526- OCD in Children with ADHD: Navigating the Dual Diagnosis

·1 hr·5 clips

Natalia Ayesa, a therapist and parent with ADHD, shares her family's struggle with OCD and ADHD dual diagnosis.

This episode of the ADHD Experts Podcast features Natalia Ayesa, a therapist and co-founder of Kairos Wellness Collective, discussing the dual diagnosis of OCD and ADHD in children. Natalia begins by sharing her personal experience as a parent and person with ADHD and OCD, establishing her credibility. She highlights that 25% of children with OCD also have ADHD, a common concurrence. Natalia explains that OCD is often misunderstood, characterized by obsessive thoughts leading to compulsions, frequently involving avoidance rather than cleanliness. She describes how OCD can manifest as mental compulsions, such as rereading texts multiple times, which she experienced as a child. Natalia details nine themes of pediatric OCD, including harm fears, people-pleasing, perfectionism, and food pickiness, providing specific examples like children stalking parents on Life360 or over-apologizing. She compares OCD and ADHD, noting both affect the frontal striatal brain system but with opposite activity levels. Natalia discusses how these conditions impact school attendance and attention, with children often zoning out due to OCD worries. She emphasizes exposure response prevention as the most effective treatment, with an 80-90% success rate when applied by specialists, and mentions medications like SSRIs and stimulants. Natalia warns against talk therapy for OCD, which can worsen symptoms, and advises consulting OCD specialists. She presents a case study of a composite child, Nadia, to illustrate misdiagnosis and treatment steps. In the Q&A section, Natalia answers listener questions on topics like clothing triggers, teen refusal of treatment, bedtime rituals, and body-focused repetitive behaviors. She addresses live audience questions on OCD in autistic brains, how OCD changes with age, school accommodations, and correlations with gaming. Natalia concludes by encouraging listeners to seek OCD specialists for proper diagnosis and treatment.

As heard by us

OCD can hide behind avoidance long before it looks like a ritual.

This episode offers a practical look at OCD in children with ADHD, moving beyond the familiar hand-washing stereotype to the quieter signs that can be easier to miss: avoidance, school refusal, panic, and distraction that may point to something deeper.

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Why you'd press play

You need a clearer read on OCD signs when ADHD muddies the picture at school and home.

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