Estimated reading time: 12 minutes
Raising a dysregulated child can feel like riding an emotional rollercoaster with no clear map—one moment it’s impulsivity and distraction, the next it’s relentless worrying or rigid routines.
Is it ADHD? OCD? Or both tangled together?
Understanding how ADHD and OCD can overlap is more than just labeling behaviors—it’s the first step in giving your child the right kind of support and reclaiming a sense of calm at home.
Why Are OCD and ADHD So Often Confused in Kids and Teens?
OCD and ADHD are two very different conditions—but they’re often confused, especially in kids and teens.
That’s because they share overlapping symptoms, particularly:
- Focus and attention
- Restlessness or agitation
- Repetitive behaviors or habits
- Emotional ups and downs (dysregulation)
Over time, a misdiagnosis can affect:
- Brain development
- Emotional regulation
- Behavioral functioning
- Academic success
- Family dynamics
While both conditions can impact attention, what’s driving those behaviors is completely different.
ADHD is rooted in:
- impulsivity
- distractibility
- executive functioning challenges
OCD is driven by:
- anxiety
- obsessive thinking
- compulsive rituals aimed at reducing distress
On the outside, these behaviors might look similar—but underneath, the brain is working in very different ways. That’s why misdiagnosis is so common.
Many kids with OCD get labeled as having ADHD—what we call a dual diagnosis misdiagnosis. And when that happens, the wrong interventions can actually make symptoms worse instead of better.
The Connecting Link: Nervous System Dysregulation
What is OCD?
A child or teen with OCD struggles with intrusive fears—obsessions—that trigger compulsions, which aren’t just habits but efforts to:
- Ease anxiety
- Neutralize fear
- Regain a sense of control
Now add ADHD into the mix. That’s where things get extra tricky.
Kids with ADHD often struggle with:
- Staying focused
- Remembering steps in a routine
- Managing impulsivity
- Dealing with frustration
Here’s what to remember:
- Obsessions are unwanted thoughts or fears that won’t go away
- Compulsions are the actions kids take to try to feel safe or reduce the anxiety
Most people experience occasional obsessive thoughts or quirky rituals now and then but that doesn’t mean they have OCD.
To meet the criteria for an official diagnosis of OCD, two conditions must be met:
- Obsessions and compulsions consume at least one hour per day
- The behaviors significantly interfere with daily life—school, friendships, family routines
Without those two? It might still be anxiety or rigidity, but not clinical OCD.
What are the General OCD Symptoms?
Every child’s OCD looks a bit different, but common patterns often emerge. Intrusive thoughts can be intense, irrational, even scary—and many kids get good at hiding them.
Parents often don’t see it coming. One day everything seems fine, then suddenly, the truth spills out in tears or tantrums or fears they’ve carried alone for far too long.
Kids with OCD often have a more inhibited temperament and worry a lot about consequences. This can disrupt learning, focus, and daily life.
Common symptoms include:
- Persistent, unwanted thoughts or images
- Irrational fears and heightened anxiety
- Compulsive behaviors aimed at reducing distress
- Difficulty with impulse control
- Trouble sleeping or relaxing
These patterns go beyond quirks or habits—they reflect a nervous system that’s stuck in overdrive.
What is ADHD?
ADHD goes way beyond just struggling with focus.
Kids with Attention Deficit Hyperactivity Disorder often struggle with:
- Hyperactivity
- Impulsive actions
- Trouble sustaining attention
- Or a mix of all three
On top of that, challenges with executive functions make school, friendships, and daily life tougher than usual.
A lot of people think ADHD means a kid can’t focus at all. Truth is, many can hyperfocus—getting completely absorbed when something sparks their interest.
That intense focus happens because their brain lights up with extra stimulation when excited or curious.
Stimulant meds may shift brain activity and even help normalize brain volume for those with ADHD.
But here’s the catch: if a child is misdiagnosed, these meds might worsen obsessive-compulsive symptoms. That’s why getting the diagnosis right matters so much.
What are the General ADHD Symptoms?
There are different types of ADHD, but the hyperactive and impulsive symptoms tend to be more identifiable with OCD. Other symptoms include a lack of executive functioning skills, problems with transitioning, and avoiding school work:
How are OCD and ADHD Similar?
OCD and ADHD are different mental health conditions, yet they share some surprising overlaps. Both impact similar brain areas—especially the frontostriatal region, part of the brain’s frontal lobe that manages how we think and act.
In kids with OCD, repetitive behaviors often respond to intrusive fears or thoughts. With ADHD, some behaviors can look alike, adding layers of complexity when both conditions show up together.
At the brain level, the key areas involved include:
- The orbito-frontostriatal circuit (primarily linked to OCD)
- The frontoparietal area (primarily linked to ADHD)
Problems with cortical inhibition—basically the brain’s “braking system”—can cause:
- The persistent compulsions seen in OCD
- The impulsive, inattentive actions typical of ADHD
This shared biology helps explain why these two conditions sometimes overlap and influence each other (Brem et al., 2014).
What are the Similar Symptoms of OCD and ADHD?
Kids with OCD and ADHD often share tricky overlapping symptoms, especially attention struggles. ADHD makes focusing tough, while OCD floods the mind with obsessions, leaving little space for anything else.
Both conditions can also spark or worsen:
- Depression
- Stress
- Anger
- Anxiety disorders
Physical symptoms may also appear, such as:
- Sleep problems
- Gastrointestinal issues
All of this can strain relationships at home and with friends. Because of these overlaps, OCD and ADHD sometimes get mixed up.
When you see inattention, hyperactivity, impulsivity, and intrusive thoughts together, it can be hard to tell them apart. For example, a kid distracted by anxiety-driven thoughts might seem like they have ADHD, but OCD could be the real cause.
Let’s break down how their symptoms connect:
Both conditions can also spark or worsen:
- Depression
- Stress
- Anger
- Anxiety disorders
Physical symptoms may also appear, such as:
- Sleep problems
- Gastrointestinal issues
All of this can strain relationships at home and with friends. Because of these overlaps, OCD and ADHD sometimes get mixed up.
When you see inattention, hyperactivity, impulsivity, and intrusive thoughts together, it can be hard to tell them apart. For example, a kid distracted by anxiety-driven thoughts might seem like they have ADHD, but OCD could be the real cause.
Let’s break down how their symptoms connect:
| Symptom | ADHD | OCD |
|---|---|---|
| Inattention | Easily distracted by random thoughts, making focus difficult | Preoccupied with obsessive thoughts, which interrupts attention |
| Hyperactivity | Constant motion—fidgeting, running, or restlessness | May pace, flap arms, bite nails, or pull hair to ease anxiety |
| Transitioning | Trouble switching tasks due to hyperfocus on interesting activities | Struggles with transitions because of perfectionism or mental rituals |
| Aggressive / Disruptive Behavior | Acts impulsively without considering consequences | May become angry or upset when rituals are blocked or anxiety spikes |
| Focusing on Schoolwork | Zoning out or daydreaming during unstimulating tasks | Overfocuses on details, repeats or erases work excessively |
| Starting Tasks | Avoids starting due to distractions or feeling tasks are too complex | Hesitates to begin because of fear of doing it wrong |
| Meltdowns | Frustration or task avoidance can lead to emotional outbursts | Overwhelming compulsions or fears trigger meltdowns |
How to Tell the Difference Between OCD and ADHD?
ADHD and OCD can look similar on the surface—behaviors overlap, lines blur, and parents are often left wondering, “Is it one? The other? Both?”. But once you understand how each affects the brain, the differences become much clearer.
ADHD is what we call an externalizing disorder. Kids with ADHD usually don’t bottle things up. They spill over—into their space, into conversations, into everything.
- Inattention
- Impulsivity
- Fidgeting or restlessness
- Interrupting or blurting out
- A visible struggle to stay focused or follow through
OCD, on the other hand, is an internalizing disorder. These kids keep their storms inside, at least for a while.
What you’re seeing is often just the tip of an iceberg made of fear, guilt, and what-ifs. Common signs include:
- Thought spirals like, “What if I hurt someone?” or “What if I left the stove on?”
- Intrusive thoughts that are sticky, weird, or scary—even when kids know they don’t make sense
- Compulsions—handwashing, checking, organizing, or needing things “just right”
- Rigid routines that seem to appear out of nowhere
But here’s the key: it’s not just about what you see—it’s about what’s going on underneath.
Both ADHD and OCD stem from a dysregulated nervous system. That means the brain is either overstimulated or underactive, which makes it hard for kids to focus, self-regulate, or manage emotions.
| Dysregulation in ADHD | Dysregulation in OCD |
|---|---|
| Restlessness or fidgeting | Overactive threat response |
| Impulsive actions or blurting | Obsessive, fear-based thoughts |
| Trouble staying focused | Compulsions to “neutralize” anxious thoughts |
| Constant need for stimulation | Rigid behaviors that feel impossible to stop |
For instance, a child with OCD might feel the urge to clean or organize—not because they want to, but because their brain tells them something bad will happen if they don’t.
At the core, both ADHD and OCD affect the frontal lobe—the command center for focus, decision-making, and emotional control. And that’s exactly why I always say: Calm the brain first.
Now that we’ve laid the groundwork, let’s take a deeper look at what each condition really looks like in daily life.
What are the Treatments for OCD and ADHD?
Medication isn’t the only option when it comes to treating OCD and ADHD. While pharmacology—like SSRIs for OCD and stimulants for ADHD—is often used, many families are turning to natural, brain-based approaches that focus on long-term nervous system regulation.
These include neurofeedback, PEMF therapy, CBT, ERP, and comprehensive programs like the BrainBehaviorReset™ method. These options aim to normalize the brain’s ability to shift between cognitive persistence and cognitive flexibility—a known challenge in both OCD and ADHD (Colzato et al., 2022).
Neurofeedback
Neurofeedback helps children with OCD and ADHD by retraining the brain to self-regulate. It uses real-time feedback to teach the brain how to produce healthier brainwave patterns that support calm, focus, and behavioral control.
- For ADHD: Improves attention, motivation, and impulse control by reducing distractibility and increasing focus.
- For OCD: Helps kids manage obsessive thoughts and compulsions by calming overactive brain areas and improving emotional control.
A study by Barzegary et al. (2011) showed that neurofeedback reduced OCD symptoms significantly—without medication or side effects.
PEMF Therapy
Pulsed Electromagnetic Field (PEMF) therapy is another non-invasive brain tool that supports nervous system regulation by enhancing brain function and promoting calm.
- In ADHD: Helps improve focus, reduce hyperactivity, and support behavioral control.
- In OCD: Calms the brain’s fear centers, reducing obsessive thoughts and anxiety while promoting emotional balance.
At my Ridgefield, CT clinic, I’ve seen how effective PEMF can be in helping children find calm and focus. That’s why I developed a portable PEMF device—so families can access this tool anytime, anywhere.
Exposure and Response Prevention (ERP)
ERP is a gold-standard therapy for OCD that gradually exposes a child to anxiety triggers while preventing compulsive behaviors.
- Builds emotional tolerance and reduces the power of obsessive thoughts.
- For kids with both OCD and ADHD, it supports impulse control and emotional regulation.
For severe OCD, concentrated exposure treatment offers an intensive form of ERP, accelerating progress by exposing children to triggers repeatedly in a short timeframe—helping them build resilience faster.
Cognitive Behavioral Therapy (CBT)
CBT is effective for both ADHD and OCD and teaches kids practical skills to manage their thoughts and behaviors.
- For ADHD: Focuses on improving organization, focus, and controlling impulses.
- For OCD: Teaches kids how to challenge obsessive thinking and reduce compulsions.
CBT provides children with coping strategies that promote both emotional stability and behavioral self-control.
The BrainBehaviorReset™ Program
I developed the BrainBehaviorReset™ Program after 30 years of clinical experience helping children with complex mental health challenges. It’s a 6-week intensive program designed to address the root cause of symptoms—nervous system dysregulation—without medication.
- For ADHD: Targets focus, calming an overstimulated brain, and improving executive function.
- For OCD: Helps reduce anxiety, obsessive thoughts, and compulsive behaviors by supporting a calm, regulated brain.
The program combines:
- Neurofeedback
- PEMF therapy
- CBT and ERP
- Nutritional support
Because when we calm the brain first, everything else becomes possible.
FAQs
What are the ADHD-like symptoms of obsessive-compulsive disorder (OCD)?
Children with OCD may exhibit inattention due to intrusive thoughts, restlessness from anxiety, and difficulty starting or completing tasks because of compulsions or perfectionism.
Can my child have ADHD and OCD?
Yes, it’s possible for a child to have both. In one study, 25.5% of children diagnosed with OCD also had ADHD (Masi et al., 2006). Because symptoms can overlap, it’s important to screen for both conditions.
Make sure your child is evaluated by a professional who understands how ADHD and OCD interact to ensure the right treatment plan.
What are the DSM-5 diagnostic criteria for identifying OCD and ADHD in children?
OCD involves:
- Obsessions: Intrusive, distressing thoughts or urges.
- Compulsions: Repetitive behaviors aimed at reducing anxiety, often not realistically connected to the fear.
- Symptoms must be time-consuming or cause significant life disruption.
ADHD includes:
- Inattention and/or hyperactivity-impulsivity with at least six symptoms lasting 6+ months (five for teens 17+).
- Symptoms must appear before age 12, show up in multiple settings, and impair daily functioning.
Accurate diagnosis is crucial for effective treatment, as the management strategies for OCD and ADHD differ significantly. Understanding these criteria helps in identifying the specific challenges a child may face and in developing appropriate interventions.
Citations
Barzegary, L., Yaghubi, H., & Rostami, R. (2011). The effect of QEEG- guided neurofeedback treatment in decreasing of OCD symptoms. Procedia – Social and Behavioral Sciences, 30, 2659–2662. https://doi.org/10.1016/j.sbspro.2011.10.519
Brem, S., Grünblatt, E., Drechsler, R., Riederer, P., & Walitza, S. (2014). The neurobiological link between OCD and ADHD. Attention deficit and hyperactivity disorders, 6(3), 175–202. https://doi.org/10.1007/s12402-014-0146-x
Colzato, L. S., Hommel, B., Zhang, W., Roessner, V., & Beste, C. (2022). The metacontrol hypothesis as diagnostic framework of OCD and ADHD: A dimensional approach based on shared neurobiological vulnerability. Neuroscience and biobehavioral reviews, 137, 104677. https://doi.org/10.1016/j.neubiorev.2022.104677
Dr. Roseann is a mental health expert in Neurodivergence who is frequently in the media:
- BCIA: Calming the OCD Brain with Neurofeedback and ERP Therapy
- Helping Children Thrive Podcast Benefits of Neurofeedback for children with ADHD
- Scary Mommy What Is Self-Regulation In Children, And How Can You Help Improve It?
Always remember… “Calm Brain, Happy Family™”
Disclaimer: This article is not intended to give health advice and it is recommended to consult with a physician before beginning any new wellness regime. *The effectiveness of diagnosis and treatment vary by patient and condition. Dr. Roseann Capanna-Hodge, LLC does not guarantee certain results.
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