Understanding The Link Between OCD And Schizophrenia

Obsessive-compulsive disorder (OCD) and schizophrenia are two chronic mental health conditions that can make performing normal daily activities, such as going to work or school, unusually difficult. While each of these disorders on their own can be challenging enough to manage, some individuals will experience both.

The good news is that treatment is possible by working closely with your healthcare provider to find a combination of psychotherapy and medication that works for you.

What is obsessive-compulsive disorder (OCD)?

Obsessive-compulsive disorder is a chronic mental health condition that occurs when unwanted, irrational thoughts and fears, called obsessions, cause significant anxiety that cannot be controlled or ignored. To cope with these recurring thoughts, the person experiencing them will attempt to control or stop them by engaging in repetitive behaviors or rituals, called compulsions. 

While no one knows exactly what causes OCD, it's thought that a combination of genetics, structural brain differences, and environmental factors can increase your chances of developing the condition, including having a parent or sibling with OCD.

Symptoms of OCD

It's possible for someone diagnosed with OCD to only experience obsessions or compulsions. However, most people will experience both.

While the way that OCD manifests itself in one person's life may be completely different than in someone else's, it's typical for obsessions and compulsions to share certain commonalities, such as taking up an extensive amount of time and interfering with normal daily activities. 

Common symptoms of obsessions include:

• Fear of germs or contamination

• Needing particular things to be very organized

• Excessive doubting

• Thoughts about harming yourself or others intentionally or accidentally

• Unwanted thoughts, including about sex, religion, or aggression

Common symptoms of compulsions include:

• Cleaning or hand washing

• Organizing

• Checking

• Counting

• Needing excessive reassurance

• Sticking with a rigid routine

What is schizophrenia?

Schizophrenia is a serious brain disorder that impacts how a person feels, thinks, and acts. A person with schizophrenia may seem out of touch with what's real, which can make it difficult for them to perform normal daily activities and interact with others. 

The condition is typically diagnosed between the ages of 16 and 30 when someone experiences their first episode of psychosis; however, there are often warning signs that can manifest before this point. It's important to seek professional medical treatment as quickly as possible for the symptoms of schizophrenia, as often there may be safety concerns for the sufferer or others around them.

Symptoms of schizophrenia

Like OCD, schizophrenia can impact people very differently. Symptoms of the condition usually affect individuals at a cognitive, emotional, and physical level. 

These include:

• Delusions: incorrect beliefs that are not based in reality

• Hallucinations: seeing or hearing things that do not exist

• Disorganized thinking and speech: answers to questions may be partially or completely unrelated

• Extremely abnormal motor behavior: actions can range from behaving like a child or exhibiting bizarre postures to resisting instruction or moving excessively

• Negative symptoms: this can include poor hygiene habits, lack of interest in activities, social withdrawal, or appearing to lack emotion

How is OCD associated with schizophrenia?

It's estimated that as many as 25%¹ of people diagnosed with schizophrenia also experience symptoms of OCD, with around 12% meeting the diagnostic criteria for OCD. While schizophrenia and OCD are two distinct mental health conditions, they share characteristics that make some people more likely to experience both disorders.

Distinguishing schizophrenia from OCD² can sometimes be difficult. In particular, the delusions one might experience in a psychotic episode may resemble the obsessions that occur with OCD and vice versa.

While delusions are consistent with how the individual feels about themselves, finding no reason to question them (ego-syntonic), obsessions are inconsistent with how the individual feels about themselves, which will cause the person to question why they are having the thought in the first place (ego-dystonic). Separating the two is often more challenging than it sounds; this is only complicated further when an individual has both mental disorders and experiences ego-syntonic and ego-dystonic thoughts.

Fortunately, effectively managing schizophrenia and OCD together is possible. By working closely with a professional mental healthcare provider, a combination of psychotherapy, such as cognitive-behavior therapy (CBT), and medications can be used to treat your specific symptoms.

It's important to note that neither schizophrenia nor OCD will go away or get better on their own. On the contrary, both conditions will likely progress and become more complicated if left untreated for an extended period of time.

With this in mind, don't hesitate to seek professional care if you notice the signs of OCD or experience a schizophrenic episode. Getting treatment early can help you manage your symptoms quicker and more effectively.

The lowdown

OCD and schizophrenia are two chronic mental health conditions that can impact a person's quality of life and should be taken seriously. People with OCD experience unwanted, recurring intrusive thoughts that make them feel distressed.

As a result, the person performs repetitive, ritualistic behaviors in an attempt to relieve their anxiety. Schizophrenia can affect how a person thinks, feels, and behaves, often causing them to be out of touch with reality. It frequently manifests in episodes of psychosis. If untreated, it can lead to delusions, hallucinations, and abnormal behaviors.

While these conditions are completely distinct, it's thought that both disorders are caused largely by genetic factors, and a percentage of people with schizophrenia also experience OCD symptoms.

Fortunately, both conditions can be effectively treated and managed with a combination of psychotherapeutic techniques,  prescription medications, and ongoing support from friends and family.