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ADHD

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What's the connection between intrusive thoughts, ADHD, and OCD symptoms

Written by Klarity Editorial Team

Published: Nov 23, 2022

Medically Reviewed by Dr. Zoe Russell

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Attention deficit hyperactivity disorder (ADHD) and OCD are complex mental health conditions with a wide array of symptoms, including intrusive thoughts. These intrusive thoughts can make it difficult to maintain stable relationships, perform well at work or school, and lead to other issues.

In this post, we’ll explore the connection between intrusive thoughts, ADHD, and OCD. We cover:

  • How OCD, ADHD, and intrusive thoughts are related
  • Different types of intrusive thoughts
  • Why intrusive thoughts are common for people with mental illness
  • Tips you can follow to cope with intrusive thoughts 

If you struggle with intrusive thoughts due to attention deficit hyperactivity disorder, obsessive-compulsive disorder, or other anxiety disorders, Klarity can help.We connect people with board-certified mental health professionals who can diagnose and prescribe ADHD and Anxiety treatment online, if necessary. Schedule an appointment and meet with a healthcare provider within 48 hours or less.

Noticing symptoms and suspect you have a mental health condition? Find fast, affordable care from a provider on Klarity today.

The Relationship Between ADHD, OCD, and Intrusive Thoughts

ADHD, OCD, and intrusive thoughts can be interconnected in various ways. While ADHD and OCD are separate disorders, they can co-occur, and intrusive thoughts can be a common feature in both conditions.

Let’s discuss the relationship between these three elements in more detail.

ADHD is a neurodevelopmental disorder characterized by persistent symptoms of inattention, hyperactivity, and impulsivity. Mental health professionals identify three types of ADHD based on these three categories—inattentive ADHD, impulsive-hyperactive ADHD, and combined ADHD.

These types of ADHD can affect various aspects of an individual’s life, including academic, professional, and social functioning and are thought to be primarily associated with imbalances in neurotransmitters, such as dopamine and norepinephrine, which play a crucial role in attention and executive functioning.

OCD is a mental health disorder characterized by repetitive, unwanted thoughts (obsessions) and behaviors (compulsions) that the person feels the urge to perform. These obsessions and compulsions can significantly interfere with daily life and cause distress. OCD is believed to be associated with abnormalities in the brain’s serotonergic system and other neural circuits, including the orbitofrontal cortex, basal ganglia, and thalamus.

Intrusive thoughts are unwanted, involuntary thoughts, images, or urges that cause distress or anxiety. They can occur in both ADHD and OCD, although the nature and response to these thoughts may differ between the two conditions.

In ADHD, intrusive thoughts can manifest as racing thoughts or difficulty in filtering out irrelevant information. Individuals with ADHD might have trouble focusing on a single task or thought due to their minds constantly jumping from one idea to another. While these thoughts might be distressing, people with ADHD usually do not engage in compulsive behaviors to alleviate their anxiety. This is a key difference.

In OCD, intrusive thoughts are typically more persistent and distressing. They are often accompanied by rituals or compulsions to neutralize the anxiety caused by these obsessions. For example, someone with obsessive-compulsive disorder might have an intrusive thought about germs and then engage in excessive hand washing to mitigate their fear of contamination.

How can you tell the difference between intrusive thoughts from ADHD and intrusive thoughts from OCD?

It’s important to note that only a qualified mental health professional can accurately diagnose and differentiate between these disorders.

However, here are some key differences between intrusive thoughts in ADHD and OCD:

Nature of thoughts

ADHD: Intrusive thoughts in ADHD are often characterized by daydreaming, forgetfulness, and a general inability to sustain attention. These thoughts may not necessarily be distressing or anxiety-provoking.

OCD: Intrusive thoughts in OCD are typically obsessive, repetitive, and distressing. These thoughts are often irrational, causing anxiety or discomfort, and may be related to fears, inappropriate images, or taboo subjects.

Response to thoughts

ADHD: Individuals with ADHD may be more likely to act impulsively on their intrusive thoughts without thinking about the consequences.

OCD: Individuals with obsessive-compulsive disorder may try to suppress or neutralize their intrusive thoughts by engaging in compulsions or rituals to reduce their anxiety or distress.

Context

ADHD: Intrusive thoughts in ADHD are more likely to arise due to difficulties with focus and attention, leading to a broad range of thoughts that may not be related to any specific theme or pattern.

OCD: Intrusive thoughts in OCD often revolve around specific themes, such as contamination, harm to oneself or others, religious or sexual themes, or the need for symmetry or order.

It’s important to remember that mental health disorders can present differently in each individual, and sometimes, ADHD and OCD can co-occur. If you suspect that you or someone you know may be experiencing intrusive thoughts related to ADHD or OCD, it is essential to consult a mental health professional for a thorough assessment and appropriate treatment.

Types of Intrusive Thoughts

Intrusive thoughts are unpredictable both in what they are about and when they are triggered. While intrusive thoughts can be about anything, there are a few key subjects they tend to center around. Identifying these subjects is central to understanding why these thoughts occur, and it’s the first step toward finding relief from harmful lines of thought.

Intrusive Sexual Thoughts

Individuals with ADHD often struggle with having a sex drive that is much higher or lower than others. This makes maintaining a healthy sexual relationship with a partner difficult and can contribute to intrusive sexual thoughts. 

These thoughts can be distracting, especially if they occur at an inappropriate time or place, making it difficult to complete work or feel comfortable in social situations.

Intrusive Violent Thoughts

Intrusive thoughts caused by ADHD can also be violent in nature, often spurred by negative feelings of anger. Just as ADHD makes it difficult to control sexual desires and compulsions, it also makes it challenging to regulate your anger and other related emotions. 

These intrusive thoughts can be particularly harmful, as acting on them could have serious consequences. It’s essential that you don’t let violent intrusive thoughts go unchecked so they don’t continue or worsen.

Catastrophizing Intrusive Thoughts

With ADHD comes heightened feelings of anxiety, and this anxiety often manifests as catastrophizing intrusive thoughts

For example, you may have catastrophic thoughts before a large public event that shift from one unlikely situation to another. You may think you’re going to embarrass yourself in some way, then you may think someone is going to physically harm you, and then your thoughts could continue to snowball from there.

For many people with mental health disorders or other mental health conditions, intrusive thoughts about the worst-case scenario are commonplace. And getting ahead of these catastrophizing thoughts is often easier said than done.

Why Are Intrusive Thoughts So Common In People With Mental Health Disorders?

Intrusive thoughts are common in people with mental health disorders because these thoughts often stem from or are exacerbated by underlying cognitive, emotional, or neurobiological factors associated with various mental health conditions. Here are a few reasons why intrusive thoughts may be more prevalent in people with mental health disorders:

  • Cognitive distortions: Many mental health disorders involve cognitive distortions or dysfunctional thought patterns, which can contribute to the development of intrusive thoughts. For instance, individuals with depression or anxiety may have a negative cognitive bias, making them more prone to experiencing distressing thoughts.
  • Dysregulated emotions: Some mental health disorders, like borderline personality disorder or bipolar disorder, involve intense and fluctuating emotions. These emotional dysregulations can make it more challenging for individuals to manage intrusive thoughts effectively, leading to increased distress and rumination.
  • Neurobiological factors: Research suggests that differences in brain function and neurotransmitter levels in people with mental health disorders may play a role in the development of intrusive thoughts. For example, imbalances in serotonin, dopamine, or norepinephrine levels may contribute to intrusive thoughts in individuals with anxiety, depression, or ADHD.
  • Stress and coping: Mental health disorders often involve heightened stress levels and impaired coping mechanisms. This can make it more difficult for individuals to effectively manage intrusive thoughts or prevent them from becoming overwhelming.
  • Sensitivity to uncertainty or threat: Some mental health disorders, such as anxiety disorders, are characterized by heightened sensitivity to potential threats or uncertainty. This increased vigilance may make individuals more prone to experiencing intrusive thoughts related to their fears or concerns.
  • Maladaptive coping strategies: In some cases, intrusive thoughts may be inadvertently reinforced by maladaptive coping strategies, such as avoidance or reassurance-seeking. For example, individuals with OCD may engage in compulsive behaviors to neutralize their intrusive thoughts, inadvertently strengthening the connection between the thoughts and anxiety.

It’s important to remember that experiencing intrusive thoughts is not exclusive to those with mental health disorders, as most people have occasional intrusive thoughts in their lives. However, the frequency, intensity, and impact of intrusive thoughts are typically more pronounced in individuals with mental health conditions.

Common Causes of Intrusive Thoughts

The root cause of intrusive thoughts can often be challenging to identify. They typically connect to how someone feels, so if you’re particularly sad or angry, you’re more likely to have intrusive thoughts in line with those emotions. Some of the most common causes of intrusive thoughts are listed below.

Periods of High Stress and Vulnerability

Periods of high pressure can lead to intrusive thoughts that can worsen your stress. If you’re working on an important project at your job, for example, you may have intrusive thoughts about what would happen if the project isn’t well received. And those thoughts can lead you to imagine this project determines the fate of your career when, in reality, the stakes are much lower.

Intrusive thoughts can also occur in situations where you feel vulnerable. Returning to the previous example from work, if you’re receiving constructive criticism, you may feel vulnerable and take the critique personally. You may overthink it to the point where you apply the criticism to your own self-worth and discourage yourself from pursuing similar projects in the future.

Periods of Isolation

When intrusive thoughts are an issue in your daily life, periods of isolation can cause you to hyper-fixate on those thoughts. Without anything to distract you or someone to tell you that your thoughts are likely irrational, it can be challenging to get yourself away from cyclical ideas and false perceptions.

After Traumatic or Stressful Events

Even if you aren’t in an actively stressful situation, you may still experience intrusive thoughts due to past stressful events. This is where many catastrophizing intrusive thoughts come into play, as ruminating on a traumatic or stressful event may lead you to believe you’ll relive it for the rest of your life. 

There is a tendency for people with post-traumatic stress disorder to experience intrusive thoughts regarding a past traumatic incident. Therefore intrusive thoughts can be a symptom of post-traumatic stress disorder.

How To Prevent Intrusive Thoughts

While it may seem impossible to prevent intrusive thoughts with how sudden and unexpected they are, there are ways to regain control of your mind. Like anything, it takes practice and dedication to find relief from this disruptive symptom of ADHD. Some of the best ways to prevent intrusive thoughts are listed below.

Identify Your Triggers

Although some intrusive thoughts may feel random, they are often triggered by some kind of stimulus. Identifying your triggers can play a significant role in overcoming intrusive thoughts, as you’ll learn how to avoid them and prevent them from happening in the first place.

Remain Calm

Whenever you do have intrusive thoughts, it’s essential to remain calm. These thoughts are just information about how you’re doing at that moment. If you allow yourself to panic, your thoughts will likely become more severe to the point where they spiral out of control. The more you can remain calm, the more likely your intrusive thoughts will pass without disrupting your day.

Find a Distraction

An effective way to avoid intrusive thoughts is by redirecting your attention elsewhere. If you find that you’re focusing too much on one negative thought, try doing something like playing a game or writing in a journal. By switching to an activity that requires focus, you’ll have fewer opportunities to focus on your intrusive thoughts.

Allow Intrusive Thoughts To Pass and Fade Away

If you have an intrusive thought that is violent or sexual, one way to prevent them from taking hold of your mind is by simply letting them pass. For many people, so long as they don’t act on their thoughts, they’ll fade away with time as other distractions arise.

However, it may take longer for some than others, and letting an intrusive thought pass can eventually show that it’s not worth thinking about.

Receive Treatment for ADHD, Obsessive-Compulsive Disorder, or Other Mental Health Conditions Associated With Intrusive Thoughts

Treatments for OCD-related intrusive thoughts:

  1. Medication: Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressant medications commonly prescribed for OCD symptoms. SSRIs may help reduce the intensity of intrusive thoughts and compulsions by increasing serotonin levels in the brain.
  2. Cognitive Behavioral Therapy (CBT): CBT is a widely used and evidence-based therapy for OCD. It involves identifying and challenging irrational thoughts and beliefs while also teaching new behavioral strategies to manage anxiety and resist compulsions.
  3. Exposure and Response Prevention (ERP): ERP is a specific type of CBT that focuses on gradually and systematically exposing individuals to their fear triggers while preventing them from engaging in compulsive rituals. This helps individuals learn to tolerate distress and reduces their reliance on compulsions.
  4. Mindfulness and Acceptance-based therapies: Approaches like Acceptance and Commitment Therapy (ACT) or mindfulness-based cognitive therapy can help individuals become more aware of their thoughts and feelings, allowing them to accept and respond to them in healthier ways.

Treatments for ADHD-related intrusive thoughts

  • Medication: Stimulant medications, such as methylphenidate (Ritalin) or amphetamine (Adderall), are often prescribed for ADHD. These medications can help improve focus, reduce impulsivity, and manage other ADHD symptoms, including intrusive thoughts.

Dependency warning: It is important to be aware that stimulant medications have the potential for dependence and misuse. These medications should only be used under the supervision of a qualified healthcare professional. 

It is essential to follow the prescribed dosage and regularly communicate with your healthcare provider to monitor effectiveness and any potential side effects. Abruptly stopping these medications can lead to withdrawal symptoms. 

If you have concerns about dependency or experience any adverse effects, please consult your healthcare provider for guidance.

  • Behavioral therapy: Behavioral interventions for ADHD often involve teaching individuals specific skills, such as organization, time management, and goal-setting, to help them manage their symptoms more effectively.
  • Cognitive Behavioral Therapy (CBT): CBT can also be adapted for individuals with ADHD, focusing on strategies to improve attention, reduce impulsivity, and manage intrusive thoughts.
  • Mindfulness and relaxation techniques: Mindfulness meditation, deep breathing exercises, and other relaxation techniques can help individuals with ADHD improve their focus and manage intrusive thoughts.

Klarity connects you with board-certified mental health providers. The treatments those providers recommend are at the sole discretion of those medical providers and not Klarity.

Find a Provider on Klarity and Get Treatment to Resolve Intrusive Thoughts

Klarity can help you get to the root cause of your intrusive thoughts, whether it’s from ADHD, an anxiety disorder, or another related mental health issue.  

When you book on Klarity, we connect you with OCD and ADHD specialists who can provide anxiety, OCD, and ADHD treatment online, so you don’t have to worry about taking time off work or commuting to the doctor’s office to receive the care you need.

Schedule your appointment and meet with a healthcare professional within 48 hours.

Sources

Abramovitch A, Schweiger A. “Unwanted intrusive and worrisome thoughts in adults with Attention Deficit\Hyperactivity Disorder.” Psychiatry Res. https://pubmed.ncbi.nlm.nih.gov/19570581/

Beth Main. “ADHD and Obsessive Thoughts: How to Stop the Endless Analysis.” ADDitude. https://www.additudemag.com/adhd-and-obsessive-thoughts-too-clingy-insecure/.

Camille Noe Pagán. “Is ADHD Causing Your Sexual Problems?” WebMD. https://www.webmd.com/add-adhd/adhd-sexual-problems.

Caroline Maguire, MEd, ACCG, PCC. “I Can’t Stop Thinking About It.” CHADD. https://chadd.org/adhd-news/adhd-news-adults/i-cant-stop-thinking-about-it/.

Jacqueline Sinfield. “How to Stop Overthinking When You Have ADHD.” Very Well Mind. https://www.verywellmind.com/how-to-stop-over-thinking-3868209.

Mayo Clinic Staff. “Adult attention-deficit/hyperactivity disorder (ADHD).” Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/adult-adhd/symptoms-causes/syc-20350878

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