ADHD and OCD Comorbidity

Can You Have Both ADHD & OCD at the Same Time?

We’ve been talking a lot about ADHD and OCD lately, giving each their individual attention and addressing each as individual topics, and rightfully so. Any person who’s been diagnosed with either one can tell you that one of them on its own is plenty to manage for any one human. What about when one human is diagnosed with both ADHD and OCD, though? That’s what we’re here to talk about today. Read on to learn all about how ADHD and OCD are similar, how they’re different, and how managing the two is more doable than you may think.

What is ADHD?

As a recap from our recent article, High Functioning ADHD: Interview with Therapy Practice Owner, you may remember that here at Claibourne Counseling, we believe that ADHD is a superpower. ADHD is often a result of a childhood trauma response and/or a genetic predisposition. It can cause high levels of hyperactivity and impulsive behaviors, can be diagnosed in children or adults, and can present in three different types: predominantly inactive, predominantly hyperactive-impulsive, or combined hyperactive-impulsive.

What is OCD?

For a quick refresher on OCD, it’s comprised of obsessions and/or compulsions, as its name implies. An obsession is an urge or repetitive thought/image that persists and can cause anxiety and discomfort. Compulsions are actions that one takes to help reduce the anxiety – typically caused by the obsessive thoughts – such as counting, cleaning, or ordering things a particular way. So, obsession equals cause and compulsion equals effect. The DSM-5 recognizes 5 main categories of OCD: checking and harm, contamination, symmetry and ordering, rumination and intrusive thoughts, and hoarding. (Note that there are a lot of different symptoms for OCD, you can find a few of them described in this OCD/ERP blog.)

How are OCD and ADHD Similar?

When someone has two conditions at the same time, it’s called comorbidity. So, when a diagnosis of both ADHD and OCD are confirmed, then ADHD/OCD comorbidity exists. The overlapping symptoms could include things like:

adhd and ocd together

    • sleep issues (can present as either sleeping too much or too little)
    • attention and focus difficulties (including hyperfocus)
    • memory problems
    • sensory sensitivities (bright lights, loud noises, large crowds)
    • depression/anxiety-related symptoms
    • tics like skin-picking and hair-pulling
    • GI issues 

OCD and ADHD are both considered to be neuropsychiatric disorders with many overlapping symptoms, making it difficult to differentiate the two for an untrained eye. It’s also more common to have overlapping symptoms in children than it is in adults. Studies are inconsistent when it comes to rates of comorbidity, ranging from 0% to 60%. Because the symptoms can be so similar, it’s important for the clinician to focus on which condition comes first. Is it OCD with ADHD or is it ADHD with OCD? This makes a difference in how symptoms are managed.

Treatment of ADHD & OCD

Cognitive Behavioral Therapy is a common place to start when it comes to treating either OCD or ADHD, as well as OCD and ADHD. This method helps one become more aware of negative thinking loops so that they can respond to a situation in a better way by learning to cope with stressful situations.

There is no standard treatment for the comorbidity of ADHD and OCD. It depends entirely on the patient and the clinician. For ADHD, the therapist may find that sensory work helps along with supporting types of exposure therapy with OCD. This is where great communication and a strong therapeutic alliance come in.

Once the therapist has established the diagnosis and which condition (ADHD or OCD) is impacting the various symptoms in the given situations, the other modalities of therapy can be recommended. Identifying which symptoms are coming from which condition is the real key to successful treatment of ADHD and OCD comorbidity.

Individuals with these conditions have found great relief and balance when clinicians incorporate Exposure Response Therapy (ERP) and/or Eye Movement Desensitization & Response (EMDR) therapies into their treatment plans.

ADHD & OCD may even complement one another!

When ADHD becomes hyper-focused and OCD starts looping, with plenty of practice and understanding of where those looping thoughts come from, this can be where ADHD and OCD can be used to steady the ship together… It can be a delicate balance, just like a good recipe, too much or too little of one ingredient can ruin the whole thing. But with balanced amounts of hyperfocus and obsessive thoughts, a person can master these comorbidities. With a team and a lot of self-awareness, these individuals can be highly successful.

Do you think you may have one or both? Reach out to Claibourne Counseling today for a free consultation!

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