Torn Between Chaos and Control: When OCD and ADHD Coexist

Imagine a brain that won’t stop looping distressing thoughts... and also struggles to stay focused long enough to finish a simple task. It might sound contradictory, but for people living with both Obsessive-Compulsive Disorder (OCD) and Attention-Deficit/Hyperactivity Disorder (ADHD), this is daily life.

While these two conditions seem like opposites—one marked by rigidity and control, the other by impulsivity and inattention—they often show up together. And when they do, the experience can be deeply confusing, especially when treatment is only targeting one part of the picture.

OCD vs. ADHD: Opposites… or Overlapping?

Let’s start with the basics.

• OCD is an anxiety disorder driven by intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) meant to reduce distress or prevent feared outcomes.

• ADHD is a neurodevelopmental disorder that affects executive functioning—things like focus, planning, working memory, and emotional regulation.

Here’s the twist: Both conditions involve difficulties with regulation. They just show up in very different ways.

• In OCD, the brain gets stuck—looping thoughts, rituals, and fears.

• In ADHD, the brain skips around—jumping from one thing to the next without finishing.

For someone living with both, it can feel like being mentally trapped and mentally chaotic at the same time. This internal push-pull is exhausting—and can leave people wondering what’s wrong with them when nothing seems to fit.

Signs You Might Be Dealing with Both

Because OCD and ADHD can mask or mimic each other, they’re often missed in assessments—or misdiagnosed altogether. Here are some common signs that both may be at play:

• Difficulty following through on compulsions due to inattention or forgetfulness

• Feeling torn between obsessively needing to “get it right” and impulsively rushing through tasks

• Trouble sticking with ERP (Exposure and Response Prevention) or therapy homework because of ADHD-related avoidance or disorganization

• Rumination over “mistakes,” real or imagined—especially when executive functioning issues lead to actual consequences

When OCD Becomes a Coping Strategy for ADHD

For many people, OCD rituals start to feel like a way to manage their ADHD—especially if they’ve spent years being criticized for forgetfulness, lateness, or “careless” mistakes. Compulsions can offer a (false) sense of control in a brain that often feels out of control.

This can lead to a fear that treating OCD will make things worse.

“If I stop checking everything five times, I will make a mistake.”
“If I don’t obsessively plan, I’ll forget something important.”
“My OCD is the only thing keeping me functional.”

In these cases, OCD becomes a compensatory strategy—one that’s anxiety-driven and unsustainable, but also deeply tied to a fear of ADHD-related failure. That fear is real, and it deserves attention in treatment.

Treating OCD and ADHD Together

When both conditions are present, therapy needs to be flexible, compassionate, and strategic.

• ADHD treatment (like structure, medication, or behavior strategies) can help—but sometimes fuels compulsions if not monitored.

• OCD treatment (like ERP or ICBT) is essential—but may need to be adapted for brains that struggle with follow-through, focus, or internal motivation.

As a therapist who specializes in both OCD and ADHD, here are a few strategies I use in my work:

• Incorporating visual reminders, timers, and external cues for exposure tasks

• Breaking therapy goals into small, achievable steps

• Helping clients differentiate between OCD-related guilt and ADHD-related forgetfulness

• Validating the distress while untangling what’s driven by anxiety vs. executive dysfunction

• Supporting clients through the fear of losing their coping mechanisms as OCD treatment begins

This is where self-compassion becomes just as important as any skill or tool.

You’re Not “Too Much.” You’re Not Alone.

OCD and ADHD can make the world feel like a maze with no map. You might feel like you’re always behind, constantly second-guessing, or trying to do things “right” without knowing what that even means anymore.

But you’re not broken. You’re navigating a brain that processes the world differently—and it’s possible to build skills, find relief, and move forward without having to choose between chaos and control.

Looking for an OCD and ADHD-Affirming Therapist?

I specialize in working with people who live at the intersection of OCD and ADHD. Whether you're struggling with compulsions, attention challenges, or both, therapy can help you build clarity, flexibility, and self-compassion.

How Sex Therapy Can Improve Relationships

Introduction

Hey there, lovebirds! Ever feel like your relationship could use a little extra spice? Or maybe you're navigating some choppy waters in the bedroom? Fear not! Sex therapy might just be the magic ingredient your relationship needs. Let's dive into how this specialized form of therapy can transform your love life and strengthen your bond.

Understanding Sex Therapy

Sex therapy is like relationship boot camp but with way more fun homework. It focuses on addressing sexual concerns and improving sexual health. Think of it as a safe, judgment-free zone where you and your partner can explore your sexual issues with the guidance of a trained therapist. The aim? To enhance sexual satisfaction, resolve any pesky dysfunctions, and boost your overall relationship vibes.

Common Issues Addressed in Sex Therapy

Sex therapy can tackle a bunch of different issues, including:

1. Desire Discrepancies: One partner's ready to go, while the other is not in the mood? Sex therapy helps you find that sweet spot where both of you are happy and satisfied.

2. Sexual Dysfunction: From erectile dysfunction to premature ejaculation and vaginal pain, sex therapy has got you covered. Therapists offer practical tips and techniques to get things working smoothly again.

3. Communication Problems: Talking about sex can be awkward, but it's crucial. Sex therapy teaches you how to chat about your desires, boundaries, and concerns without turning fifty shades of red.

4. Intimacy Issues: Emotional and physical intimacy go hand in hand. Sex therapy helps you and your partner reconnect and build a deeper, more meaningful bond.

5. Past Trauma: Sexual trauma can cast a long shadow. Sex therapists provide a supportive space to process these experiences and move towards healing.

Benefits of Sex Therapy

So, what can sex therapy do for you? A lot, actually! Here are some of the benefits:

1. Enhanced Communication: Learn to talk about your needs and desires openly, leading to better understanding and a stronger connection.

2. Increased Intimacy: By addressing sexual concerns, sex therapy helps you and your partner rebuild and deepen your intimacy.

3. Greater Sexual Satisfaction: Overcome sexual issues and discover new techniques to improve your sex life, leading to happier, more fulfilled partners.

4. Better Conflict Resolution: Gain tools and strategies for resolving conflicts, reducing tension, and fostering harmony in your relationship.

5. Healing from Trauma: For those who've experienced sexual trauma, sex therapy offers a path to healing and healthier sexual relationships.

Conclusion

Sex therapy isn't just for couples in crisis—it's for anyone looking to improve their sexual connection and overall relationship satisfaction. Whether you're dealing with desire discrepancies, sexual dysfunction, or just want to spice things up, sex therapy can be a game-changer. So why not give it a try? Your relationship might just thank you for it!

Remember, a happier, healthier relationship is just a conversation away. Ready to dive in? Let's make it happen!

Anxious Attachment in Romantic Relationships

It’s been twenty minutes; why hasn’t your partner responded to your text?  You take it upon yourself to frantically catalogue every scenario which could conceivably explain why they have chosen to abandon you. Are they bored of you? They do seem to get along so effortlessly with their work friend; it’s never like that with you. Maybe being with you just demands too much time and attention.

Whatever the details may be, one thing is certain: your relationship is over. You are alone. Of course it would come to this. You begin to plot the perfect revenge, but before long your phone lights up and your partner apologizes for the delay, explaining that their meeting ran long.

If this experience, or one like it, is quite familiar to you, you may have an anxious attachment style.

What’s an attachment style?

According to psychiatrist and psychoanalyst John Bowlby, attachment styles begin to develop the second we’re born. How a caregiver responds to an infant plays a role in forming the way the infant will perceive close relationships. As children, we’re dependent on our caregivers to comfort us and to meet our physical and emotional needs. Parents who are sensitive and responsive to those needs teach their children that they can rely on others. When a child grows up with a caregiver who is attuned to their needs (even when these needs are not expressed), they’re likely to be “securely attached.”  

Bowlby believes a secure child can carry this confidence into their adulthood and future romantic relationships. This attachment style can also be shaped as an adult by experiences in social and romantic relationships. Securely attached folks are comfortable both relying on and being relied upon by their partner. They’re comfortable being on their own; they don’t depend on their partner’s response or approval in order to have a positive self-image. They also tend to view sex and emotional intimacy as the same, and don’t feel the need to create distance by separating the two.

Conversely, misattunement from a caregiver can lead to an insecure attachment. The two main insecure attachment styles are avoidant and anxious.     

What’s an avoidant attachment?

Those with an avoidant attachment style tend to view themselves as independent “lone wolves.”  They don’t like depending on others or having others depend on them.

As an adult, avoidant attachment can show up as:

• Pulling away from a relationship when things are going well

• Forming relationships with an impossible future, such as with someone who is in a monogamous marriage

• Avoiding physical closeness

• Pining after an ex-partner

What is anxious attachment?

People with an anxious attachment style often feel insecure and their relationships consume a large part of their emotional energy. As children, they may have clung to caregivers or became inconsolable when a caregiver left.

As an adult, anxious attachment can show up as:

• Difficulty trusting partners

• Low self-worth

• Frequent worry that a partner will abandon you

• Sensitivity to small changes in a partner’s mood and behavior 

Can you change your attachment style?

Fortunately, there are things you can do to develop more secure attachments and healthier relationship dynamics.  It may require substantial effort and self-examination, but you’ve got this! 

Here are some steps you can take:

• Find a therapist with expertise in attachment theory

• Seek a partner with a secure attachment who can provide you with patience and support, and in time can help you overcome your insecure impulses

• Use mindfulness and other coping skills to help regulate your emotions and respond differently

If you’d like to talk about the anxiety you feel in relationships, reach and let’s start the conversation.