time).
For OCD, this is often due to spending excessive time (more than 1 hour a day) completing compulsions or ruminating on obsessions.
Sensory Difficulties
Studies show that children with OCD have an increased intolerance to sensory stimuli and sensory processing sensitivities [5]. This is similar in ADHD individuals, who often struggle with sensory overresponsivity (being easily overwhelmed by sounds, textures, lights, or clothing).
Intrusive Thoughts
In OCD, intrusive thoughts form the core of obsessions that lead to high anxiety and compulsive behaviors for relief. ADHD individuals also experience frequent intrusive thoughts, often manifesting as mental “noise,” or mind-wandering that impacts focus.
Unlike OCD, intrusive thoughts with ADHD are usually random ideas or distractions, less anxiety-provoking, and linked to executive function challenges rather than fear-driven avoidance [6].
Attention
Both conditions impact a person’s ability to hold attention and concentrate. ADHD individuals often appear distracted or restless due to deficits in dopamine and underactivity in the prefrontal cortex region of the brain.
In OCD, intrusive thoughts and distress can make it hard to focus on anything else. People with OCD often become preoccupied with obsessions or compulsions, making it difficult to focus and pay attention.
Mood Disorders and Self-Harm
Both conditions have high rates of co-occurring anxiety and depression, and are linked to behaviors such as self-harm. Women with ADHD are at an increased risk for self-harm due to a lack of impulse control and emotional dysregulation. People with OCD are also at an increased risk of self-harm, either as a response to OCD distress or a subtype of OCD (Harm OCD).
Sleep
Both of these disorders are associated with sleep challenges, with around 70% of OCD individuals reporting sleep difficulties and 25% to 50% of people with ADHD struggling with sleep issues such as insomnia, restless leg syndrome, narcolepsy, and sleep-disordered breathing, such as sleep apnea [7].
Body Focused Behaviors
Skin-picking and hair-pulling are associated with OCD and classified as an obsessive-compulsive-related disorder, but also occur in individuals with ADHD due to anxiety, sensory stimulation, and impulsivity.
Studies suggest that decreasing impulsivity and increasing attention (through medication) may help with ADHD skin-picking, while OCD often requires specialized CBT therapy to address and break compulsions [8].
Spotting the Difference Between OCD and ADHD
Accurate diagnosis requires a formal screening by a mental health professional, however, two key differences to look for are:
1) Level of impulsivity. Those with ADHD are more likely to be sensory/thrill-seeking and risk-taking.
2) Examine the function of behaviors. In OCD, compulsive behaviors serve to reduce the obsession, while behavior in ADHD individuals is due to chemical or structural differences in the brain and hyperactivity/restlessness.
How Are OCD and ADHD Treated?
OCD focuses on breaking anxiety-driven obsession-compulsion cycles, while ADHD targets executive function deficits like inattention and impulsivity. OCD’s gold-standard therapy, Exposure and Response Prevention (ERP), directly confronts fears without completing mental or physical rituals. ERP is often paired with antidepressant medication to reduce the intensity of obsessive thoughts.
ADHD treatments focus on stimulation and structure, using medication to increase dopamine for focus, alongside behavioral therapy.
OCD Treatments
- ERP (Exposure and Response Prevention): Gradually faces obsessions without compulsions to relieve anxiety.
- SSRIs Antidepressants: Increase serotonin to lessen obsession frequency and severity.
ADHD Treatments
- Stimulants: Increase focus and impulse control via dopamine/norepinephrine.
- Behavioral skills training: Builds organization, time management, and routines through therapy, coaching, or parent training (for kids and teens).
OCD and ADHD Treatment at Maple Mountain
At Maple Mountain Mental Health and Wellness, our compassionate team of clinical psychiatrists and experienced therapists provides evidence-based treatments for both OCD and ADHD. Our licensed mental health team prioritizes your well-being and safety throughout the therapeutic process.
Through a holistic, blended approach, we address each aspect of your health and recovery needs to support long-term healing. Reach out today for an evaluation.
Sources
[1] Smith, R. (2025). Untangling the Threads: The Impact of Co-Occurring OCD and ADHD Symptoms for Black and/or Latiné Youth. Children (Basel, Switzerland), 12(6), 674.
[2] Brock, H. et al. 2024. Obsessive-Compulsive Disorder. StatsPearl Publishing.
[3]Kumminimana, R. (2025). Attention-deficit/hyperactivity disorder: insights, advances and challenges in research and practice. Postepy psychiatrii neurologii, 34(3), 196–206.
[4] Wergeland, G. et al. 2025. Psychiatric comorbidity in children and adolescents with ADHD: A systematic review and meta-analysis. Clinical Psychology Review.
[5] Carmeli, R. et al. (2012). The relationship between sensory processing, childhood rituals and obsessive-compulsive symptoms. Journal of behavior therapy and experimental psychiatry, 43(1), 679–684.
[6] Schweiger, A. (2009). Unwanted intrusive and worrisome thoughts in adults with Attention Deficit\Hyperactivity Disorder. Psychiatry research, 168(3), 230–233.
[7] Kvale, G. (2018). Sleep disturbances in treatment-seeking OCD patients: Changes after concentrated exposure treatment. Scandinavian journal of psychology, 59(2), 186–191.
[8] Nazar, B. P. (2018). Skin picking disorder comorbid with ADHD successfully treated with methylphenidate. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999), 40(1), 111.
