By the end of his freshman year in college, my son Dan’s obsessive-compulsive disorder (OCD) was so severe that he could not even eat. He would sit in one particular chair for hours, doing absolutely nothing, and he was not able to enter most of the buildings on campus. Because he desperately wanted to be well enough to return to school in the fall, Dan spent his summer at a world-renowned residential treatment program for OCD.

Fast-forward a few months and Dan has returned to college. Though he understands his OCD now, and has improved greatly thanks to Exposure Response Prevention Therapy, he is still battling the disorder. He is also taking three different medications. His program of study is intense, and his anxiety levels are high. He is having a hard time keeping track of his cell phone and glasses, and is quite disorganized. His room is a mess. He tells his therapist that he often has trouble focusing in class.

Given this information, Dan’s therapist and psychiatrist now think he may have attention deficit hyperactivity disorder (ADHD) in addition to OCD. I don’t know a lot about ADHD, but I do know that it doesn’t just appear. Throughout his schooling, before OCD made its appearance, Dan had been a teacher’s dream: obedient, attentive and engaged. He excelled academically and never once were there any issues of concern. In fact, we often marveled at how he could read, or stay focused on anything, for hours at a time. It seemed obvious to me that Dan’s disorganization and inability to focus were a byproduct of having to deal with OCD.

It is known that OCD sufferers are at risk of having one or more co-morbid conditions (meaning two or more disorders that co-exist together). According to one study, some of the more common co-existing conditions with OCD include major depression, social phobias, additional anxiety disorders, and Tourette syndrome.

There are also those who believe that OCD and ADHD often occur together. This site on ADHD states, “It is not uncommon for someone to have both ADHD and OCD.” I find this statement baffling, as the basic symptoms of ADHD (listed below), in my opinion, seem to be in direct contrast to those of OCD:

Inattention: Having a short attention span and easily distracted. (Most people with OCD would love to be able to not pay attention to their thoughts.)

Impulsivity: Causes a person to do dangerous or unwise things without thinking about the consequences. (Those with OCD do the exact opposite. They play it safe and obsess about the consequences.)

Hyperactivity: Inappropriate or excessive activity. (Those with OCD often go out of their way to do what they feel is appropriate. Also, in Dan’s case, he often had very low energy as he was “wiped out” from struggling with his OCD.)

The fact that the symptoms of OCD and ADHD appear to be opposite should not really come as a surprise. Research has shown that both OCD and ADHD involve problems with the prefrontal cortex region of the brain. However, while OCD is associated with overactivity in this region, those with ADHD present with reduced activity in this area of the brain. So how can these disorders coexist?

In Dan’s case, there was no question in my mind that he did not have ADHD. But the psychiatrist and Dan wanted to try a stimulant, and because Dan was over 18, the decision was his.

Though Vyvanse definitely gave Dan more energy, he showed no improvement at all in his “ADHD-like” symptoms. As his new psychiatrist would later tell us, this should have been an immediate red flag. If Dan had indeed had ADHD, the medication should have helped.