ADHD and OCD

A fellow ADHDer asked me some great questions about ADHD and OCD and whether they’re related. I’m not sure I’m the authority on ADHD (despite having it myself) but I’ll do my best explaining how I understand it.

OCD and ADHD have some overlapping symptoms. Psychomotor agitation, repetitive beahviors, obsessive thinking, and deficits in flexibility of attention are hallmarks of both. But to me, they seem to function differently.

Folks with OCD are distractible because they are in a cycle of intrusions/obsessions, compulsions/safety behaviors, and environmental triggers that send them back into the OCD cycle. ADHDers also have a lack of flexibility of attention but when hyper focus is happening, it’s subject is often enjoyable and during hyper focus, my ADHDer clients report a sense of pleasurable flow. They keep coming back to the subject of fixation but it’s not unpleasant. Folks with OCD are focused on their internal psychological experience while ADHDers are focused on the thing in front of them.

Both ADHD and OCD can be frustrating to clients and loved ones because they can’t get the person’s attention on the thing they “ought” to be focusing on. But the ADHDers I’ve worked with are totally happy to stay in their state of hyper focus for as long as the environment allows whereas OCDers are distressed.

FINALLY - I like to think of ADHD as a normal variation in how brains work. ADHDers have inflexible attention that can impact their ability to navigate a neurotypical world but it’s not a dysfunction if the right accommodations are provided. ADHDers thrive in the right environment when their strengths are leveraged. In contrast, no amount of accommodation will help an OCD sufferer recover or do better over time. Their OCD cycle will continue until it’s broken through disengagement, which to me, makes it a target for treatment and an Axis I disorder as opposed to natural neurodiversity.