Anxiety, OCD, or ADHD?
Why They’re Often Confused and Why the Difference Matters
Anxiety, OCD, and ADHD often look similar on the surface. Racing thoughts. Overwhelm. Trouble focusing. But underneath, they’re driven by very different systems — and that difference matters for treatment.
Generalized Anxiety Disorder (GAD)
What drives it: Ongoing threat perception
Core experience: Persistent worry about many areas of life
People with anxiety are stuck in “what if?” mode. The nervous system stays on high alert, even when there’s no immediate danger.
Key question: “What if something goes wrong?”
When anxiety eases, focus usually improves.
Obsessive-Compulsive Disorder (OCD)
What drives it: Intolerance of uncertainty
Core experience: Intrusive thoughts + compulsive attempts to neutralize them
OCD isn’t about liking things a certain way. It’s a loop: obsession → distress → compulsion → temporary relief.
Key question:“What if this thought means something — and I don’t fix it?”
Reassurance often makes OCD worse, not better.
Attention-Deficit/Hyperactivity Disorder (ADHD)
What drives it: Differences in dopamine and executive functioning
Core experience: Difficulty starting, organizing, and sustaining tasks
ADHD isn’t a motivation issue. Attention is inconsistent — strong for interesting things, difficult for everything else.
Key question:“How do I start and follow through?”
Anxiety is often secondary, developing after years of feeling behind or overwhelmed.
Why They’re So Often Mixed Up
All three can include:
Racing thoughts
Overwhelm
Difficulty focusing
Restlessness
They are the same behavior, but stemming from different causes!
Why This Distinction Matters
Treating ADHD as anxiety often leads to burnout, reassuring OCD fears can unintentionally reinforce symptoms, and addressing anxiety without executive-function support frequently results in only partial relief; effective care starts with understanding what’s driving the struggle—not just what it looks like on the surface. Can these exist together? ABSOLUTELY. Everyone is different. Clarity isn’t about more diagnoses— It’s about getting the right support for the right system.