October is both OCD and ADHD Awareness Month. Both tend to be quite misunderstood, and the ways in which they interact are often looked over. Let’s take a brief dive into each of these neurotypes, and how they can interact with each other.
OCD (Obsessive Compulsive Disorder)
“I’m so OCD!” has become an everyday phrase to describe wanting things a particular way (clean, orderly, etc.). People who have OCD will instead have a more distressing experience involving repetitive, intrusive thoughts which can result in compulsions that are used to “resolve” the anxiety of such thoughts. This sense of relief may be felt in the moment; however, the action of compulsions will typically increase anxiety in the long term. There are a large variety of types of OCD. For a more in depth look, check out Dr. Megan Anna Neff’s article here.
ADHD (Attention Deficit and Hyper Activity Disorder)
Arguably one of the top most incorrectly named neurotypes. ADHD is not a deficit in attention, but rather a variation of it. There are three types of ADHD: Inattentive, Hyperactive, and Combined. ADHD experiences can show up in ways such as hyperfocus (often referred to as “inattentive”), hyperactivity, and/or impulsivity. For a more in depth look, check out Dr. Megan Anna Neff’s article here.
Interacting Experiences:
OCD and ADHD can look very similar in terms of hyperfocus/rumination, working memory, intrusive thoughts, etc. Let’s go through a couple examples that highlight the relationship between OCD, ADHD, and self trust.
“Did I remember to do that?”
A common compulsion in the OCD experience is repetitive checking- “Did I lock the door?” or “Did I really catch all of the errors in that email?” Compulsive checking is believed to be rooted in a distrust in oneself and their memory, resulting in anxiety-filled, excessive checking. However, in the ADHD experience, these may be perfectly valid questions, and viewed as compensating for differences in working memory. Perhaps there have been times when you had proofread an important email, but still found errors later after sending, so you feel the need to check one more, two more, five more times just to be sure. Or maybe you’ve had instances in which you thought you had locked the door, but upon returning home, you find it unlocked; so the sense of needing to excessively check feels like the right thing to do. The repetitive checking has become a compensation tool for the ADHD part of the brain, and a compulsion for the OCD part. Overlaps like these add complexity to the lived experiences of those of us with both OCD and ADHD. When seeking support and treatment, it is important to approach this from an affirming paradigm that validates the analogous neurotypes.
“Okay, body, I’m listening!”
Sensory experiences seem to be another area in which self trust is tested. Many ADHDers experience interoceptive disconnects (interoception is the eighth sense of the body that allows the brain to receive and process the body’s signals, i.e. tired, hurt, thirst, etc.). This is why many of us don’t realize we are hungry until our starvation signals “emergency,” or we often find bruises and scrapes on our bodies that we have no memory of acquiring, let alone feeling the sensation of pain. ADHDers with OCD may develop obsessions with health or other sensory experiences as a result of not trusting their connection to their body. This is one of the many reasons eating disorders, self harm, and health anxiety exist in higher rates in ADHDers and those with OCD- the complexity increases in those who are both. For example, someone in eating disorder treatment may be working towards intuitive eating- listening to the body’s hunger cues and eating when hunger signals arise. But for an OCD ADHDer who does not always receive hunger cues in time or in full, this system may not be as reliable.
Closing Thoughts
However, within all the intricacies of the OCD/ADHD overlap, there is not a hopelessness of balance! Treatment can be adapted to support both neurotypes. Goals will not be thrown out, but they may be adjusted, or the path towards them is shifted to support this unique nervous system. Finding a provider who is knowledgeable in intersecting neurodivergences is a key part of finding stability and freedom in a way that is affirming of all parts of the self. As with all forms of identities, the lived experiences vary greatly! These examples are only a taste of how OCD and ADHD can interact. Continue to seek out the voices of those with lived experiences to gain a broader understanding of how things can show up.
Check out the resources below to learn more about ADHD, OCD, as well as how they overlap.
-Mikaila Vieyra, LPMT, MT-BC
Identity of the author*: white, neurodivergent (Autistic, ADHD, OCD), queer, cis-woman.
*Why do we include this? Intersectionality is the way that the various identities we hold (race, gender, sexual orientation, dis/ability, etc.) impacts the way that we experience and perceive the world. How/what we take in from the world impacts how/what we put into the world. Though we are committed to consistently engaging in reflexive practices to explore our explicit/implicit biases, we share the identity to be transparent on what perspective this blog post is coming from.
Resource Starting Points:
Neurodivergent Insights- website of resources
I-CBT and Neurodivergent Approaches to OCD- podcast with Divergent Conversations ft. Brittany Goff
Interoception is a Sense Few Understand- podcast with The Neurodiversity Podcast about interoception and how it connects to EDs and other sensory experiences for neurodivergent folks