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ADHD vs OCD: Similarities, differences, and why they often get misdiagnosed.

women's mental health podcast
The Truth about women's mental health

This episode is part of our ADHD Series that we will be exploring throughout 2023.

In this episode we are going to compare ADHD and OCD and go over how they are different and the same.

As well as why they are often misdiagnosed.

Transcript – ADHD vs OCD: Similarities, differences, and why they often get misdiagnosed.

Randi: 0:02

1, 2, 3, 4. Hi friends. It's Randy and Jess, and we're gonna cut theJess: 0:07

bullshit and let's get into women's mental health.Randi: 0:12

Welcome to the podcast unapologetically All over the place with Randy and Jess. Where we talk about women's mental health issues and how it's all normal and you're not alone, right? FindJess: 0:22

us and more information at randy and jazz podcast.com.Randi: 0:26

We're two psychotherapists that are not afraid to be vulnerable and call out the bullshit.Jess: 0:31

All right, so this episode is gonna be part of our D h D series, uh, that we've been doing here in 2023. Yeah.Randi: 0:37

In this episode, we're gonna compare a D H D and O C D and go H over how they can be different and somehow how they can. Same, and sometimes how they are often misdiagnosed. Right?0:49

Okay.Jess: 0:50

ADHD vs OCD So have you ever thought,Randi: 0:52

am I A D H D or O C D or can I be both?Jess: 0:56

Right. Why does so many people joke about being A D H D or O C D? How doRandi: 1:00

I tell if I'm a D H D or how do I tell if I'm O C D?Jess: 1:04

What does a ac A C D C? Oh my gosh, what my God, right? What does A D H D and O C D look like togetherRandi: 1:12

and what is the difference between A D H D and O C D?Jess: 1:15

What the hell is A D H D and o cRandi: 1:17

d? I think I'm gonna have, um, O C D right now from saying those acronyms. I know it's right.Jess: 1:23

I'm apparently, you know, on the highway to hell here. Okay. So let's go over O C D versus A D H D. Okay.Randi: 1:31

Um, go for it. Okay. So ADHD vs OCD , which is obsessive compulsive disorder. yes. If we didn't get to that first, right? Um, and attention deficit hyperactivity disorder, they don't behave the same way. And so when one is present though, it can be hard to see the other, like one can kind of overshadow the other and vice versa. TheyJess: 1:54

do have some traits though that look the same, which is why sometimes it's hard to diagnose. Right. Right. We think of, um, you know, they have extremes, but then they have things in the middle that are very similar. Right. Um, it's not very common to have both at the same time. Right. That is a little bit more rare. I've only known one person mm-hmm. that has that. And typically you are bornRandi: 2:18

with a d h, adhd. Yes. A D H D is, um, mostly genetic. And, um, O C D is mostly like developed in lieu of other things that are causing, you know, you mental healthJess: 2:31

issues. Right. They both can run in the family though. Mm-hmm. so they, there is a genetic piece to it. Right. But just because with o c. You don't always end up O C D because of genetic. You're not born with it. Right. But you are definitely born with a d h, adhd.Randi: 2:45

Right. So what is A D H D again? It's being inattentive. It's being impulsive. It's being hyperactive. You can listen in into our episode number one. We dive into what it is to be a D h adhd and there's a quiz up to on our website Yep.Jess: 3:03

And so you can kind of see if you are ADHD or not. Yeah. Right. Um, it is a neuro. I can't talk A developmental disorder, a neurological brainRandi: 3:14

disorder. Yes. Is what this is. It's not environmental. It's not behavioral. It's not behavioral, it'sJess: 3:20

not the time change did nothing for us.Randi: 3:22

Yeah. We are nothing. We are, we are not here today for that time change. So, um, yes it is. Not behavior based. It is genetic based.Jess: 3:32

Okay, so let's go through O C D. So O C D once again is obsessive compulsiveRandi: 3:38

disorder and it is the fourth most common psychiatric disorder in the world.Jess: 3:43

In theRandi: 3:44

world. Yep. So it affects about. 3% of the population at some point in their lives, and it usually onset, which means just starts during, um, childhood or likeJess: 3:56

adolescence. Yeah. Like they say like, like preteen. Mm-hmm. kind of idea is where itRandi: 4:00

starts, kind of like around like, uh, uh, like 11. Yeah. 11 to like 21. So like when you're like starting to like develop.Jess: 4:08

So, and the idea is that these obsessions, right? These things that you have to do mm-hmm. um, they can also be thoughts that reoccur or cause anxiety. And so that's where these compulsions things you have to do. Like, don't touch that, I have to touch that kind ofRandi: 4:23

thing. Yeah. And so some of the symptoms when you have O C D are like fear of like contamination, fear of germs, fear of dirt, um, NeedingJess: 4:32

things super in order and like Neat. Yeah, right. Like, like, you know, if somebody has moved something on your desk by like a millimeter,Randi: 4:41

right? Yeah, exactly. Um, you have like horrific thoughts. I call them like worst case scenario, like thoughts about like losing yourself, like losing control, like getting hurt or like, you know, people you love being hurt are harm.Jess: 4:55

Um, I was always, uh, taught that, well, I call 'em dark fantasies. Mm-hmm. Yes. They're like dark fantasies, like daydreams,Randi: 5:01

right. Dark things. And that's like a lot of, um, that's can be, um, huge with like, uh, a lot of people have a sexual, um, component or unwanted thoughts, um, with O C D and that can be like that dark fantasy things. Like you're like, why am I even thinking this? Like, Horrible and horrific. Or like, you think about like really aggressive things and things like that, and it seems like out of character for yourself, but like sometimes you can't stop thinking about it or, um, like religious things and stuff like that. You can get hyperfocused on those kind of things,Jess: 5:29

right? And so the similarities between them is that they impact like our lives, right? Mm-hmm. they impact work, then school. They cause problemsRandi: 5:37

there. What else? They also have. Intrusive thoughts, like those unwanted thoughts, those dark fantasies, like those, those, um, you know, rapid thoughts and things. They can both have those. So sometimes it's hard to differentiate with that. And, um, they both have attention issues and stuff like that. Right. Cuz you'reJess: 5:54

distracted thinking about these thoughts. Right, right. Um, they also have what we call this is, this is a fun word, not fun, but trichotillomania. Yes. I'll say that again. Tri mania,Randi: 6:05

which is. Hair pulling, um, pulling out your hair or skin picking, pulling your skin and things like that.Jess: 6:12

Um, they both can have mood disorders and self-injury. Yes. Um, self-harm, like people who cut or, youRandi: 6:19

know, um, suicidal ideation. Yep. Like thinking about suicide or obsessing about it. Even if you're not gonna go through with it, sometimes you think about it, you know, or like you said, like the cutting or the burning or things like that. And women, and, you know, young women, adults. Teenagers. Teenagers are at a elevated risk for self-harm because with both ADHD vs OCD, because we have a difficult time regulating our emotions and our impulse control. Yep.Jess: 6:48

Oh, eating disorders. We just talked about that in our last podcast, right? Yeah. They're both linked to having eating disorders.Randi: 6:55

Yes. And both come with sleep issues disorder. And let's be honest, when it's hard to sleep, it's hard to regulate, regulate, manage daily life, let alone when you have a mental health issue or a neurological issue like this. Okay,Jess: 7:09

so let's talk about. The differences, right? Why are they often misdiagnosed? Because there are some definite differences, right? Yeah.Randi: 7:19

So there's just like a poor understanding of like we were talking about these differences and these similarities between them. And a lot of people will go to like their primary care, like a medical, you know, doctor who doesn't specialize in this. And so they might not. Understand these subtle differences between these diagnosis. Like Jess and I went to school for this and we have taken course after course of this huge manual called the DSM five, which helps us diagnose these things. And even after you've gone to school for it, it's still very hard to understand and they continuously like update it and change it all the time. So like a lot of profess. Like if they're not in this field and being educated on it constantly might miss these, you know, slight differences or things. And it's very easy then for them to misdiagnose you because they shouldn't be diagnosing you in the first place. Well,Jess: 8:13

okay, so let's go. Randy's gonna back my train. Yep. She's gonna get on her soapbox here. Okay. So let, like one example would be, It's D, h, D. You want a new experience, right? You want something unique and different, and it's always changing. Mm-hmm. but Ooc D, they want routine and familiarity, right? Yeah. They need something that is the exact same all the time, otherwise it causes a lot of anxiety. Right? Right. And so that is one of the main differences that we'll see. Right? Mm. Um,Randi: 8:44

so for like a D H D, you are very like impulsive and you like risk taking with O C D, you don't, you wanna avoid any risk, anything that could cause you any harm, you over worry. So it's like that same thing about like that routine and like, you know, I like step A, B, and C. We're like a d h, adhd. You're like, no, I, no. Forget all the steps. We're just, yep. Yeah, we're just gonna, gonna deep dive off the end whichJess: 9:08

is why I can't bake. I can't bake. There's just too many directions. Always messing up stuff, I swear. Okay. Um, there's also, like with adhd, there's that hyperactivity and impulsivity. Mm-hmm. Right. But like with Ooc d I think it's more of like the, it's more of the thoughts, right? It's the distressing thoughts, sensations and ideas versus the hyperactivity and bouncing around.Randi: 9:31

Right. And usually thes. Session leads to a compulsion that you have to partner with it. So it's like, if you're so worried about somebody coming in and like harming you or like harming your family, you're gonna obsess over like your security system and like the locks on your house, and then you gonna start check your door. You're gonna start four times checking your door. And then that can lead to like rituals, you know, of like locking your door 20 times, you know, to the left or to the right, or like doing a, you know, I, I've watched this before, like literally, you know, I, we had a family, you know, friend that I grew up with that had that where she had to like, you know, do a circle. Go around the house and do, you know, the ritual like over and over again. And so that was different between being like hyper-focused on, I'm worried somebody's gonna come like in and break into my house. And then it goes like a step further where you lead to an this obsession that leads to compulsion, which can lead to a ritual about it. Right. AndJess: 10:22

and the difference though with like me, is that I have to go check all the locks at night because more than likely, one of us has forgot to actually lock the door. Mm-hmm. because we're, we just forget. Right. So I have a habit, it's not a ritual, but it's a habit to make sure all of our doors are locked because they're usually not. Yeah. And so that's different than somebody who has O C D where they would check it like sixRandi: 10:45

times. Right. And so it's kind of like the thing, like with h adhd, you often have time blindness so you forget things or object, permanence issue, which means kind of like outta sight, outta mind. Whereas like somebody with like O C D, they're not gonna be outta sight outta mind. They're gonna be. So focused on that, they can't think of anything else. Right. So it's like with ADHD we might be like, oh, like I saw that there and I know I need to do that. And then you forget about it and then you're like, oh shit, I forgot about it with like O C D, you might be like, oh my god, that's there. Oh my God, I have to do something about it. I can't do anything else until I do something about this. And then you end up in that like cycle like that. So like those are kind of like where they can be similar, but like so far set apart at the same time.Jess: 11:27

Right. And, you know, having GI issues, like having like i b s irritable, irritable bowel syndrome is part of both of them. Mm-hmm. and I was like, oh, that's reallyRandi: 11:37

interesting. It is. And so is, there's a higher level of, you can also have depression, anxiety. Eating disorders and more likely for self-harm too. Those also like overlap and so that's why sometimes with these overlapping, you know, things, it can be confusing. Like where do I lie on the spectrum? Like do I have a d D, do I have O C D? Do I have both? Do I have one or the other? And that's why you have to like really dig deep and see like, where is this coming from and really what are the differences between these two things? And where do I lie on this spectrum? And evenJess: 12:11

being a therapist that, you know, looks at this, treats this, sometimes I'm like, Hmm. I can't quite put my finger on it quite yet. Yeah, it can take a little bit of time of working with somebody for an hour a week. Yes. Before we can go. Okay. I think this is. because sometimes you have to get the anxiety taken care of. Mm-hmm. once you have the anxiety, what's causing the anxiety. Right. You haveRandi: 12:32

to, you have to also break apart all these puzzle pieces that are together. Yes. And then put it back together. And the hard thing with this is when with insurance, they want to label it and they want people to turn in a diagnosis. Sorry, I just did a big old sign. You gotta like, And this is why I don't take insurance. I'm sorry, but because they want people to turn in a diagnosis and they wanna label it from one hour of meeting this client. And that's just not possible or, I mean, it is possible.Jess: 13:02

I'm, I'm, I'm kind of going, it is possible.Randi: 13:04

It is possible, but it's not smart to do. But insurance companies require it, which is why I say of insurance companies, but we need them. Okay. In the US because medical is a hot mess. Super crazy expensive. You'reJess: 13:16

gonna go off on another time. Yes. In a little, little soapbox here. Yeah.Randi: 13:19

So off my soapbox. But that's why you have to advocate for yourself and work with your therapist or your doctor or your psychiatrist and breaking apart all these pieces to see what's stemming. Do I have the right diagnosis? Have I been diagnosed? Is something missing or am I on the rightJess: 13:36

track? Stemming she said, stemming. She meant something totally different. I. But you know what? One day we're gonna have to go into what stemming is. Yes. Cause that's kind of a neat to topic too. It is. Yeah. Okay, so where are we at with this now? I think we are ready to wrap up. Oh my God. Time change is not good for us. Ooh, timeRandi: 13:53

change is not your friend.Jess: 13:55

not your friend. All right. So anyway, those are some of the quick differences and similarities between a D h, ADHD and O C D. So weRandi: 14:02

hope you have under, we have helped you guys understand a little bit more about A D H D and O C D. And if you guys have questions, please feel free to hop on the. Email us anytime and we will try to dig into that, and IJess: 14:14

really hope y'all are doing better with the time change this week,Randi: 14:17

All right, we'll talk to you next week. Bye. Talk you later. Thanks for listening and normalizing mental health with us.Jess: 14:25

Don't forget to check out our free resources and favorites on our website, unapologetically, randy and jess.com,Randi: 14:31

like and share this episode and tune in next week.

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Episode 32 – ADHD vs OCD