ADHD and OCD: Differences, Similarities, and Living With Both

ADHD and OCD are different conditions, yet they can look similar at times because they affect some of the same brain systems. In this post, we explore what the ADHD-OCD overlap is, how the drivers behind OCD and ADHD behaviours differ, and what it’s like to live with both.

What is ADHD?

ADHD is a neurodevelopmental condition that creates issues with inattention, hyperactivity, and impulsivity. There isn’t a single “ADHD presentation” that’s the same for everyone – different combinations of traits appear in different individuals. For example, some people with ADHD may have more inattentive traits, while others may be more hyperactive.

ADHD is a disorder of executive function. This means people with ADHD find it harder to self-regulate, plan, prioritise, and manage time.

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In the workplace, ADHD may present as:

  • Executive Dysfunction: Difficulty initiating tasks, organising workloads, or following multi-step instructions.
  • Time Blindness: Not knowing how long things take, leading to chronic lateness or missed deadlines.
  • Emotional Dysregulation: Heightened sensitivity to stress or frustration, often referred to as Rejection Sensitive Dysphoria (RSD).

You can find out more about ADHD at work in our blog: A Guide to ADHD in the Workplace.

What is OCD?

OCD is a mental health condition characterised by a cycle of obsessions and compulsions. In  OCD, obsessions are intrusive thoughts or images that cause significant anxiety, while compulsions are the repetitive physical or mental acts people use to try to reduce the anxiety or prevent bad things from happening.

In the workplace, OCD can manifest as:

  • Never-ending Doubt: The persistent feeling that a task is incomplete or incorrect, leading to excessive re-checking.
  • Mental Rumination: Becoming stuck on a specific worry or ethical concern, which feels all-consuming.
  • Rigid Need for Symmetry or Exactness: The need for things to be “just right” before a task can be moved past.

ADHD and OCD: How They Differ

Although ADHD and OCD can create behaviours that look similar, the reasons behind them are different in each condition. We can better understand the difference by looking at the brain’s inhibitory control. This is how easy it is for someone to pause and override an unhelpful thought or response. 

Decision Making

When it comes to decision-making, people with ADHD often struggle with decision paralysis due to too much external stimuli. The brain may jump to a conclusion impulsively to end the discomfort of choice.

In OCD, it’s less about decision paralysis and more about doubting the decision. OCD brains can get stuck in a loop of “what if”, requiring 100% certainty before proceeding.

Risk Taking

In ADHD, there’s often a reduced sensitivity to risk because the brain prioritises immediate dopamine rewards over long-term consequences.

In OCD, it tends to be the opposite. There’s often an aversion to risk. This causes the brain to become hyper-vigilant, scanning for potential errors or threats to prevent harm.

Difficulty Completing Tasks

For people with ADHD, tasks may remain unfinished due to distraction or boredom. Once the initial novelty wears off, the executive system struggles to maintain momentum.

In OCD, this delay in completing tasks is more likely due to perfectionism. An individual may become stuck on a single detail, unable to move forward until it feels “just right”.

ADHD and OCD Overlapping Traits

Despite their differences, both ADHD and OCD involve the frontostriatal circuits. These are the areas of the brain responsible for planning and switching attention. This creates shared traits, such as:

  • Inattention: A person with ADHD may be distracted by external stimuli, while a person with OCD is distracted by internal intrusive thoughts.
  • Procrastination: Both conditions can lead to task avoidance, though for different reasons (overwhelm vs. anxiety).
  • Fatigue: The mental effort required to navigate either condition often leads to significant cognitive exhaustion by the end of the working day.

To the untrained eye, these traits can look similar. That’s why it’s so important to seek professional help if you’re struggling to understand your own behavioural patterns.

Living with both ADHD and OCD

It’s hard to say for sure how many people with ADHD also have OCD; however, research suggests that comorbidity lies somewhere between 11.8% and 30%.

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If you’re living with both OCD and ADHD, it can create a confusing, contradictory internal experience. For example, you may feel impulsive due to ADHD, yet simultaneously feel a need to be rigid and check things for safety. 

In the workplace, this can lead to masking behaviours, such as leaning on OCD-related checking to compensate for ADHD-related forgetfulness or over‑structuring your workflow to counteract ADHD‑related disorganisation. While this may initially result in high-quality work, it carries a high risk of burnout due to the intense psychological pressure involved. This is why it’s so important to get support from someone you trust, who can help you find strategies to cope.

FAQs

Can you have ADHD and OCD at the same time?

Yes. You can have ADHD and OCD at the same time. When a person has both, symptoms can sometimes mask each other, making the diagnosis more complex. Specialists often look at the motivation behind a behaviour (e.g. seeking a reward vs. avoiding a threat) to distinguish between the two.

Are ADHD and OCD considered disabilities in the UK?

Not automatically; however, both ADHD and OCD can be classed as disabilities under the Equality Act 2010 if they have a substantial and long-term effect on a person’s ability to carry out normal day-to-day activities. 

How are comorbid ADHD and OCD managed?

Managing comorbid OCD and ADHD usually involves psychological therapy (such as Cognitive Behavioural Therapy) and, in some cases, medication. However, stimulants used for ADHD can sometimes exacerbate the anxiety symptoms of OCD, so a personalised approach is usually recommended.

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What support is available in the workplace?

Individuals with neurodivergence and/or long-term mental health conditions are entitled to reasonable adjustments in the workplace. This may include assistive technology to aid with executive functioning, environmental changes to manage sensory overload, and communication adjustments to create clarity. Some workplaces may also provide employees with counselling via Employee Assistance Programmes

Dr. Richard Purcell

Rich is one of the Founders and Directors here at CareScribe. Rich has a passion for healthcare and assistive technology and has been innovating in this space for the last decade, developing market leading assistive technology that’s changing the lives of clients around the globe.

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