Within the mental health field, there are a plethora of mental diagnoses. Today the focus will be on Major Depressive Disorder (MDD), Obsessive-Compulsive Disorder (OCD), and Attention Deficit Hyperactivity Disorder (ADHD).
The relationship between MDD, OCD, and ADHD illustrates the intricate nature of mental health conditions. The aim of exploring the complex relationship between the three is to offer further insight into commonalities of symptoms, the difficulties involved with diagnoses, and the treatment options available for healing.
Identifying Unique Symptoms
In case there is unfamiliarity with these diagnoses, we have an overview of the manifestation of symptoms for each:
- OCD tends to manifest with symptoms that have persistent, intrusive and obsessive thoughts and repetitive behaviors designed to alleviate anxiety, such as excessive hand washing or constant checking.
- MDD symptoms can involve ongoing feelings of sadness, loss of interest in activities, and noticeable changes in sleep patterns or appetite.
- ADHD symptoms can vary but are often characterized with difficulties with attention, hyperactivity, and impulsive behavior.
Common Questions After a Diagnosis
Once receiving an MDD, ADHD, or OCD diagnosis – most people will have many questions. They’ll quickly google how it impacts their lives, or what others may perceive regarding individuals with these diagnoses. This is how individuals stumble on a lot of misconceptions regarding the diagnoses.
Misconceptions About Mental Health
What’s vital is unlearning any misconceptions and understanding that any diagnosis does not define you. A diagnosis merely gives you insight into your inner workings so you can now move forward with management tools. It’s critical to acknowledge that a diagnosis for some may mean some hard conversations with yourself and the people closest to you, especially about unlearning any misconceptions.
Understanding the Role of the DSM-5
These disorders are formally diagnosed using criteria from the DSM-5, which is a guidebook for diagnosing mental health conditions 7. This is the main guidebook used in the psychiatry field. Yet despite the DSM-5 being professionally used for diagnosis, it does not prevent misconceptions.
Debunking Misconceptions About MDD, OCD, and ADHD
Some examples of simple misconceptions are that:
- OCD is only an obsession with cleanliness.
- MDD tends to be characterized as extreme sadness.
- Individuals with ADHD are characterized as lazy.
All of these are blanket statements that create false narratives.
The Daily Impact of MDD, OCD, and ADHD
The impact of each condition on daily life can be profound, often disrupting work, relationships, and personal well-being.
Gender Differences in Symptom Presentation
Gender differences further complicate their presentation, with women more likely to show internalizing symptoms of OCD and MDD, while men with ADHD often exhibit outward, externalizing behaviors 5.
Shared Challenges in Executive Functioning
Despite their distinct features, MDD, OCD, and ADHD share some important commonalities, particularly in the realm of executive functioning. Individuals with these conditions frequently struggle with maintaining focus, starting tasks, and managing their time effectively 4.
Anxiety Across MDD, OCD, and ADHD
Anxiety is also a shared element, though it manifests differently:
- As a driver of OCD rituals.
- A persistent feature of MDD.
- As a secondary result of ADHD-related disorganization.
Related: What is Anxiety?
Effects of Overlapping Challenges
These overlapping challenges often have significant effects on academic and workplace performance, as well as on personal relationships, where misunderstandings about the individual’s struggles can lead to tension or conflict.
Differentiating Co-Occurring Conditions
While these conditions are different, the outward difficulties people face with the symptoms can make it difficult to differentiate for diagnosis when they occur together.
Origins and Manifestations
Key differences between these disorders lie in their origins and how they manifest:
- OCD symptoms are rooted in intrusive thoughts that lead to compulsive behaviors.
- MDD symptoms stem from feelings of hopelessness and diminished motivation.
- ADHD symptoms, on the other hand, arise from neurodevelopmental delays that affect attention, impulsivity, and self-regulation.
Distinct Motivational Patterns
Motivational patterns also vary:
- OCD behaviors are driven by the need to reduce anxiety.
- MDD is often associated with a lack of motivation altogether.
- ADHD-related behaviors are frequently shaped by impulsivity or the pursuit of stimulation.
Differences in Attention-Related Struggles
Attention-related difficulties differ as well:
- OCD may involve an intense focus on specific fears.
- MDD often causes general mental sluggishness.
- ADHD leads to scattered or fleeting attention.
The Importance of Distinctions for Effective Treatment
These distinctions are essential for creating effective treatment plans that address the unique challenges posed by each condition.
The Complexity of Diagnosing Co-Occurring MDD, OCD, and ADHD
When MDD, ADHD, and OCD occur together, the diagnostic process becomes particularly complex. Overlapping symptoms, such as concentration problems and mimicking anxiety disorders or other mental health conditions, can mask the presence of individual disorders, leading to delays in accurate diagnosis.
MDD and ADHD
When experiencing symptoms of MDD, it can mask some symptoms of ADHD. For example, experiencing executive dysfunction – an inability to complete tasks, could be assumed as a symptom of MDD. Symptoms of ADHD like hyperactivity, might be muted due to MDD.
Related: ADHD and Depression: Understanding the Connection
OCD and ADHD
When experiencing symptoms of both ADHD and OCD, the overlap manifests differently. According to the Frontiers in Psychiatry, OCD and ADHD tend to co-occur at 11.8% 7. Individuals with ADHD experience a type of impulsiveness as a symptom, which is a common trait of OCD as well. When they co-occur, an individual may experience a lessening of ADHD impulsiveness. Instead, it will manifest heavily as OCD impulsiveness, which presents differently. This overlap can make diagnosis more complex.
MDD and OCD
When MDD and OCD overlap, the depression symptoms from MDD tend to be extremely apparent. MDD doesn’t exacerbate OCD symptoms, but they do commonly co-occur. Additional research needs to be completed on the link between MDD and OCD. As of now, it is common to be diagnosed with OCD first, then MDD 9.
Treating Overlapping Disorders
This overlap also complicates treatment, as approaches that work well for one disorder may worsen symptoms of another. For instance, exposure therapy used to treat OCD can increase emotional distress for someone with MDD, while stimulant medications for ADHD might exacerbate anxiety in individuals with OCD.
When experiencing two diagnoses together, it amplifies the challenges of daily life, intensifying difficulties in school, work, and social interactions. Conflicting coping mechanisms further complicate management, requiring carefully coordinated interventions that consider the unique needs of each individual 6.
A Thoughtful Approach to Complex Diagnoses
Here at Neuro Wellness Spa and Your Behavioral Health, we have a thoughtful and detailed approach in addressing the complex interactions between OCD, MDD, and ADHD and acknowledge both their shared traits and distinct characteristics. Comprehensive evaluations are essential to tease apart symptoms and allow us to develop personalized treatment strategies.
Comprehensive and Individualized Care
Treatment at Neuro Wellness Spa for ADHD, MDD, and OCD is done by a qualified professional through a comprehensive and individualized approach. Our approach identifies the conditions and their interplay. When reaching out to the Neuro Wellness Spa team, they’ll be able to guide you to what treatment you may be seeking. The option for in-person therapy, medication management or interest in TMS treatment will dictate which mental health professional you’ll be assigned to.
The Role of TMS in Treatment
We believe that transcranial magnetic stimulation (TMS) has emerged as a top choice for most cases, especially for individuals with MDD and OCD who struggle with traditional treatments 3. TMS has been approved by the FDA, is non-invasive, and there is no downtime 1. Medication management can also play a role in therapy, ranging from daily intensive outpatient or weekly 1-on-1 2. This process is invaluable in fostering better mental health conditions.
A Holistic Treatment Plan for Lasting Results
Combining in-person and online psychiatry, medication management, talk therapy, and TMS provides a holistic treatment plan that targets the symptoms from multiple angles, ensuring a comprehensive approach to improving functioning and quality of life. Reach out today so you can begin your journey.
Resources:
- Transcranial magnetic stimulation – Mayo Clinic. https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625
- Harvard Health Publishing. (n.d.). Medication or therapy for depression? Or both? Retrieved January 21, 2025, fromhttps://www.health.harvard.edu/staying-healthy/medication-or-therapy-for-depression-or-both
- TMS Depression and OCD treatment – MagVenture. (2024, October 1). MagVenture. https://magventure.com/depression-treatment/
- Snyder, H., Kaiser, R., Warren, S., & Heller, W. (2014). Obsessive-Compulsive Disorder is associated with broad impairments in executive function: A meta-analysis. Clinical Psychological Science. Association for Psychological Science.
- Quinn, P. O., & Madhoo, M. (2014). A review of Attention-Deficit/Hyperactivity Disorder in women and girls: Uncovering this hidden diagnosis. The Primary Care Companion for CNS Disorders, 16(3), PCC.13r01596.https://doi.org/10.4088/PCC.13r01596
- Hallion, L. S., Tolin, D. F., Assaf, M., Goethe, J., & Diefenbach, G. J. (2017). Cognitive control in Obsessive-Compulsive Disorder: A meta-analysis. Behaviour Research and Therapy, 95, 10–26. https://doi.org/10.1016/j.brat.2017.05.008
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text revision).Arlington, VA: American Psychiatric Publishing.
- Cabarkapa, S., King, J. A., Dowling, N., & Ng, C. H. (2019). Co-Morbid Obsessive–Compulsive Disorder and Attention Deficit Hyperactivity Disorder: Neurobiological Commonalities and Treatment Implications. Frontiers in Psychiatry, 10. https://doi.org/10.3389/fpsyt.2019.00557
- Abramowitz, J. (2010). International OCD Foundation | OCD and Depression. International OCD Foundation. https://iocdf.org/expert-opinions/ocd-and-depression/