ADHD and OCD. How they overlap and how to tell them apart
If you struggle with focus but also feel trapped by intrusive thoughts or rigid routines, it can be hard to understand what is going on.
Many adults, especially women, find themselves questioning whether they have ADHD, OCD, or a combination of both.
This confusion is common. ADHD and OCD are different conditions, but they can overlap and even mask one another. Understanding the difference matters because the treatment approaches are not the same.
A lot of people arrive here after years of trying to explain themselves away, rather than being properly understood.
How ADHD and OCD work differently
ADHD and OCD are both neurodevelopmental or neuropsychiatric conditions, but they operate through very different mechanisms.
Attention Deficit Hyperactivity Disorder (ADHD) is defined by inattention, impulsivity and sometimes hyperactivity. It is driven by difficulties with executive function, including:
- Planning
- Working memory
- Time awareness
- Impulse control
ADHD tends to be outward-facing. People may act before thinking, struggle with organisation, or appear inconsistent. [1]
From the outside this can look careless. Internally, it usually feels chaotic and hard to control.
You can explore a fuller breakdown of ADHD traits and how they show up in adults here.
Obsessive Compulsive Disorder (OCD) is defined by obsessions and compulsions.
- Obsessions are intrusive, unwanted thoughts or urges
- Compulsions are repetitive behaviours or mental rituals performed to reduce anxiety
OCD is anxiety-driven and inward-facing, with a strong need for certainty and control. [2] The behaviour is not the problem. The anxiety underneath it is.
A useful way to understand the difference is impulsivity versus compulsivity.
- ADHD pushes behaviour forward quickly.
- OCD pulls behaviour into repetitive loops.
Someone with ADHD may forget to lock the door because their attention moved on.
Someone with OCD may check the lock repeatedly because uncertainty feels intolerable.
ADHD vs OCD
|
Trait area |
ADHD |
OCD |
|
Core driver |
Impulsivity, distractibility |
Anxiety, fear of uncertainty |
|
Attention |
Easily pulled away |
Locked onto intrusive thoughts |
|
Behaviour |
Acts quickly |
Repeats behaviours to feel safe |
|
Risk style |
Novelty seeking |
Risk avoidant |
|
Relationship with mistakes |
Often moves on |
Fear of errors or harm |
Similar behaviours can look identical on the surface. The cause underneath is different.
Can you have ADHD and OCD at the same time?
Yes. ADHD and OCD can occur together. This is known as comorbidity.
Research suggests that between 8 and 25% of people with OCD also meet criteria for ADHD, depending on age and diagnostic method. [3] ADHD traits may be overlooked in people with OCD because anxiety and rituals dominate the clinical picture.
OCD can also be missed in people with ADHD. Repetitive behaviours may be dismissed as coping strategies rather than anxiety-driven compulsions.
In some cases, one condition masks the other.
- OCD routines can hide ADHD disorganisation.
- ADHD impulsivity can interrupt OCD rituals, making symptoms appear inconsistent or confusing.
This overlap is one reason misdiagnosis happens. If one condition is missed, treatment can feel ineffective or even make things worse. Treating one condition without recognising the other can slow progress or increase distress.
Why ADHD and OCD get confused
ADHD and OCD share some outward features, which is often where confusion starts.
Common overlapping experiences include:
- Difficulty concentrating
- Mental restlessness
- Task paralysis
- Emotional overwhelm
- Anxiety and rumination
- Sleep disruption
- Executive dysfunction
The overlap is real. The reasons behind it are not the same.
The difference lies in why the symptom occurs.
In ADHD, difficulty focusing usually comes from distraction or shifting attention. In OCD, focus is hijacked by intrusive thoughts that feel urgent and threatening.
Repetitive behaviours in ADHD often serve stimulation or regulation. In OCD, repetition is driven by anxiety relief.
Same behaviour. Different drivers.
One reason ADHD and OCD are often confused is that both conditions affect how attention behaves under stress.
In ADHD, attention is unstable. The brain struggles to regulate focus, so it jumps between tasks, thoughts, or stimuli. This can lead to repetitive behaviours such as fidgeting, pacing, or rechecking messages, because the nervous system is seeking regulation.
In OCD, attention is narrow and rigid. The brain locks onto a perceived threat or uncertainty and struggles to disengage. Repetition happens to reduce anxiety, not to stimulate or self-soothe.
From the outside, both can look similar. Internally, the experience is very different. That difference is usually felt long before it is recognised.
This distinction matters because strategies that help ADHD, such as novelty or stimulation, can worsen OCD symptoms. Likewise, rigid routines that soothe OCD may restrict an ADHD brain and increase frustration.
Understanding intent behind behaviour is often more useful than focusing on the behaviour itself.
ADHD and OCD in women and girls
Both ADHD and OCD are underdiagnosed in women.
Women with ADHD are more likely to present with inattentive traits rather than hyperactivity. Many internalise difficulties, mask symptoms, and overcompensate through perfectionism and people-pleasing. [4]
OCD in women may also be missed, particularly when compulsions are mental rather than visible. From the outside, this often looks like overthinking rather than distress. Constant checking, rumination, reassurance-seeking, or mental reviewing can be mistaken for anxiety or personality traits.
Hormonal changes can influence both conditions. Many women report worsening symptoms during menstrual cycles, pregnancy, or menopause. These fluctuations can intensify emotional regulation difficulties and anxiety, further blurring diagnostic clarity.
Late diagnosis is common. Many women only seek assessment after burnout, anxiety, or depression develops.
This pattern often ends in burnout rather than answers. You can read more about that here.
Why many adults are diagnosed late
Many adults with ADHD, OCD, or both spend years adapting without realising they are compensating.
Masking may include:
- Over-preparing to avoid mistakes
- Creating rigid systems to control anxiety
- Avoiding tasks that feel overwhelming
- Expending energy to appear organised
For people with ADHD, anxiety-based coping strategies can resemble OCD. For people with OCD, perfectionism can hide attentional difficulties.
Over time, this constant self-management increases mental load. Many adults reach assessment after burnout or a sudden loss of coping capacity, often during major life transitions such as parenthood, menopause, or increased work demands.
Late diagnosis does not mean symptoms were mild. It usually means coping came at a cost.
When it is time to get assessed
You may want to seek professional support if:
- You recognise traits from both ADHD and OCD
- Anxiety and control behaviours coexist with impulsivity or disorganisation
- Symptoms affect work, relationships:, or daily functioning
- You feel stuck despite trying self-help strategies
Assessment usually begins with a GP referral or private specialist. A thorough evaluation looks at developmental history, current symptoms, and how traits interact across contexts. [1] [2] Good assessments look at patterns, not isolated traits.
Dual diagnosis is manageable. Treatment plans are personalised and may include therapy, medication, or both.
ADHD treatment may involve stimulant or non-stimulant medication alongside behavioural support. OCD treatment typically includes cognitive behavioural therapy with exposure and response prevention. [2] [5]
When both conditions are present, care needs to be coordinated. This is where specialist services matter.
If ADHD is part of your picture, structured support can make a measurable difference. You can explore ADHD management with HealthHero here.
If anxiety or low mood are also present, these guides may help you understand how they interact with ADHD:
What helps when both ADHD and OCD are in the mix
When ADHD and OCD coexist, treatment works best when both are acknowledged from the start.
This does not mean treating everything at once. It means understanding which symptoms are driving distress and sequencing care appropriately.
For example:
- Improving attention and impulsivity may help someone engage more effectively in OCD therapy
- Reducing anxiety may free up cognitive capacity needed for ADHD strategies
Medication decisions require care. Some ADHD medications can increase anxiety or obsessive thinking in some people. Others experience improvement in OCD symptoms once emotional regulation improves. Monitoring and adjustment are essential.
Therapeutic support often focuses on:
- Reducing avoidance and reassurance-seeking
- Building flexible routines rather than rigid rules
- Supporting executive function without feeding compulsions
Integrated care reduces the risk of improving one condition while unintentionally worsening the other.
ADHD and OCD are different conditions. They can also coexist.
If you have lived with confusion around focus, control, anxiety, or impulsivity, clarity can be the grounding you’ve been looking for.
Understanding the difference is not about giving yourself labels. It is about accessing the right support. And understanding your own brain better.
Recognising the pattern is the first step. The next step is support that fits the pattern you actually have.
If this article reflects your experience, consider exploring professional ADHD assessment and support with HealthHero.
Medical disclaimer
This article is for informational purposes only and is not a substitute for medical advice. Always consult a qualified healthcare provider.
