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ADD and OCD Together?

Doctor Roberto Olivardia, a specialist in ADHD and O.C.D., Obsessive Compulsive Disorder, talks about the overlap, the links, and how having both of these disorders can impact the severity of each one.


(Dr. Roberto Olivardia) In my private practice I see a lot of people not only with ADHD but I also specialize in the treatment of obsessive-compulsive disorder or OCD, and OCD is a disorder that’s characterized by repetitive obsessional thoughts that somebody has that could lead them to feel very anxious and very distressed and oftentimes as a way of reducing that anxiety they might perform certain rituals or compulsions to mitigate that anxiety, but it often actually makes the OCD worse, and surprisingly people often think of OCD as being on an opposite spectrum than people with ADHD, but about 30% of people with obsessive-compulsive disorder also have ADHD and if the ADHD is not recognized then the treatment for the OCD is going to come at a standstill and you find that the opposite is true that when the ADHD is recognized and when the treatment is actually through an ADHD lens the momentum and the movement that somebody can make and their OCD treatment is quite significant.

For example, I had a patient recently who actually came in for work around his ADHD and realized that he had a lot of these sort of obsessive compulsive habits where he would check things a certain number of times which a lot of people with ADD might actually forget to shut off the stove or they might not lock the door. So he always thought of those behaviours as being part of his ADHD and when in reality there were other things that he was doing that clearly were not part of his ADHD. He was, he had to unplug every appliance out of in his whole house for fear that there might be a fire, and it’s not that the appliance is on, he would just unplug it from the wall because the fear that there was any active electricity might burn down his house.

That is not an ADHD thing that’s an OCD thing and that was one of many things. When he, before leaving his car, it would take him sometimes 20 to 25 minutes from the time he shut off his car to actually exit out of the car because he had to make sure, did he shut off the car? and he would see himself, the key would be in his hand but it would be well did I really shut it off? So he would turn the car on, and then shut it off again then turn the car on and shut off up again. He would make sure that there was nothing on the gas pedal even though he’s not in the car, but what if there was a rock or something on the gas pedal that might cause the car to accelerate in some way? What if he left a light on? So he would be late for appointments that a lot of people chalked up to his ADHD but were actually very much part of his OCD, and a lot of times when someone has both ADHD and OCD they can co-mingle in a way that can make it difficult to tease out you know what’s the ADD and what’s the OCD?

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