Is it OCD, Anxiety or ADHD: How Assessment Can Help Answer That Question

OCD, Anxiety, ADHD, and Learning Disorder Assessments in Austin, TX

Austin Anxiety and OCD Specialists provides comprehensive psychological assessments for children, adolescents, and adults in Austin and the surrounding Central Texas area. We specialize in diagnostic evaluations for obsessive-compulsive disorder (OCD), anxiety disorders, attention-deficit/hyperactivity disorder (ADHD), and learning differences such as dyslexia. Our assessments are evidence-based, individualized, and designed to guide effective treatment planning and school or workplace accommodations when appropriate. Comprehensive psychological assessment is often the first step toward effective, evidence-based treatment for OCD, anxiety disorders, ADHD, and learning differences.

While more than one out of 100 people experience obsessive-compulsive disorder (OCD), research shows that it takes up to 17 years for many people experiencing OCD to receive that diagnosis. A delay can exacerbate the shame and general distress that people with OCD experience, as they will not understand the reason they are struggling, and it means that they are typically not receiving effective treatment prior to that diagnosis. Therefore, diagnosis as early as possible is critical to accessing effective treatment and beginning the journey toward improving functioning.

One challenge with receiving this diagnosis as soon as possible is that some symptoms can represent multiple challenges, and assessment is required to differentiate between possible OCD and other diagnoses, including dyslexia and attention-deficit/hyperactivity disorder (ADHD). Anxiety disorders can also complicate this picture. Below, these conditions will be explained along with the ways that dyslexia and ADHD can be differentiated from OCD and/or anxiety through the assessment process.

Defining OCD and Anxiety

Obsessive-compulsive disorder (OCD) involves having either obsessions and/or compulsions that are causing impairment, significant distress, or taking up significant amounts of time. Most people with OCD experience both obsessions and compulsions. Obsessions are repeated, unwanted thoughts that are distressing or cause discomfort. Compulsions are repeated behaviors that someone feels they have to do, even if they do not want to do them; they often lead to temporary relief but an increased need to do them over time, which leads to symptoms worsening. The distress that comes with OCD is often described as anxiety, but it can also be other emotions, such as discomfort or frustration.

Anxiety, on the other hand, could refer to one of several anxiety disorders. The broadest of these disorders is called generalized anxiety disorder (GAD), in which someone worries much of the time about a variety of topics and experiences specific related symptoms when worried. A GAD diagnosis also requires that someone has difficulty controlling their worries and that the worry causes significant impairment or distress. Other anxiety disorders include the following:

• Social anxiety disorder: worry related to social situations

• Panic disorder: panic attacks combined with worry about future panic attacks or avoidance related to efforts aimed at preventing such attacks

• Separation anxiety: worry related to separation from an attachment figure

• Specific phobias: fear and related avoidance of a specific feared object, situation, animal, etc.

Dyslexia vs OCD and Anxiety

The condition that is commonly known as dyslexia is officially called a specific learning disorder with impairment in reading. Learning disorders in reading involve difficulty with accurately reading words, how quickly someone reads, and how well someone understands what they read. Typically, dyslexia specifically refers to difficulty with recognizing or decoding words or spelling words. In order to qualify for a learning disorder in reading, the person’s reading ability must be “substantially and quantifiably below those expected” given the person’s age, and this must get in the way of their academic or work performance or with day-to-day activities. These challenges must have begun during school-age years, though they may not become clear until the person experiences sufficient demands that tax the area of challenge. Learning disorders also require ruling out other diagnoses that may better account for these challenges.

One of the ways that OCD can most often appear like dyslexia is when someone has a re-reading compulsion. In the case of OCD, people will repeatedly read information despite the fact that they understood it the first time, either due to a worry that they did not fully understand it, a fear of some negative outcome if they do not read it again, or a general feeling of discomfort that is relieved by repeatedly reading. In the case of dyslexia, reading is repeated because it was not fully understood or decoded the first time. The assessment process evaluates various aspects of reading to determine if a person’s reading ability is significantly below where they are expected to be for their age and observations during the assessment process. OCD is evaluated through rating scales and diagnostic interviews. This allows for discussion of the process that occurs when re-reading as well as data compared to other people their age on both reading abilities and OCD symptoms.

Though anxiety is less likely to be mistaken for dyslexia or vice versa, anxiety that occurs when completing schoolwork or examinations in school can have a negative effect on a person’s grades and other outcomes. These effects may occur due to the person becoming distracted, worries about their performance, perfectionistic tendencies, etc. Additionally, if someone is experiencing both dyslexia and anxiety, they may know that reading is an area of difficulty for them and, as a result, feel more worried about how they will perform. In the end, anxiety can interact with dyslexia to lead to a lower performance on schoolwork and tests than the person would be capable of producing if the anxiety were not a factor.

ADHD vs OCD and Anxiety

Attention-deficit/hyperactivity disorder (ADHD) includes three different types of disorders: the predominantly hyperactive/impulsive presentation (ADHD-PHI), the predominantly inattentive presentation (ADHD-PI), and the combined presentation that includes symptoms of both the other presentations (ADHD-C). For all presentations, symptoms must have been present prior to the age of 12, must be present in at least two settings, and must cause impairment. Hyperactive and impulsive symptoms include frequent fidgeting, difficulty remaining seated, difficulty playing quietly, acting as if driven by a motor, excessive talking, running or climbing in inappropriate situations, blurting out answers before the end of the question, difficulty waiting their turn, and interrupting or intruding on others. Inattentive symptoms include frequent careless mistakes, difficulty sustaining attention, frequently not listening when spoken to directly, frequently failing to follow through on instructions, frequent difficulty with organizing, frequent avoidance of tasks that require sustained mental effort, and often losing items.

In the case of both OCD and anxiety disorders, as well as other disorders such as depression, people can appear to be inattentive. However, the cause of inattention is different in ADHD than in these other conditions. Specifically, people with anxiety, OCD, and depression tend to become distracted by distressing thoughts or struggle to focus due to lack of energy cause by the energy they are expending coping with their distress. In the case of ADHD, there is no specific thought that causes distraction. Instead, someone with the inattentive presentation of ADHD tends to have difficulty controlling their attention. They can often focus well on preferred tasks, but tasks they consider to be boring or unwanted are more challenging. Symptoms of hyperactivity and impulsivity could also be present in OCD or anxiety. They may appear to be hyperactive, but this is caused by agitation from their distress. Similarly, when OCD and anxiety are utilizing much of the person’s mental resources, they may react impulsively without time to appropriately consider choices.

Through the ADHD assessment process, data is collected and compared to other people their age from multiple settings. For children and adolescents, this is typically collected both from home and school, providing information on whether the possible ADHD symptoms are being observed by different people and in different settings. For adults, observers are chosen who can report on the symptoms in various settings, such as the workplace or in social settings. If the symptoms are not occurring in multiple settings, this typically points to an alternative explanation. The assessment process also includes rating scales and diagnostic interviews for other mental health symptoms that may be occurring, provides an opportunity for observations of the person’s style of work, and rules out any learning disorders that may be contributing to the person’s challenges. Someone’s narrative explanation of what happens when they become distracted, impulsive, or restless may also be telling when attempting to separate ADHD symptoms and OCD or anxiety symptoms. Additionally, these conditions can co-occur, and the assessment process is the best way to evaluate this possibility.

Meet Austin Anxiety and OCD Specialists’ Assessment Psychologist: Dr. Rebecca Suffness

Dr. Rebecca Suffness, is a licensed psychologist with specialized training in comprehensive psychological assessment and evidence-based care for children, adolescents, and young adults. She brings extensive experience in evaluating anxiety disorders, obsessive-compulsive disorder (OCD), ADHD, learning differences, and related concerns, using structured interviews, standardized assessment measures, and thoughtful clinical observation to inform accurate diagnosis and treatment planning. Dr. Suffness earned her Bachelor’s degree in Psychology from Duke University and her Master’s and PhD in Clinical Psychology from the University of North Carolina at Greensboro, and she has completed an APA-accredited pre-doctoral internship with valuable school-based assessment and intervention experience. Known for her collaborative approach and commitment to individualized care, Dr. Suffness partners with families and clients to clarify diagnostic questions and outline clear next steps toward effective support.

Psychological Assessment at Austin Anxiety and OCD Specialists

If you or your child are struggling with symptoms that may involve OCD, anxiety, ADHD, or learning differences, and you’re unsure what is truly driving the challenges, comprehensive assessment can provide clarity and direction. At Austin Anxiety and OCD Specialists, our assessment process is designed to carefully differentiate between these experiences, identify co-occurring concerns when present, and offer clear, evidence-based recommendations for next steps. Early and accurate diagnosis can reduce unnecessary distress and help you move toward effective treatment sooner. To schedule an assessment or learn more about our testing services, we invite you to contact us today and take the first step toward understanding and support.