Obsessive Compulsive Disorder–known by its acronym of OCD–is an anxiety-based condition marked by obsessive and compulsive behaviours. Obsessions include uncontrollable, unwanted, and unpleasant thought patterns. And compulsions are very often repetitive actions that can include self-harm.
OCD has a significant impact on people’s lives and interferes with their personal and professional relationships. While many of us could find ourselves going back to double-check something from time to time, OCD is a real, diagnosable medical condition based on intense thoughts needing therapeutic or medical interventions.
So is OCD neurodivergence? Or is OCD a disability? We’ll review these questions and get into more detail in this post.
Does Having OCD Make You Neurodivergent?
The exact cause of OCD is unknown. But it is a form of acquired neurodiversity since it emerges during adolescence and adulthood.
Having OCD makes someone neurodivergent because neuroscientists and researchers believe that it’s rooted in a complex set of biological, physical, and developmental factors. The charity Mind suggests OCD links to serotonin levels. And it can overlap with other forms of neurodiversity such as ADHD and autism, along with forms of applied neurodivergence like dyslexia or dyspraxia.
OCD also shares some similarities with trauma-based disorders such as PTSD. Estimates suggest up to 22% of people with PTSD also have a diagnosis of OCD. Being clear on the presence of each condition makes it imperative that individuals seek full complete diagnosis for their conditions and symptoms.
Is OCD a Disability?
According to the World Health Organisation, OCD is in the top 10 most disabling conditions. It’s also the fourth most common disorder in the UK concerning the mind.
OCD can have a substantial effect on someone’s ability to carry out their daily tasks. The Equality Act 2010 classifies it as a disability since it’s a form of acquired neurodivergence and a mental health condition. In this act, a disability includes any mental health condition that imposes long-term limitations on someone’s day-to-day life, up to and around 12 months. OCD ranks alongside other restricting mental health conditions such as depression, bipolar disorder, and dementia.
It’s worth noting that symptoms of OCD can manifest in different subtypes:
- Contamination obsessions: Fear of infections or illnesses leading to excessive and repeated cleaning and washing compulsions.
- Doubt and harm obsessions: Checking compulsions to avoid accidents, injuries, or illness to self or others.
- Resistance to change: Becoming attached to people, things, situations, and unusual behaviours such as hoarding.
- Routines, symmetry, and order: A need for things to be precise or perfect which leads to compulsions and obsessions with order and routine.
- Taboo thoughts: Disturbing thoughts of a sexual or violent nature can lead to rituals that help sufferers move away from or cancel out such thoughts.
While there is no available cure, sufferers can find relief in acceptance and management of their thoughts and feelings. This may include formal therapeutic support and mindfulness practice.
Can You Have OCD and Other Types of Neurodivergence?
OCD can and does overlap with other forms of neurodivergence, including applied, clinical, and acquired neurodivergence. With this in mind, individuals must pursue a diagnosis for all their symptoms. Different conditions can reveal similar symptoms, and this overlap can result in misdiagnosis or underdiagnosis.
To help with understanding the types of symptoms, let’s review the similarities between OCD and other neurodivergent conditions.
OCD and Autism (ASD)
Studies suggest up to 36% of individuals with ASD also have OCD. And while both conditions are neurodivergent, OCD is a mental health disorder while ASD or autism spectrum disorder is a neurodevelopmental condition. ASD indicates a difference in brain function whereas OCD reflects differences in behaviour and thinking.
Symptoms of OCD and ASD will overlap. And both conditions may feature the following:
- Repetition of sounds or actions
- Fixation on specific rituals, routines, and order
- Focused, intense interest in a particular subject or object
- An inability to start or maintain a conversation
- Difficulty with changing plans, routines, or aspects of their lives
Differences in Behavioural Motivation
OCD behaviours are born out of emotions and the fear that something bad will happen if they don’t carry out certain actions. The distress caused by such actions can exacerbate a sense of fear or urgency for sufferers.
For people with autism, motivations will differ. Their routines and order help them feel comforted, soothed, and more in control of their response. Anxiety in someone with autism is likely to come about from a disruption to preferred routines or instances of sensory overwhelm. This differs from someone with OCD who can experience fear or obsessional thinking from their anxieties.
OCD and ADHD
While both OCD and ADHD are associated with neurotransmitter brain chemistry, OCD has links to serotonin while ADHD relates to dopamine. Both disorders are heritable and have some overlaps.
ADHD can show up in the form of persistent ADHD or symptomatic ADHD. The persistent form tends to reveal itself in childhood whereas symptomatic ADHD can decrease with age. In 2020, around 140 million adults had persistent ADHD while 360 million had the symptomatic form globally.
UK statistics suggest around 750,000 people suffer from OCD at any one time while around 1% of the global population experiences OCD – roughly 80 million.
Symptoms of OCD and ADHD can overlap and the presence of both can exacerbate symptoms in individuals. For instance, comorbid OCD may ramp up hyperactivity in some ADHD patients or show up as hoarding or repetitive body-based behaviours.
Differences in Behavioural Motivation
The root causes of behaviours can differ between individuals with OCD and ADHD and we’ve outlined some of these below.
- ADHD has motivations rooted in impulsivity whereas OCD is a defence mechanism based on over-thinking.
- People with ADHD may hoard items after a phase of impulse buying whereas OCD sufferers tend to avoid giving items away, seeing it as wasteful.
- Repetitive behaviour can offer stress relief and improved focus for people with ADHD while people with OCD can be stuck in behavioural loops that exacerbate their anxiety.
- Behaviours in people with ADHD can be goal-oriented whereas people with OCD tend to lean towards perfectionism and impaired inhibitions.
OCD and Depression
There is a close link between OCD and depression. Studies show up to 50% of people with OCD will also experience depression in the form of MDD (Major Depressive Disorder) or Dysthymia. This results in a common dual diagnosis of depression and OCD.
Scientists are still unsure of the exact reasons behind the frequency of this comorbid diagnosis but some suggest there may be structural differences in parts of the brain for people.
It’s also likely that people who experience OCD are dealing with depression since they may become more isolated. Symptoms can overlap, but it’s worth noting the following symptoms for people who experience MDD:
- Extreme lethargy, low energy, and trouble sleeping
- Loss of or lack of interest in their usual activities
- Feeling worthless or hopeless about life
- Eating-related disorders such as binge eating or not eating enough
- Brain fog and an inability to make decisions
Differences in Behavioural Motivation
Depression can develop in people with OCD because of the disruption to their lives from compulsive and intrusive thoughts and unwanted behaviours. This can create problems in their personal and professional lives and lead to isolation.
Both OCD and depression are mood disorders. But motivations will differ where, for instance, people with OCD will feel compelled to carry out actions as part of their compulsions or obsessions. In contrast, individuals with depression may engage in negative actions because of how low they feel. This may result in self-destructive behaviours rather than compulsive actions as a result of the anxiety that OCD attempts to reduce.
Does Being Neurodivergent in Another Way Impact Treatment?
Treatment for OCD includes CBT, talking therapies, and medication. But a therapist or Doctor who prescribes treatment should also factor in any additional conditions or disorders.
For instance, a person with depression may need talking therapies or medications to help them in the same way that someone with OCD needs. And someone with autism may need to engage in CBT or other therapies too.
Along with therapies and interventions prescribed by a Doctor, individuals need to engage in self-help too. One specific way for people with OCD to engage in self-help is through Jeffrey Schwartz’s Four-Step Method:
- Relabel: People with OCD should try to accept their thoughts and label them.
- Reattribute: Remind yourself that ‘It’s not me, it’s my OCD’.
- Refocus: Shift gears and distract yourself from the thoughts.
- Revalue: Question the thoughts you have and try to remind yourself that it’s OCD causing them.
OCD vs OCPD
Along with OCD sits another acronym that looks similar but represents something different.
OCD refers to the mental health condition of ‘Obsessive Compulsive Disorder’ whereas OCPD is an acronym for ‘Obessesive Compulsive Personality Disorder’. As a personality disorder, people with OCPD display traits and behaviours that look and feel quite different to people with OCD.
People with OCPD are overly focused on achieving perfection in themselves but also in others. The following behaviours distinguish the disorder from OCD:
- A focus on being high-achieving and conscientious in life and work
- Look forward to ways of maintaining control and order in the lives and environments
- May resist constructive criticism and struggle to understand other’s viewpoints
- Lack flexibility and openness to change
- Can find it hard to give away old or valueless possessions
At first look, this list may represent similar characteristics to people with OCD. The key difference lies in the motivation since feelings of anxiety and fear drive symptoms of OCD. OCPD is instead a personality disorder featuring more consistent behaviours and a characteristic of someone’s lifestyle.