If you live with obsessive-compulsive disorder (OCD) it’s common to deal with another mental health or neurodevelopmental condition, as well. Co-occurring conditions like these can come with challenges, but there are ways to learn to manage symptoms more effectively. Keep reading to learn about some of the most common conditions associated with OCD, and how to navigate treatment options.
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
OCD and depression
If you’ve experienced depression and OCD, you’re definitely not alone. OCD can cause significant distress and isolation, which can trigger depression. As @baldyoj, a member of NOCD’s online community, puts it, sometimes this results in “symptoms like apathy [and] zero energy.”
If your depression has developed as a result of OCD, treatment will focus on managing OCD symptoms first. “Once you treat OCD, depression naturally lifts,” explains April Kilduff, MA, LCPC, LMHC, licensed therapist at NOCD. “You don’t always need extra or parallel treatment.”
If depression is your primary symptom, treatment might look a bit different, but a therapist with specialty training in OCD can help assess the best path for you. For example, your NOCD therapist might first assess you for medication, or start you with behavioral activation (BA)—a form of cognitive behavioral therapy that helps you gradually re-engage in meaningful activities that once brought you joy, like exercising or reading. Once you start to better manage your symptoms of depression, you’ll be better equipped to embark on ERP therapy.
OCD and PTSD
Post-traumatic stress disorder (PTSD) can occur if you’ve experienced or witnessed a traumatic event, and can cause flashbacks, severe anxiety, and nightmares. OCD may latch onto these traumatic memories and turn them into highly distressing obsessions.
“For me, my PTSD really presents through OCD and disturbing intrusive thoughts,” writes NOCD app user @crazycat9. “I have had compulsions / intrusive thoughts since I was a child, but honestly being traumatised has made it a million times worse!”
If you have PTSD, Kilduff says diving right into ERP might trigger dissociations or flashbacks, which can compromise OCD treatment. Instead, your NOCD Therapist might start you with a PTSD treatment called prolonged exposure (PE) therapy and then move on to ERP.
PE works by teaching you to gradually and intentionally approach your trauma-related experiences and feelings. By learning to identify negative thoughts that emerge, and confront these painful memories in a controlled environment, you’ll be better able to cope with related feelings that arise outside of sessions.
OCD and anxiety
Anxiety is a common part of the OCD cycle, as obsessions often provoke anxiety, and compulsions—while done in an attempt to find relief—typically only fuel that anxiety. On the flipside, an anxiety disorder can also exacerbate your OCD, causing you to spend more time obsessing and compulsing. “I have always suffered with OCD and social anxiety, but as I got older it’s gotten so much worse,” writes @zoedoyle “I haven’t left the house in a few weeks and that being tied in with OCD is HORRIBLE!”
While talk therapy can be used to treat anxiety disorders, it can make OCD worse by giving attention to intrusive thoughts, which can make them feel even more real and overwhelming. Luckily, ERP is also really effective for treating anxiety—and can be used to manage both conditions at once. Your NOCD Therapist will zero in on what type of anxiety disorder you’re dealing with, and adjust your treatment plan accordingly. For instance, if you have social anxiety, sessions may focus on gradual exposures to scary-feeling social situations, so you can learn to stop partaking in safety behaviors, like avoidance. In time, you’ll realize that these scenarios are not as frightening as your mind is telling you they will be.
OCD and autism
Autism is a neurodevelopmental condition that shapes how a person interacts with the world. OCD and autism can both involve repetitive behaviors and a need for routine, but are driven by different motivations.
“As an autistic person who struggles with neurotypical type socialising, I can’t stop obsessing about past and future social interactions and all the mistakes I’ve made or might make in future,” writes @hopefulvegan.
While neurodivergent traits don’t necessarily need to be treated, they can make adapting to various situations difficult. If you’re dealing with OCD and you’re autistic, a therapist trained in ERP will know how to help, and can add practices like occupational therapy (OT), cognitive behavioral therapy (CBT), or dialectical behavioral therapy (DBT) adapted for autistic individuals. An OCD specialist, like Kilduff, who also understands autistic experiences, will know how to identify autistic sensory overload, and can suggest breaks to help settle your nervous system, so treatment moves at the right pace for you.
OCD and ADHD
Attention deficit hyperactivity disorder (ADHD) is a neurological condition that is categorized by impulsivity, inattention, and/or hyperactivity. OCD and ADHD can both make it hard to focus and may make interacting with others difficult—but the conditions also have some symptoms that can feel at odds. For example, people with OCD tend to be risk-averse, while people with ADHD may be more drawn to risky behaviors.
@SdnrckwdI lives with both ADHD and OCD and shares in the NOCD community that sometimes it feels like the two conditions “hate” each other: “My OCD is like I have to double check that thing, and my ADHD is like, but I’m having fun, I don’t want to. The worst, though, is when they work together and my ADHD makes me hyperfixate on my compulsions.”
Although NOCD does not treat ADHD directly, medication is typically the first-line treatment for the condition. Your NOCD therapist can refer you to an ADHD specialist who can support you alongside your ERP work at NOCD. Treating both ADHD and OCD at the same time is important to effectively manage both conditions.
Bottom line
Living with OCD alone can be difficult enough, but when there’s an additional condition thrown into the mix, life can feel very challenging. Luckily, these experiences are very common, and specialists in OCD are trained to create treatment plans for everything you’re experiencing. In time, you can get back to doing the things you love without the burden of unmanaged symptoms.
