Dopamine + Doubt: Untangling ADHD and OCD

Rachel Keefe, LCSW
  • 5.0 (10)
  • Mental Health
  • Updated Weekly

Dopamine and Doubt is a podcast about the overlap between ADHD and OCD—and what happens when it’s hard to tell which one is driving the behavior. Hosted by therapist Rachel Keefe, LCSW, the show explores ADHD and OCD symptoms including executive functioning difficulties, hyperfixation, reassurance seeking, intrusive thoughts, rumination, checking, avoidance, time blindness, and uncertainty. Each short episode breaks down confusing or relatable experiences in plain language, with real-life examples and practical strategies. You’ll learn how ADHD and OCD can look similar, where they differ, and how to respond when your brain gets stuck trying to figure everything out. Because the goal isn’t always to find the perfect answer. Sometimes, it’s learning to live with a little more uncertainty—and a little less doubt.

Episodes

  1. 1d ago

    Using AI As An ADHD Accommodation Without Feeding OCD

    AI can feel like magic for an ADHD brain and like gasoline for OCD. I’m Rachel, a licensed clinical social worker who lives and works at the intersection of ADHD and OCD, and I’ve noticed the same tool can either support real-life functioning or quietly turn into reassurance seeking. The difference isn’t whether you use AI. The difference is the job you’re asking AI to do.  • how AI can be an ADHD accommodation through scaffolding and structure • breaking big tasks into smaller steps to support executive function • using AI for time estimation to reduce time blindness and unrealistic scheduling • lowering decision fatigue with meal planning and prioritizing • when AI supports OCD recovery by reducing compulsive rewriting and checking • the difference between drafting help and seeking certainty about tone or outcomes • using “read once and send” as response prevention practice • a practical test: values-based action versus escaping uncertainty If this resonates, subscribe so you don’t miss future episodes, share it with someone who’s navigating ADHD or OCD, and leave a review to help more listeners find the show. What’s one way you’ve noticed AI helps you move forward, or pulls you into checking? Send us Fan Mail Support the show How to Connect Visit the website: https://www.dopamine-and-doubt.com Follow on Instagram: @Dopamineanddoubtpodcast  https://www.instagram.com/dopamineanddoubt/ Email: dopamineanddoubtpod@gmail.com Love the show? Please leave a review on Apple Podcasts or Spotify-it helps listeners find the show! Resources from episodes: https://linktr.ee/dopamineanddoubt

  2. Sep 1

    ADHD Hyperfixation or OCD Reassurance Seeking Spiral: A Simple Framework

    “One more article. One more Reddit thread. One more Google search.” If you’ve ever looked up and realized you’ve been researching the same question for way too long, you’re not alone and you’re not broken. I am talking about the ADHD and OCD overlap where hyperfocus and reassurance seeking can look almost identical, even though the “why” underneath is completely different. I share the framework I use when stuck in that blurry space. First, we work with ADHD hyperfocus by building “exit ramps” instead of hard stops: movement breaks, body check-ins, alarms, transition cues, and simple boundaries like app blockers or scheduled hobby time. The goal isn’t to kill your focus or curiosity. It’s to protect the strength of hyperfocus while reducing the cost, so your body doesn’t end up running on empty. Then we zoom in on the pivot point: “Am I still learning, or am I trying to feel certain?” I break down information seeking versus OCD reassurance seeking, why the “are you sure?” loop never feels finished, and how to tell when a question is answerable versus fundamentally uncertain. If you’re already in the spiral, I walk through practical OCD tools rooted in response prevention: naming the urge, using uncertainty statements like “maybe, maybe not,” delaying the compulsion for five to ten minutes, and reorienting toward what matters to you. If you’ve been trying to out-research anxiety, this conversation gives you a kinder and more effective next step. Subscribe for more ADHD and OCD strategies, share this with a friend who gets stuck in loops, and leave a review with the question you want us to tackle next. * **Episode Resource**: Download the original Information Seekers vs. Reassurance Seekers PDF developed by the Anxiety Disorders Center at the St. Louis Behavioral Medicine Institute https://iocdf.org/wp-content/uploads/2016/04/18-Information-seekers-vs-reassurance-seekers.pdf Send us Fan Mail Support the show How to Connect Visit the website: https://www.dopamine-and-doubt.com Follow on Instagram: @Dopamineanddoubtpodcast  https://www.instagram.com/dopamineanddoubt/ Email: dopamineanddoubtpod@gmail.com Love the show? Please leave a review on Apple Podcasts or Spotify-it helps listeners find the show! Resources from episodes: https://linktr.ee/dopamineanddoubt

  3. Aug 25

    ADHD Hyperfixation or OCD Reassurance Seeking? How Can You Tell?

    You can spend hours researching the same question for two totally different reasons and your brain will swear they’re the same. Sometimes it’s ADHD hyperfixation: energized, fascinated, locked in because the topic is rewarding. Other times it’s OCD reassurance seeking: urgent, tight, and driven by the need to feel certain enough to finally be safe. The behavior can look identical, but the function is everything. I unpack the moment “I’m curious” quietly turns into “I need certainty,” and why ADHD hyperfixation and OCD reassurance seeking can look identical on the surface. I share a simple way to tell which brain state is driving, so you can pause sooner and stop feeding the research loop. • the ADHD and OCD crossover and why context matters • hyperfixation as “tell me more” and how hyperfocus fits in • reassurance seeking as “tell me I am okay” and why it feels urgent • why reassurance looks like problem solving but only relieves anxiety briefly • real-world spirals like health Googling, Reddit deep dives, rereading texts, seeking validation • gentle check-ins to spot the shift from curiosity to certainty chasing • naming what is happening and practicing the pause  If ADHD hyperfocus creates the perfect runway for OCD certainty-chasing, this framework helps you pause, name it, and choose your next step on purpose.  Subscribe for more ADHD and OCD tools, share this with someone who lives in the tabs, and leave a review with the question you want answered next. Send us Fan Mail Support the show How to Connect Visit the website: https://www.dopamine-and-doubt.com Follow on Instagram: @Dopamineanddoubtpodcast  https://www.instagram.com/dopamineanddoubt/ Email: dopamineanddoubtpod@gmail.com Love the show? Please leave a review on Apple Podcasts or Spotify-it helps listeners find the show! Resources from episodes: https://linktr.ee/dopamineanddoubt

  4. Aug 18

    The Checking Trap: When ADHD Accommodations Turn into OCD Compulsions

    Checking can save you when you have ADHD, and it can also steal your life when OCD gets behind the wheel. Today I am breaking down a pattern I see constantly: the same outward behavior that supports executive function can also become a compulsion fueled by anxiety and the need for certainty. • ADHD checking as information-seeking that has an endpoint • OCD checking as anxiety-driven certainty-seeking that expands doubt • “System vs search” as a quick decision filter • Reasonable accommodations like planned calendar reviews, photos, smart locks, and departure routines • OCD skills like limiting checks, delaying checks, and practicing uncertainty tolerance • A real missed-appointment story that highlights guilt versus shame and the power of repair • Building flexible systems that reduce preventable mistakes while accepting inevitable ones You’ll leave with a clear question to ask yourself (“Is this a system or is this a search?”), plus practical strategies for ADHD systems and OCD uncertainty tolerance so you can stop losing hours to “one more” confirmation. If this helps, subscribe, share it with a friend who overchecks, and leave a review so more people at the ADHD and OCD intersection can find us. Send us Fan Mail Support the show How to Connect Visit the website: https://www.dopamine-and-doubt.com Follow on Instagram: @Dopamineanddoubtpodcast  https://www.instagram.com/dopamineanddoubt/ Email: dopamineanddoubtpod@gmail.com Love the show? Please leave a review on Apple Podcasts or Spotify-it helps listeners find the show! Resources from episodes: https://linktr.ee/dopamineanddoubt

  5. Aug 11

    ADHD Time Blindness: Why My Schedule Was....Optimistic

    Your calendar says you have plenty of time. Your body says you’re already behind. If you’ve ever planned a full “before lunch” lineup and then looked up to realize you scrolled your phone, got gas, and somehow lost the whole morning, we’re talking about the real culprit: time blindness. I’m Rachel, a licensed clinical social worker who specializes in ADHD and OCD, and I’m sharing both clinical insight and lived experience on why time can feel warped in an ADHD brain. We unpack what time blindness actually is, how it shows up as impossible scheduling, the “just one more thing” trap, and that frozen feeling of “I have an appointment later, so I can’t start anything.” We also dig into perfect world scheduling, the kind of plan that only works when nothing goes wrong, and why that sets you up for stress when real life inevitably interrupts. • Time blindness defined as difficulty sensing time and estimating duration • Impossible scheduling and the overbooking trap • “Just one more thing” and the accordion time delusion • Transition resistance and the “I can’t start anything” freeze • Perfect world scheduling and why small hiccups derail the day • Why it happens: executive function challenges, duration estimates, hyperfocus, planning optimism • What helps: adding 20 to 30% buffer time and doubling estimates • The three bucket system: Today, Urgent To Do, Important But Later • Setting a reasonable daily cap and rolling tasks over without shame • Micro strategies: timing routines, visual timers, protecting the pre-leave gap Tools mentioned: Minimalist app- a simple task-list app that can help get things out of your head and into an external system. This is what I use for the three bucket system mentioned in the episode.  https://apps.apple.com/us/app/to-do-list-minimalist-widget/id993066159 If time keeps slipping through your fingers, listen along and try one small change this week. Subscribe, share this with a friend who’s always sprinting out the door, and leave a review so more people can find it. What’s the time blindness pattern you want to break first? Send us Fan Mail Support the show How to Connect Visit the website: https://www.dopamine-and-doubt.com Follow on Instagram: @Dopamineanddoubtpodcast  https://www.instagram.com/dopamineanddoubt/ Email: dopamineanddoubtpod@gmail.com Love the show? Please leave a review on Apple Podcasts or Spotify-it helps listeners find the show! Resources from episodes: https://linktr.ee/dopamineanddoubt

  6. Aug 4

    OCD Rumination: Why Can't I Stop Thinking About It?

    Your mind can turn into a courtroom in seconds. One tiny moment from a conversation becomes “evidence,” and suddenly you’re replaying every word for days, hunting for certainty that you didn’t offend someone, miss something important, or reveal something “bad” about yourself. That pattern has a name: mental rumination, one of OCD’s most invisible compulsions and one of the easiest to mistake for being thoughtful, responsible, or just “someone who overthinks.”  I break down what rumination actually is, why it feels so convincing, and how it differs from ADHD hyperfocus when you live with both ADHD and OCD. The key distinction is the goal: hyperfocus is fueled by interest or novelty, while OCD rumination is fueled by anxiety and the belief that if you think a little longer you’ll finally feel certain. We walk through common rumination themes like replaying conversations, reviewing memories, mentally confessing, checking intentions, and arguing with intrusive thoughts, and we look at how internal reassurance keeps the cycle alive.  • Mental rumination as an internal compulsion aimed at certainty • Common rumination patterns like replaying conversations and reviewing memories • ADHD hyperfocus versus OCD rumination and the role of anxiety • Why rumination offers brief relief then intensifies doubt • The fear and false comfort loop and how it keeps you stuck • Middle path as a way to hold uncertainty without compulsions • Dropping the mental rope, radical uncertainty, and ACT defusion skills • Response prevention and understanding the difference between real problem solving and rumination Recommended Resource:  Overcoming Unwanted Intrusive Thoughts: A CBT-Based Guide to Getting Over Frightening, Obsessive, or Disturbing Thought by Sally M. Winson, PsyD and Martin N. Seif, PhD. If todays discussion on mental rumination resonated with you, I highlight recommend this accessible, evidence-based guide that helps explain why intrusive thoughts stick around and how changing your relationship with them-not trying to eliminate them-can help break the cycle.  Send us Fan Mail Support the show How to Connect Visit the website: https://www.dopamine-and-doubt.com Follow on Instagram: @Dopamineanddoubtpodcast  https://www.instagram.com/dopamineanddoubt/ Email: dopamineanddoubtpod@gmail.com Love the show? Please leave a review on Apple Podcasts or Spotify-it helps listeners find the show! Resources from episodes: https://linktr.ee/dopamineanddoubt

  7. Jul 28

    ADHD and OCD Avoidance: When it Isn't Just Procrastination

    Avoidance can look identical on the outside while serving totally different needs on the inside, especially when ADHD and OCD overlap. I share a client tax story that shows how quickly the driver can switch and how the right intervention changes with it.  Understanding the "why" behind avoidance can help you choose strategies that actually fit what is happening, instead of feeling stuck in a cycle of trying harder.  In this episode, you will learn:  • a real-life example of ADHD avoidance turning into OCD doubt mid-task  • ADHD avoidance as escaping overwhelm, friction, boredom, decision fatigue, and executive demand  • body doubling as external structure that supports focus and follow-through  • externalizing steps and lowering activation energy to make starting easier  • behavioral activation and why motivation often follows action  • OCD avoidance as escaping uncertainty and the fear of catastrophic mistakes  • spotting when ADHD accommodations become OCD compulsions through excessive checking or over-listing  • choosing interventions by asking what the behavior is accomplishing  • a two-question check-in to tell overwhelm from fear of mistakes  If you are enjoying Dopamine and Doubt, I would love it if you would follow the show, leave a rating or review, and share it with someone who mind find it helpful! Brain Bonus! My brains favorite avoidance activity this week: Organized my podcast episodes instead of responding to emails Send us Fan Mail Support the show How to Connect Visit the website: https://www.dopamine-and-doubt.com Follow on Instagram: @Dopamineanddoubtpodcast  https://www.instagram.com/dopamineanddoubt/ Email: dopamineanddoubtpod@gmail.com Love the show? Please leave a review on Apple Podcasts or Spotify-it helps listeners find the show! Resources from episodes: https://linktr.ee/dopamineanddoubt

  8. Jul 21

    We All Can Have ADHD and OCD Traits-So What Makes it a Disorder?

    Have you ever heard someone say, "Everyone's a little ADHD," or "I'm so OCD," and wondered why those statements don't feel quite right? In this episode, we explore why so many ADHD and OCD experiences sound familiar-and why that doesn't mean everyone has these conditions.  We'll talk about: Why everyone experiences distraction, worry, habits, and forgetfulness sometimesThe difference between everyday human experience and clinical symptomsHow frequency, intensity, and impact help distinguish a disorder from a traitWhy it's important to avoid gatekeeping while also respecting the reality of neurodevelopmental and mental health conditionsHow understanding these differences can increase empathy for everyone If you have ever questioned your own experiences-or wondered why these diagnoses seem so relatable-this episode will help you think about ADHD and OCD with more nuance and compassion.  If you enjoyed this episode, consider following the podcast and sharing it with someone who might find it helpful.  Dopamine + Doubt explores the overlap between ADHD and OCD through evidence-based information, real-life examples, and practical strategies. New episodes are released weekly.  Send us Fan Mail Support the show How to Connect Visit the website: https://www.dopamine-and-doubt.com Follow on Instagram: @Dopamineanddoubtpodcast  https://www.instagram.com/dopamineanddoubt/ Email: dopamineanddoubtpod@gmail.com Love the show? Please leave a review on Apple Podcasts or Spotify-it helps listeners find the show! Resources from episodes: https://linktr.ee/dopamineanddoubt

  9. Jul 21

    Stop trying harder- Understanding ADHD and executive function

    Have you ever been told you just need to "try harder," "get organized," or "be more disciplined"-only to wonder why those strategies never seem to stick? In this episode, we unpack what executive function actually is and why ADHD is not a problem with motivation, intelligence, or laziness. Executive function is the brains management system, and when it works differently, everyday tasks can feel much harder than they look from the outside.  We will explore:  What executive functioning is and why it mattersWhy ADHD is more than just being distractedWhy trying harder often is not the answerHow shame develops when people misunderstand ADHDPractical ways to work with your brain instead of against itWhether you have ADHD, love someone who does, or simply want to better understand how the ADHD brain works, this episode offers a compassionate, practical perspective.  If you enjoyed this episode, consider following the podcast and sharing it with someone who might find it helpful.  Dopamine + Doubt explores the overlap between OCD and ADHD through evidence-based information, real-life examples, and practical strategies. New episodes are released weekly.  Send us Fan Mail Support the show How to Connect Visit the website: https://www.dopamine-and-doubt.com Follow on Instagram: @Dopamineanddoubtpodcast  https://www.instagram.com/dopamineanddoubt/ Email: dopamineanddoubtpod@gmail.com Love the show? Please leave a review on Apple Podcasts or Spotify-it helps listeners find the show! Resources from episodes: https://linktr.ee/dopamineanddoubt

  10. Jul 15

    ERP: Learning to Live With Uncertainty

    If you have ever felt trapped in a cycle of intrusive thoughts, anxiety, checking, reassurance seeking, or avoiding situations that feel uncomfortable, you may have heard of ERP.  ERP (Exposure and Response Prevention) is considered one of the most effective treatments for OCD, but it is also commonly misunderstood.  In this episode of Dopamine + Doubt, we break down what ERP actually is, why it works, and how it helps us change our relationship with uncertainty.  ERP is not about forcing yourself to "just stop thinking about it" or convincing yourself that everything will be okay. Instead, its about practicing facing discomfort while choosing not to engage in the bheaviors that keep the OCD cycle going.  In this episode we discuss:  What Exposure and Response Prevention (ERP) is and is notThe difference between exposure and response preventionWhy reassurance and rituals can unintentionally strengthen OCDHow avoidance keeps anxiety feeling powerfulWhy the goal of ERP is not certainty, but learning to tolerate uncertaintyWhat acceptance has to do with recoveryWhy ERP is challenging-but empoweringIf OCD has ever convinced you that you need to feel 100% certain before moving forward, this episode is for you.  Listen to Dopamine + Doubt wherever you get your podcasts.  Send us Fan Mail Support the show How to Connect Visit the website: https://www.dopamine-and-doubt.com Follow on Instagram: @Dopamineanddoubtpodcast  https://www.instagram.com/dopamineanddoubt/ Email: dopamineanddoubtpod@gmail.com Love the show? Please leave a review on Apple Podcasts or Spotify-it helps listeners find the show! Resources from episodes: https://linktr.ee/dopamineanddoubt

  11. Jul 15

    ADHD and OCD: When They Look the Same but Aren't

    ADHD and OCD can sometimes look surprisingly similar from the outside. Both can involve feeling stuck, needing systems, struggling with routines, overthinking, or repeating behaviors-but the reason behind those behaviors may be very different.  In this episdoe of Dopamine + Doubt, we explore the overlap between ADHD and OCD and why understanding the function behind a behavior matters.  I share part of my own experience recognizing the difference between ADHD-related challenges and OCD-driven patterns, including how the same action can be motivated by very different things.  In this episode, we discuss:  Why ADHD and OCD are often confusedHow teh same behavior can come from different processesADHD, executive functioning, attention regulation, and working memory differences OCD, uncertainty, responsibility, and attempts to gain reliefWhy understanding the function of a behavior is more helpful than judging the behavior itselfWhat it can feel like to live with both ADHD and OCDHow to start asking "What is driving this behavior?"Why people with both ADHD and OCD may feel like they are constantly pulled in opposite directionsUnderstanding the difference isnt about labeling every behavior as "ADHD" or "OCD"- it is about finding strategies that actually match what is happening underneath Listen to Dopamine + Doubt wherever you get your podcasts Send us Fan Mail Support the show How to Connect Visit the website: https://www.dopamine-and-doubt.com Follow on Instagram: @Dopamineanddoubtpodcast  https://www.instagram.com/dopamineanddoubt/ Email: dopamineanddoubtpod@gmail.com Love the show? Please leave a review on Apple Podcasts or Spotify-it helps listeners find the show! Resources from episodes: https://linktr.ee/dopamineanddoubt

  12. Jul 15

    Why I Started Dopamine and Doubt

    Why did I start Dopamine and Doubt? Welcome to the very first episode of Dopamine + Doubt! In this episode, I share the personal story behind the podcast, how discovering my own ADHD and OCD changed the way I understood myself, and why these two conditions are so often confused.  Whether you are navigating your own mental health, supporting someone you love, or you are simply curious about the overlap between ADHD and OCD, my hope is that this podcast offers practical tools, relatable stores, and compassionate conversations.  In this episode, we discuss: Why I decided to start Dopamine and DoubtMy journey with ADHD and OCDWhy these diagnoses are commonly misunderstoodWhat you can expect from future episodesWhy understanding the "why" behind behavior mattersThanks fo rlistneing! If this episode resonated with you, I would love fo ryou to follow the show and share it with someone who might find it helpful.  Next episode: ADHD and OCD: When They Look the Same but Aren't Send us Fan Mail Support the show How to Connect Visit the website: https://www.dopamine-and-doubt.com Follow on Instagram: @Dopamineanddoubtpodcast  https://www.instagram.com/dopamineanddoubt/ Email: dopamineanddoubtpod@gmail.com Love the show? Please leave a review on Apple Podcasts or Spotify-it helps listeners find the show! Resources from episodes: https://linktr.ee/dopamineanddoubt

  • 12 Episodes

5
out of 5
10 Ratings

About

Dopamine and Doubt is a podcast about the overlap between ADHD and OCD—and what happens when it’s hard to tell which one is driving the behavior. Hosted by therapist Rachel Keefe, LCSW, the show explores ADHD and OCD symptoms including executive functioning difficulties, hyperfixation, reassurance seeking, intrusive thoughts, rumination, checking, avoidance, time blindness, and uncertainty. Each short episode breaks down confusing or relatable experiences in plain language, with real-life examples and practical strategies. You’ll learn how ADHD and OCD can look similar, where they differ, and how to respond when your brain gets stuck trying to figure everything out. Because the goal isn’t always to find the perfect answer. Sometimes, it’s learning to live with a little more uncertainty—and a little less doubt.

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