"I can't focus." "I make lists all day." "My brain won't stop." People with ADHD say these things, and so do people with OCD. On the surface the two can look alike, but underneath they often work in nearly opposite ways. This guide walks through common situations to show where ADHD and OCD differ, how one can be mistaken for the other, and what ADHD and OCD comorbidity treatment usually involves when both are present.
This post is general information, not a diagnosis or medical advice. Only a qualified clinician can diagnose ADHD or OCD.
Can you have ADHD and OCD at the same time?
Yes. Can you have ADHD and OCD together? It happens, though researchers disagree on how often. A systematic review of ADHD and OCD across the lifespan found that reported rates of co-occurrence vary widely between studies. The authors also pointed out that the two conditions differ a lot in how they show up and in how the brain handles attention and control, which makes the question more complicated than it looks.
In plain terms, the National Institute of Mental Health describes ADHD as an ongoing pattern of inattention, hyperactivity or impulsivity that gets in the way of daily life. It describes OCD as uncontrollable, recurring thoughts (obsessions), repetitive behaviours (compulsions) or both. One is mostly about regulating attention and action. The other is mostly about anxiety and the urge to neutralize it.
"I can't focus": two very different reasons
Trouble focusing is one of the most common complaints in both conditions, but the reasons can be very different.
With ADHD, attention tends to drift outward. You sit down to write an email, notice a notification, remember a bill, wonder about lunch and twenty minutes later the email is still blank. Your mind is pulled by whatever is most interesting or new.
With OCD, attention is often pulled inward and held there. You sit down to write the email, and an intrusive thought shows up: "What if I offended someone in that last message?" You reread it, check it again and mentally review the conversation. You're not distracted by everything. You're stuck on one thing.
Same complaint, different engine. That's why ADHD or OCD can't be sorted out from a single symptom.
Lists, checking and routines: coping or compulsion?
Many people with ADHD rely on lists, alarms and routines to stay on track. These are tools. If you lose the list, you're frustrated, but you can carry on.
In OCD, lists, checking and routines can become compulsions. They're driven by anxiety and a feeling that something bad might happen if they're not done "right." Skipping them brings a spike of distress, not just inconvenience. Some plain examples:
Checking the stove. In ADHD, you may genuinely forget whether you turned it off. In OCD, you remember turning it off and still feel compelled to check, sometimes many times.
Rewriting a to-do list. In ADHD, you might rewrite it because you lost the old one. In OCD, you might rewrite it until it feels "just right."
Routines. In ADHD, routines are scaffolding. In OCD, breaking a routine may feel dangerous.
When OCD looks like ADHD, and the reverse
This is where it gets tricky. The review in our sources notes that OCD symptoms, and the thinking difficulties that can come with them, may produce ADHD-like problems with attention. Someone constantly busy with intrusive thoughts and mental checking can look distracted, slow or disorganized. The authors suggest this may lead some people with OCD to be misread as having ADHD.
The reverse can happen too. Some people with ADHD build rigid systems to manage forgetfulness, and those habits can look compulsive from the outside even though they aren't driven by fear.
ADHD vs OCD isn't something to settle with an online quiz. If you recognize yourself in both, that's a good reason to talk with a professional rather than pick a label.
When both are present: a tug of war
People who have both often describe feeling pulled in two directions. ADHD pushes toward speed and novelty, while OCD pushes toward caution and certainty. You might rush through a task, then spend an hour checking it. You might start five projects, then freeze on one because it doesn't feel "right."
A few things that often help day to day:
Name which one is talking. "Is this distraction, or is this a fear I'm trying to settle?"
Use timers for both. A timer can keep an ADHD task moving, and it can also cap time spent checking.
Write the plan down. Clear, simple plans reduce forgetting and reduce the urge to mentally review.
ADHD and OCD in adults
Many adults only start asking these questions later in life, perhaps after a child's diagnosis, a demanding new job or a period of burnout. ADHD and OCD in adults can be masked by years of coping strategies, which is part of why sorting them out takes care. A clear picture of your history, including childhood, often helps.
Why the order of treatment matters
When both are present, treatment usually works best when it's planned around both. A few general principles:
OCD is often treated with ERP. This exposure-based therapy helps you face triggers gradually while resisting compulsions, so the anxiety loses its grip. Our post on pure O OCD and ERP explains how this works for intrusive thoughts.
ADHD-informed strategies focus on structure, planning, breaking tasks down and building routines that actually stick.
The two need to fit together. ERP homework, for example, can be adapted for someone with ADHD, using reminders, shorter practice blocks and clear written plans.
Your therapist will help decide what to focus on first. Often the condition causing the most distress gets attention first, while skills for the other are woven in. Medication is a separate conversation with a medical professional, and we don't give medication advice.
Getting assessed
If you're unsure whether you're dealing with ADHD, OCD or both, an assessment can bring clarity. A psychological assessment looks at your history, current symptoms and how they affect your life, so that treatment can be planned around what's really going on.
Our OCD psychological assessments page explains how an OCD assessment works, and we also offer ADHD assessments. For details on assessment fees and which assessment fits, book a free consultation and our admin team will walk you through it.
Support at our offices or online
We offer counselling for both ADHD and OCD at our offices in Kitchener-Waterloo, Cambridge and Ottawa, and online anywhere in Ontario. Our page on counselling for ADHD describes how therapy can help with focus, organization and emotional regulation.
Online sessions use a secure, encrypted video platform. We email you a link, and there's nothing to download.
Cost, billing and your first step
Sessions with our therapists range from $130 to $200, depending on the clinician.
Depending on your plan, insurance may cover some or all of the cost. Coverage varies, so check your plan.
We accept Health Spending Accounts (HSAs).
We can direct bill many insurers, including for sessions with a Registered Psychotherapist (Qualifying). Desjardins is the exception: through TELUS eClaims, we can direct bill Desjardins for sessions with an RSW, RP or psychologist, but not for an RP (Qualifying).
Book a free 15-minute consultation with our admin team. Mention that you're wondering about both ADHD and OCD, so we can suggest the right next step.
If you're in crisis: if you or anyone else is in immediate danger, call 911. If you're having thoughts of suicide, call or text 9-8-8 any time.
Two brains in one can be exhausting. With the right plan, both parts can get the help they need.
Last reviewed: October 2026
Sources
Abramovitch A and colleagues. Comorbidity Between ADHD and OCD Across the Lifespan: A Systematic and Critical Review, Harvard Review of Psychiatry, 2015
National Institute of Mental Health, Attention-Deficit/Hyperactivity Disorder
National Institute of Mental Health, Obsessive-Compulsive Disorder