When ADHD and OCD Collide in the Same Brain

Have you ever wondered why some ADHDers also seem to wrestle with compulsive routines, obsessive thoughts, or intense anxiety when things don’t feel “just right”?

You're not imagining it.

Approximately 13% of ADHDers also have Obsessive Compulsive Disorder (OCD).

These two conditions can look alike on the outside and often coexist in the same brain.

But here’s the kicker: ADHD and OCD often don’t play well together.

The Surface Similarities

ADHD and OCD can both cause:

• Trouble focusing

• Repetitive behaviors or thoughts

• Task avoidance

• Emotional dysregulation

To the outside world? It can all look like “someone who’s scattered, overwhelmed, or overly rigid.”

But internally, these are two very different brain experiences.

What’s Really Going On?

🧠 OCD is largely driven by a serotonin deficiency, and research links it to specific areas in the brain that are heavily affected by stress.

Spoiler alert: ADHDers deal with a lot of stress. 😅

🧠 ADHD stems more from dopamine dysregulation, executive function challenges, and nervous system sensitivity. It shows up as impulsivity, hyperactivity, forgetfulness, and difficulty with follow-through.

So while both can trigger anxiety and avoidance… the why behind them is different.

The Big Difference

💥 OCD isn’t just “I like things clean” or “I get upset when my routine changes.”

It’s a debilitating obsession paired with anxious discomfort that gets in the way of everyday functioning.

People with OCD aren’t just annoyed when something’s “off”, they feel compelled to fix it or else experience intense distress.

What ADHD + OCD Might Look Like Together

When these two neurotypes exist in the same brain, it can be a lot:

• “I can’t do X until Y is this way.”

• Constantly questioning yourself: “Did I lock the door?”

• Deep fear of losing autonomy

• Paralysis over perfection

• Anxiety from not trusting your own thoughts

Sound familiar?

The Internal Tug-of-War

Here’s why ADHD and OCD often clash:

ADHD says:	OCD says:
“I need freedom!”	“I need control!”

ADHD craves spontaneity, exploration, and flexibility.

OCD demands order, certainty, and repetition.

That can feel like a mental ping-pong match with no off switch.

What Helps? Naming the Voice

Ask yourself:

“Is this ADHD distractibility or OCD compulsion?”

“Do I need to do the thing distracting me or do I need a boost of dopamine?”

Being able to name which voice is speaking, and what it’s asking of you, can help you regain clarity and self-compassion.

Awareness is your first tool in separating the mental noise from your actual needs.

Nervous System First, Logic Second

Before you can “think” your way through these moments, your nervous system needs to feel safe. Here’s what helps:

✅ Grounding techniques (breathwork, movement, cold exposure)

✅ Body doubling for accountability and reassurance

✅ Therapy that targets both ADHD and OCD, like CBT (Cognitive Behavioral Therapy)

ADHD and OCD are both complex on their own. Together? It’s a layered, nuanced, and very real lived experience.

But with the right strategies, support, and self-awareness, we can absolutely learn to manage both and build a life that honors our unique brains.

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You've Got This,

Coach Brooke