ADHD vs. OCD: how to tell them apart (and why it matters for treatment)
- Dr. Amitai Abramovitch
- May 28
- 2 min read
ADHD and OCD can look surprisingly similar: both can involve trouble concentrating, distractibility, procrastination, problems with executive functions, and generally feeling stuck. Importantly, however, OCD and ADHD are very different conditions that require very different treatments. To complicate things further, in some cases, they can also co-occur. Distinguishing them accurately is a specific area of Dr. Abramovitch's expertise, based on his own published research, extensive clinical experience, and his role as an International OCD Foundation subject-matter expert on OCD and ADHD.
What's the difference between ADHD and OCD?
ADHD is a neurodevelopmental condition affecting attention, self-regulation, and executive functioning. OCD is a fear-based, anxiety-related condition that revolves around intrusive obsessions and the compulsions or avoidance used to relieve them. The overlap is that OCD can produce inattention and executive dysfunction, because people with OCD frequently get distracted by intrusive thoughts and anxiety.
Why is OCD so often misdiagnosed as ADHD?
Obsessions consume cognitive resources and therefore affect attention, processing speed, and executive functions. Dr. Abramovitch's research identified this mechanism and led to the development of the Executive Overload Model of OCD. This model illustrates how the cognitive load of managing obsessions and compulsions can produce attention and executive-function difficulties that resemble ADHD on the surface. Treating that as ADHD misses the underlying OCD dynamics and therefore does not address the true source of the cognitive dysfunction.
Can you have both ADHD and OCD at the same time?
Yes, although not frequently, and usually in the presence of other neurodevelopmental problems. When a careful assessment reveals that both are genuinely present, each needs its own treatment approach, which is why a careful evaluation distinguishes between ADHD alone, another condition mimicking ADHD, and both present together.
Why does getting the diagnosis right matter?
The treatments point in different directions. ERP and OCD-focused CBT target obsessions and compulsions, while CBT for ADHD builds executive functioning and organizational skills and enhances emotional regulation. An accurate diagnosis, sometimes supported by neuropsychological testing, is therefore an essential component of successful therapy.
Frequently asked questions
Can anxiety or perfectionism also look like ADHD? Yes. Anxiety, perfectionism, OCD, and depression can all produce ADHD-like procrastination and difficulty concentrating, which is why differential diagnosis matters. In fact, Dr. Abramovitch's research coined the term C-Factor, which captures the transdiagnostic nature of cognitive dysfunction: difficulties that emanate, to differing degrees, from all mental health conditions.
How do you tell them apart? Through a detailed clinical interview, validated measures, and, when needed, neuropsychological testing that clarifies whether attention problems stem from ADHD, another condition, or both.
Do you treat both OCD and ADHD? Yes. Both are core areas of the practice, in person in Austin and via telehealth across Texas and Florida.
Research referenced in this article
Where to next
Read more about OCD assessment and treatment, adult ADHD, or neuropsychological assessment to clarify your diagnosis.