Are OCD And Depression Related?

Obsessive-compulsive disorder (OCD) and depression are two mental health conditions affecting many Americans today. Once you’re diagnosed with these disorders, life can feel challenging. It is important to remember that you are not alone and that treatments are available. 

Studies have shown that individuals with OCD are also at an increased risk of experiencing depression along with other mental health conditions. While both are different, one has been known to trigger the other.

It begs the question: Are OCD and depression related?

This post digs deep into the relationship between the two conditions to know how one relates to the other and the possible management options for this dual diagnosis.

Understanding OCD and depression

OCD and depression are officially listed in the Diagnostic Statistical Manual of Mental Disorders, 5th Edition¹ as mental health conditions. However, to know how they relate, you must first understand them individually.

Major depressive disorder

MDD is characterized by more than just a feeling of sadness. You often lose interest in the things you love or find enjoyable for more than two weeks. During this time, you may also experience:

• Low energy levels

• Problems focusing

• Irritability

• Feeling hopeless

• Trouble sleeping

• Loss of appetite

• Feeling agitated or slowed in your movements

• Thoughts of self-harm

Obsessive-compulsive disorder

OCD is a psychiatric disorder that triggers uncontrollable obsessions and compulsive behavior in people. Studies show that about 2.3%² of adults have OCD, which interferes with their daily activities.

Common symptoms of OCD include intrusive thoughts or unwanted thoughts that often result in high levels of distress. Attempts are usually made to suppress these unwanted thoughts or neutralize them by another thought or action.

Common intrusive thoughts may be around self-hygiene, safety, or organization. They may result in behaviors such as excess grooming (hand washing, brushing teeth), checking things (appliances, switches, locks), or arranging and rearranging objects.

Individuals may also engage in repeating rituals (counting to a certain number) to neutralize their thoughts.

The relationship between OCD and depression

Depression is common among patients with OCD. Research by the National Library of Medicine³ shows that OCD patients are ten times more likely to develop depression than the general population.

While there are rare situations where depression precedes OCD, or the two disorders occur simultaneously, most people develop OCD symptoms first and then depressive symptoms after. This may be due to the distress and difficulties that OCD causes. 

How OCD causes depression

There are several reasons why depression affects people with OCD the most. Scientists believe that the onset of OCD symptoms contributes to depression in the following ways:

Obsessions and depression

OCD contributes to unwanted thoughts that cause anxiety and distress. Experiencing unwanted intrusive thoughts can result in several feelings, including shock, shame, sadness, and distress. This may result in someone developing depression. 

Compulsions and depression

Compulsive behavior comes as a response to intrusive thoughts. Many times, you do it as a way to escape the negative thoughts in your mind. When compulsive actions aren’t executed to the letter, it creates an unattainable obsession for perfectionism. As such, you become more stressed and depressed.

Functioning and depression

Living with OCD means having repeated intrusive thoughts and compulsive behaviors at any time. Such thoughts and actions can interfere with your quality of life, whether at work, school, or social setups, making you depressed. 

Individuals with OCD may also have a change in the levels of serotonin within their brains. Changes in serotonin‌ cause depression.  

Managing a dual diagnosis of OCD and depression

Managing a dual diagnosis can be challenging, as depression can make you feel hopeless about the future and any treatment for OCD and depression. Despite being hard, many treatments are available to help manage these conditions. 

Some of the best treatment methods for OCD and depression involve medical and non-medical procedures. These include‌:

Cognitive-behavioral therapy

Cognitive-behavioral therapy (CBT) is a psychological treatment that aims to help you identify and recognize intrusive or unwanted thoughts. Once these thoughts are identified, you can work with your therapist to understand them and change your thinking.  

Once the negative thoughts that contribute to depression and anxiety are altered, you can often see immediate improvements in your daily functioning and subsequently improve your mood. CBT is vital for people with a dual diagnosis. 

Exposure and response prevention

Exposure and response prevention (ERP) is used to treat OCD. This therapy focuses on gradually exposing you to your fears so you can learn to tolerate them without experiencing high levels of distress or using harmful coping mechanisms to make you feel better.  

ERP is the standard gold treatment for OCD as it changes your response to a stimulus by exposing you to the feared stimulus through imagination or real-world exposure.

Medication

If you have OCD and depression symptoms, a mental health professional or a doctor can recommend some helpful medications. 

These can range from antidepressants to selective serotonin reuptake inhibitors (SSRI), a chemical drug that prevents serotonin from being absorbed from the brain into the blood. It all depends on the severity of your diagnosis. Examples of SSRIs include:

• Citalopram (Celexa)

• Fluoxetine (Prozac, Sarafem)

• Fluvoxamine (Luvox)

• Paroxetine (Paxil, Paxil CR, Pexeva)

• Escitalopram (Lexapro)

• Vilazodone (Viibryd)

• Sertraline (Zoloft)

Support groups

Isolating yourself is the last thing to do when you have a dual diagnosis of depression and OCD. Feelings of hopelessness tend to arise when you’re alone and disconnected from the rest of the world.

Connecting with family and close friends during such a time is necessary to help keep your mind off negativity and intrusive thoughts. You can also connect with people with similar cases near you or through various online and in-person support groups. 

Some good options include the International OCD Foundation, the Anxiety and Depression Association of America, and the National Alliance on Mental Illness.

The lowdown

OCD and depression are like two peas in a pod. Often, OCD manifests itself first, and then depression follows. It means that OCD contributes to major depressive disorder. 

The good thing is that both conditions are treatable through psychotherapy and medication. Remember, it’s always easier to start by treating depression than OCD if OCD symptoms interfere with therapy.

FAQs

Does depression cause OCD to get worse?

Yes, depression is among the comorbidities of OCD; it is a mental health condition that can accelerate OCD symptoms.

Are there any similarities between OCD and depression?

The two mental health conditions have overlapping symptoms such as negative thoughts or beliefs, dull mood, and deteriorative thinking patterns.

How long does it take to recover from a dual diagnosis?

It depends on the severity of your condition. Both OCD and depression, however, require long-term treatment for effective management.