“I began advocating for individuals who live with OCD and their loved ones because I want to educate people on proper OCD treatments and use my story to let them know there is hope.” — Maya Todross on "Why I Became An Advocate"
Written by IOCDF Advocate Maya Todross. Learn more about our advocate program and resources.
“I think we need to rule out ADHD,” my therapist of four years carefully explained to me. At 20 years old, I had been under the care of mental health professionals for over six years for obsessive-compulsive disorder (OCD), and this was the first time that the possibility of an ADHD diagnosis was ever brought up.
Therapists and psychiatrists always labeled my case as “textbook OCD.” A genetic predisposition plus the environmental stressor of entering high school likely triggered the onset of common OCD symptoms like contamination, perfectionism, and scrupulosity obsessions and compulsions. Thankfully, because of the content of my symptoms, my OCD was very easily diagnosed. However, no other diagnoses were explored. I didn’t even think to seek other diagnoses, as OCD could be used as an explanation for every single symptom I experienced from ages 14 to 19. And OCD was an accurate attribution for a lot of of these symptoms!
Thankfully, my OCD responded very well to the golden-standard treatment for OCD- exposure and response prevention therapy (ERP) and antidepressant medication, that is, once I admitted myself into residential treatment at age 16. For two whole years, from ages 14-16, my entire being was consumed by obsessive thoughts and the drive to perform compulsions as I bounced from professional to professional seeking appropriate treatment. Like many, I mistakenly believed that my OCD was fully managed by the time I was discharged from residential treatment. It took almost five years of biweekly therapy after residential to be able to (somewhat) confidently say that I have my OCD managed. I learned more about myself in those five years than I ever expected.
"There’s no way I could have ADHD,” I immediately responded. My father and sister both have ADHD, and I was nothing like them. Any inattention or restlessness I experienced was surely an anxiety or OCD symptom. Also, I’ve always done well in school. How could I have ADHD? I reluctantly began to monitor how I felt when I got restless or fidgety.
Surprisingly, a lot of my inability to sit still occurred when I wasn’t anxious at all. Over the next few weeks I noticed that my procrastination, which I thought was due to perfectionism, actually felt more like an inability to switch or initiate tasks. I also began to recognize that my inattention in class was not tied to intrusive thoughts but boredom with the subject matter.
ADHD symptoms as an adult alone are not enough to warrant a diagnosis, I remembered from my psychopathology class. Self-reflection over the following months as well as speaking to my parents helped me remember some key things from my childhood. I made lots of careless mistakes on schoolwork and interrupted people in conversation, two hallmark ADHD symptoms. I also had sensory issues, trouble sleeping, and excessively daydreamed as a kid, all of which are associated with neurodevelopmental disorders like ADHD.
The next logical step, an ADHD assessment, was near impossible to access. My new psychiatrist agreed that my symptoms aligned with ADHD but did not seem to impact me enough to warrant a diagnosis or treatment. I consulted a second psychiatrist, who believed my symptoms were solely school-related. The third psychiatrist with whom I met finally agreed to do a clinical assessment of ADHD after making sure my symptoms were not anxiety-related. Finally, I was diagnosed with ADHD, a disorder I never thought I could have due to 1) severe OCD and 2) ADHD stigma.
After my ADHD diagnosis, I continued my journey of self reflection. Gradually, I began noticing how my OCD and anxiety compensated for many ADHD symptoms throughout my life. Scrupulosity obsessions made me afraid of being rude, so I compulsively inhibited my urges to interrupt people. Perfectionism OCD masked executive functioning difficulties. Further, my OCD was so severe and obvious that clearly it had to be treated first before anything else.
I am ashamed that as a mental health advocate, I held stereotypes about ADHD in my mind. Specifically, I believed ADHD was homogeneous and manifested solely as impulsivity and hyperactivity. Unfortunately, these stereotypes were reinforced by some mental health professionals, one of whom suggested I could not have ADHD because I do well in school.
Proper treatment for my OCD left my ADHD visible, and proper ADHD treatment has helped me get to a point in recovery I never thought possible before my ADHD diagnosis. I have now become an advocate for those with comorbid OCD and ADHD. If you have OCD and suspect you may have ADHD, it is worth getting assessed! There may be many hoops to jump through and hurdles to jump over, but fighting for answers is worth it. You are not alone in this!
I wonder if you could write another post about how your adhd was treated (medication?) and how they worked with your ocd medication? My daughter is 16, diagnosed with OCD last year but I’d bet anything she has adhd also. Similar issues to you, very smart, sensory issues, sleeping issues, interupting, can’t see to get motivation to start things despite her above average intellect. Our psychiatrist has pretty much said the med for OCD and ADHD are different and you can’t take both. So, can only treat one. I’d love to hear a bit about your treatments for both if that’s possible.
Thanks
Your situation reminds me so much of my 23 year old daughter. I was curious what specific treatment you had for ADHD? She is only in ocd treatment but continues to struggle with executive functions etc.. any suggestions are appreciated.