“You can’t focus at work—is it ADHD inattention or an OCD obsession pulling your thoughts away?”. It’s often a challenge to know. While OCD (Obsessive-Compulsive Disorder) and ADHD (Attention-Deficit/Hyperactivity Disorder) are distinct conditions, they can look similar from the outside, leading to misdiagnosis.
OCD and ADHD can both cause distraction, restlessness, and difficulty finishing tasks, but the “engine” behind those problems is very different: ADHD is driven by underpowered attention and impulse control, while OCD is driven by intrusive, distressing thoughts and anxiety-relieving rituals.
In this article, I explain the key differences, help you identify core symptoms, explain what it means when they co-occur, and describe how to get assessed.
Understanding the Core Engines: Anxiety vs. Regulation
ADHD is primarily about performance variability (getting things done, focusing). OCD is primarily about managing intense distress (quelling anxiety, preventing feared outcomes).
People with ADHD are often distracted by external stimuli or boredom, whereas people with OCD are pulled off-task by internal anxiety and rumination.
The ADHD Engine
ADHD is a neurodevelopmental disorder of executive dysfunction in the brain. It is an externalizing condition, meaning it affects how people relate to their environments outwardly [1]. The core challenge is regulating attention, impulses, and activity levels. The brain seeks stimulation and struggles with “brakes” and prioritization.
ADHD is defined by:
- Inattention
- Hyperactivity
- Impulsivity
This leads to:
- Disorganization
- Forgetfulness
- Jumping between tasks or topics
The OCD Engine
OCD is an anxiety-related disorder characterized by the obsession-compulsion cycle. It is an internalizing condition, which means people who live with it respond to their anxiety by turning inward.
The core driver is intense anxiety/distress from intrusive thoughts, images, or urges (obsessions), temporarily relieved by repetitive behaviors or mental acts (compulsions) done to reduce anxiety or prevent something bad. An analogy: A catastrophic alarm system that won’t turn off until you perform a specific, ritualized “safety check.”
Where They Look Alike (But Aren’t)
Many people commonly think that ADHD is just about being ‘hyperactive’ or that OCD simply involves being excessively neat or organized [2]. But both conditions are complex, and while OCD and ADHD may have some similar behaviors, they have different roots. Some presentations can look similar on the surface, especially in kids and teens.
Both can involve trouble focusing, task-switching problems, and repetitive behaviors, but in ADHD, these are typically impulsive or due to low focus, while in OCD, they are purposeful, rule-bound attempts to neutralize fear or discomfort.
Both can involve emotional intensity and irritability, often from chronic frustration, shame, or exhaustion from trying to function in school, work, or relationships
This table compares apparently “similar” key features of each, showing their differences:
| Symptom | OCD Manifestation | ADHD Manifestation |
| Focus & Attention | Preoccupation. Attention is absorbed by the obsessive thought or fear. Because the intrusive thought is drowning out everything else, they have difficulty focusing. | Distractibility. External stimuli or internal thoughts pull attention. This leads to frequent, unintentional shifts. Difficulty sustaining focus on mundane tasks. |
| Repetitive Behaviors & Restlessness | Compulsions. Ritualistic, repetitive acts (handwashing, checking, counting) are performed according to strict, self-imposed rules to neutralize anxiety or prevent a dreaded event. | Fidgeting, hyperactivity. Physical restlessness to self-stimulate; tapping, pacing, squirming. It’s often aimless or for excess energy release. |
| Forgetfulness & Disorganization | “Checking” doubt. Forgetting if you locked the door because the compulsive checking ritual undermines memory confidence (“Did I really check it?”). | Working memory challenges. Forgetting appointments, losing keys due to inattention, distractibility, or poor organizational systems. |
ADHD Features
Common ADHD features include:
- Lifelong pattern of being easily distracted, losing items, missing details, or procrastinating on tasks that require sustained mental effort.
- Hyperactivity and impulsivity, such as fidgeting, talking over others, difficulty waiting turns, or engaging in riskier or novelty-seeking behaviors.
- Disorganization and inconsistency rather than rigid, perfectionistic standards; “messy mind and messy environment” is common.
OCD Features
Common OCD features include:
- Intrusive thoughts (e.g., fears of contamination, harm, mistakes, moral failure) that feel unwanted and disturbing, often with intense guilt or fear.
- Repetitive rituals or mental acts (checking, cleaning, arranging, repeating, reassurance seeking, silent counting, or praying) done to reduce anxiety or prevent something bad, often with a sense of “I have to do this until it feels right.”
- High internal tension, perfectionism, and risk aversion; people with OCD are usually very cautious rather than thrill-seeking.
The Challenge of Co-Occurring OCD and ADHD
But it’s not always one or the other. ADHD and OCD can co-occur, and this is not rare; a notable minority of people with OCD also meet criteria for ADHD, and vice versa.
Based on current neurobiological knowledge, OCD and ADHD appear to have different and apparently opposing deficits in the frontostriatal and related areas of the brain [3].
Studies suggest that patients experience more disabling OCD symptoms when ADHD is also present, but the actual nature of OCD symptoms is not significantly different from patients with OCD alone.
In co-occurrence, people may show both disorganization and impulsivity (ADHD) plus intense rituals and mental checking (OCD), and may even use rigid routines as a coping strategy to manage ADHD-related chaos.
Having both can create a vicious cycle. For example, ADHD impulsivity might trigger an intrusive “bad” thought (OCD). ADHD difficulty shifting focus can make it harder to disengage from that obsession. The need to perform a compulsion to reduce anxiety then further derails attention from the task at hand.
This overlap can mask symptoms, making an accurate diagnosis more difficult and emphasizing the need for a specialist.
Co-occurring ADHD–OCD can complicate treatment, because stimulants that help ADHD may, in some cases, transiently increase anxiety or obsessive focus, and exposure-based CBT can be harder if attention and working memory are weak, so clinicians often sequence or combine treatments thoughtfully.
4 Questions to Ask
These reflection questions can help distinguish patterns, but they are not a substitute for a full assessment:
- What interrupts tasks more: boredom and external distractions (sounds, notifications, new ideas), or internal intrusive thoughts and “what if” fears?
- Are repeated behaviors impulsive and spur-of-the-moment, or are they rule-based rituals done to reduce a very specific fear or discomfort?
- Is the main distress about consequences of losing focus (missing deadlines, forgetting things), or about feared catastrophe, contamination, harm, or being a “bad” person?
- Is there a long history (since childhood) of general distractibility across many settings, or did symptoms build around particular obsessions and rituals?
When to Seek a Professional Evaluation
Because misdiagnosis is common, especially in children whose OCD-related distraction looks like ADHD, a structured evaluation by a mental health professional is important when there is significant impairment.
Both OCD and ADHD are highly treatable with specific, evidence-based approaches (therapy, medication, skills training). Getting the right diagnosis is the first, most powerful step toward effective management and relief.
A thorough assessment typically covers developmental history, family history, symptom course, specific fears and rituals, risk-taking vs risk-avoidant patterns, and may use standardized rating scales for both ADHD and OCD, such as the Yale Brown Obsessive Compulsive Scale for OCD and ADHD Rating Scale 5 or similar.
Immediate professional support is especially important if obsessions involve harm (to self or others), if rituals consume large amounts of time, or if inattention/impulsivity is leading to dangerous behavior, school or job loss, or relationship breakdown.
If you see yourself in these descriptions, the goal is not self-diagnosis but informed seeking of help. Track your patterns. Keep a simple journal of what you do/feel and, more importantly, why you think you do it (to relieve anxiety or due to distractibility?).
Look for a mental health professional (psychiatrist or psychologist) experienced in both conditions for a differential diagnosis.
Treatment for both ADHD and OCD is similar, consisting of a form of behavioral therapy and medication. However, the goal of behavioral therapy and the type of medication doctors prescribe differ between the two [4]: SSRIs for OCD and psychostimulants such as methylphenidate and dextroamphetamine for ADHD. Limiting treatment to only one disorder when both are present appears to be associated with poorer outcomes.
Finding Support for Healing at Corner Canyon
Treatment for mental health conditions and trauma is available in Utah. Are you or a loved one looking for a compassionate space to heal from anxiety, trauma, PTSD, CPTSD, other mental health conditions, or addictions? Our licensed trauma-informed professional therapists and counselors at Corner Canyon Health Centers can provide compassionate help using a range of therapeutic and holistic techniques.
Reach out to our Admissions team now at Corner Canyon. We’re in a peaceful setting bordered by the beautiful Wasatch Mountains.
Sources
[1] Smith, K. 2022. ADHD vs. OCD: What’s the Difference? Talkspace.com.
[2] MyPsychiatrist.com 2023. ADHD vs. OCD: What’s the Difference?
[3] Cabarkapa, S., et al. (2019). Co-Morbid Obsessive-Compulsive Disorder and Attention Deficit Hyperactivity Disorder: Neurobiological Commonalities and Treatment Implications. Frontiers in psychiatry, 10, 557.
[4] Sherrell Z. 2024. What to know about ADHD vs. OCD. MedicalNewsToday.com.