Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Can ERP Improve Symptoms of Depression?

By Stacy Quick, LPC

Jul 01, 20225 minute read

When someone meets the criteria for clinical depression, they often experience several of the following symptoms: pervasive sadness, loss of energy, difficulty with sleep, loss of interest in usual activities, changes in eating (such as a weight increase or decrease), trouble concentrating, excessive or inappropriate feelings of guilt or hopelessness, and thoughts about death or suicide. 

The severity of the symptoms associated with depression includes severe fatigue and mental exhaustion, which can make it difficult for the person suffering to get out of bed and do even the most mundane activities, such as brushing their hair, brushing their teeth, showering, or even getting dressed.

It is not uncommon for a person with OCD to also have depression. The International OCD Foundation (IOCDF), reports that about 25% to 50% of people with OCD also meet the diagnostic criteria for a major depressive episode.  

Having intrusive thoughts and doing compulsions throughout one’s day can undoubtedly lead to feelings of sadness and often hopelessness. The old adage of which came first, the chicken or the egg, comes to mind. OCD can certainly impact the way that someone functions and lives their life. OCD can cause an individual to become so anxious that going out or doing things that they may have previously found enjoyable becomes unbearable. This can lead to depression. Oftentimes, mental health issues can be comorbid, meaning they exist together.

If you have been diagnosed with both OCD and depression, the symptoms of depression may cause you to feel a sense of hopelessness and to feel overwhelmed by life’s challenges, which can impact therapy. Many people even consider dropping out of treatment. One of the things we know about people who are depressed is that they often feel like they are not “good enough” or that they are “failures.” 

These core beliefs can impact them on a substantial level. If you believe this about yourself, it makes sense that this would trickle into every area of your life—including treatment. When you’re depressed, you may think “what’s the point in trying?” Or “I’ll always feel this way.” These thought patterns can be persistent and often can lead to a person not feeling competent enough to make the necessary changes in their life. 

Feelings catch up to actions

I always tell members that their feelings catch up to their actions or behaviors. In other words, when you are depressed, you likely do not feel like showering, but the more you make yourself shower (i.e., change your behavior) the more likely you are to feel good about yourself, and eventually, your feelings catch up to our actions. 

The choices that we make are important. This not only applies to depression but to OCD as well. In exposure and response prevention (ERP) therapy, the gold standard OCD treatment, we teach you that even though you feel a certain way this doesn’t mean you cannot still act a different way. An example would be maybe you felt really anxious about going to a social event because you are worried about having intrusive thoughts. Even though you felt anxious, perhaps you chose to go anyway and let yourself experience the discomfort. The more that you do activities like this, the more you are able to see that it is not dangerous and your anxiety will eventually reduce. Members often say that the hardest part is the initial decision to do something different. Change is hard for everyone, whether they have OCD and depression, or not. 

It’s important that someone suffering from OCD and depression learn the impact of their behaviors on their feelings. Changing one can change the other. In many cases, the intense anxiety from intrusive thoughts or the lost hours and missed opportunities from compulsions can cause or contribute to symptoms of depression. In these instances, a therapist can use ERP therapy to treat OCD as the root cause of other issues, and people often see a reduction in their depression symptoms as a result. 

In fact, recent research found that people receiving ERP in a virtual setting experienced an average decrease in OCD symptoms, resulting in dramatic improvements in depression, anxiety, stress, and overall quality of life. The study suggested that treating only the depression likely wouldn’t have the same outcome. This is because it treating the whole person effectively often starts with treating the root issue of OCD, and for most, treating OCD is what will lead to an improvement in other mental health issues.

ERP as an avenue of change

A therapist with specialized training in OCD will be familiar with seeing people who struggle with depression. An OCD specialist can help you address the symptoms of OCD while at the same time reducing the depression that is associated with OCD symptoms. Because of this, OCD specialists build evidence-based treatment plans with depression in mind. They’ll tailor it to your unique needs and address the root issues causing your depression. Their goal is to get you back to living your life and doing the things you love.

By addressing both depression symptoms and OCD, the chances of the person being successful at treatment can increase. When someone believes that they can recover, they tend to be more motivated to adhere to treatment and are more committed to getting better. It is important to recognize the way in which certain thought patterns impact the individual and impact their treatment. 

At NOCD our licensed therapists deeply understand OCD and are specialty-trained in treating OCD with ERP. We work side-by-side with the OCD experts and researchers who designed some of the world’s top OCD treatment programs – and that means the best care for our members. Our therapists are trained to treat dual diagnoses and to help you receive proper treatment for depression as well. 

As you progress through your ERP sessions, your NOCD therapist will regularly check to see if the depression you’re experiencing in your life is decreasing. They’ll work with you to create a personalized treatment plan to get you back to living your life. 

To get started with OCD treatment, you can book a free 15-minute call with our team to get matched with an OCD specialist at NOCD. 

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