Little girl with a dual diagnosis of ADHD and OCD uses headphones while on laptop.

If you are a parent and have noticed new or specific behaviors in your child, then you probably have done what most parents do in this situation; search Google for any possible answers before calling your physician. The internet can be an excellent resource for information when it comes to finding quick answers, especially if you are concerned about your child’s behavior. However, it’s important for parents to understand that many conditions or disorders share similar symptoms or behaviors, so although an online search can be a good first place to start, it’s always important to discuss behavioral changes or specific symptoms with your physician.

In the past, we have discussed the overlapping symptoms of such conditions as ADHD, social anxiety disorder, and Autism Spectrum Disorder (ASD). Due to the similarities between such conditions, there are often cases where a child may be misdiagnosed and is only correctly diagnosed after seeking second opinions due to ineffective treatment plans.

Today, we will discuss the similarities and differences between two additional disorders that are commonly misdiagnosed: attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD).

ADHD and OCD: What are They?

Attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD) are among the most commonly diagnosed neuropsychiatric disorders. Although each diagnosis is distinct with its own set of criteria, the two disorders also share several overlapping symptoms and behaviors. So before we dive into the similarities and differences between ADHD and OCD, let’s take a look at each of these conditions separately to define what each is and how symptoms can look on their own.

ADHD

Attention deficit hyperactivity disorder or as most people refer to it, ADHD, is one of the most common neurodevelopmental disorders in children. Most children diagnosed with ADHD are usually diagnosed at an early age when it becomes evident that their behavior is noticeably different from other children in their age group. The National Institute of Mental Health (NIMH) defines ADHD as a disorder marked by an ongoing pattern of inattention and hyperactivity-impulsivity that interferes with functioning or development. ADHD is usually treated through stimulant medications, behavioral therapy, or supplements & dietary intervention. Early signs can include:

  • Becoming easily distracted and having difficulty holding attention
  • Being unable to finish tasks due to loss of focus
  • Having difficulty with organization and time management
  • Avoiding tasks that require a prolonged mental effort
  • Appearing not to listen when others are speaking
  • Fidgeting and seeming unable to remain still
  • Finding it difficult to take turns in activities and conversations
  • Speaking and making noises excessively
  • Having difficulty being patient

OCD

OCD, as the name suggests, is defined as having obsessions and/or compulsions. Most individuals diagnosed with OCD are usually diagnosed in early adolescence, or before the age of 25. Treatment for OCD is usually through exposure and response prevention (ERP) or cognitive behavioral therapy (CBT). There is a lot of misinformation surrounding OCD, but we will take a look at both parts of the disorder for a better understanding.

  • Obsessions can include recurrent behaviors and impulses that are experienced as intrusive and inappropriate thoughts or visions. Because these behaviors, thoughts , impulses cannot be controlled, they can cause a great sense of anxiety or distress to an individual.  Other hallmark symptoms of OCD obsession include: 
    • Thoughts, impulses, and mental images are not simply excessive worries about real-life problems
    • The individual often attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action
    • The individual recognizes that the obsessive thoughts, impulses, or images are a product of their own mind (not imposed from without as in thought insertion)
  • Compulsions can be experienced on their own but can also be an extension of obsessive behaviors. They can be defined as repetitious, purposeful physical or mental actions that the individual feels compelled to engage in according to their own strict rules or in a stereotyped manner. Other hallmark symptoms of compulsions include:
    • Counting or repeating: the need to touch something a certain number of times or the need to repeat a specific behavior or pattern of behaviors
    • The need to check and recheck something. For example, whether the stove is off, the car keys are on the key rack, the closet light is off
    • Cleaning and washing: the need to lather and rinse an exact number of times in the shower or to brush one’s hair a certain number of times in a pattern

    Similarities & Differences of ADHD and OCD

    As you can see, there are many differences between the symptoms and characteristics of each condition when you look at them side by side on paper. However, in presentation, they can look very similar to one another, which is why they are often misdiagnosed. More specifically, children who actually have OCD are often misdiagnosed and treated for ADHD.

    In terms of the brain, both ADHD and OCD affect the frontostriatal system. However, the difference lies in how the disorders affect this part of the brain. People with OCD have been found to have an overactive frontostriatal system, while people with ADHD have an underactive one. In other words, people with OCD think too much about decisions and plans, while those with ADHD may not be thinking enough about those same things.

    Conclusion

    Although there are similarities between ADHD and OCD, it is imperative that we understand the differences. A diagnosis does not “define” your child as a person, but it is critical to receive a proper diagnosis, so they can receive the proper care. If you want to know more about OCD and ADHD and whether or not your child may be exhibiting symptoms, it’s important to talk with your family physician as soon as you start noticing early signs of either of the disorders.