What Is The Relationship Between PTSD And OCD?

Post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD) are two mental health disorders that can occur in people who have experienced significant trauma. While the two conditions are separate, they are related.

Research¹ shows approximately 30% of individuals with PTSD will develop OCD-like symptoms within a year.

To understand why they overlap, we must understand both conditions, their causes, and their treatments.

Understanding PTSD

Post-traumatic stress disorder² is a psychiatric disorder that may occur in individuals who have experienced a traumatic event, like a car crash, violent encounter, or being physically or sexually abused.

It is normal to experience fear, sadness, or anxiety after a traumatic event, but a disorder can develop when those feelings don’t subside. PTSD is characterized by the failure to recover after a traumatizing event. 

PTSD can last for a long time if not treated, sometimes for years. Those with PTSD may notice that certain places or situations bring up memories of the traumatic event and may experience intense physical and mental reactions to these triggers. This is commonly known as “being triggered.”

PTSD symptoms

People with PTSD often feel intense shame, fear, or panic when triggered. They may also experience overwhelming anxiety on a daily basis. Common symptoms of PTSD include:

1. Re-experiencing the traumatic event through intrusive memories, nightmares, or intense physical and emotional reactions when thinking about the trauma

2. Avoidance and numbing, for example, avoiding anything related to the traumatic event, losing interest in activities that used to be fun, or feelings of detachment from friends and family

3. Hyperarousal symptoms like irritability, issues sleeping, chronic anxiety, aggressive behavior, or angry outbursts

4. Negative thought patterns like feelings of alienation, isolation, distrust, or difficulty focusing on tasks

PTSD treatments

The most effective form of treatment for PTSD is psychotherapy. Sometimes called ‘talk therapy,’ psychotherapy involves talking with a professional therapist to analyze what happened, what the patient felt, and how they reacted. Therapy can help patients to develop healthier beliefs and thought patterns.

Medications can also be helpful for some people with PTSD. The most common type of medication used for PTSD is a type of antidepressant known as SSRI. These medications can help lift and stabilize mood in a person with PTSD, which can help them better manage their trauma.

Understanding OCD

Obsessive-compulsive disorder, or OCD, is characterized by chronic obsessions and compulsions that significantly affect a person's life.

Obsessions are intrusive, unwanted thoughts or urges that trigger distressing feelings. These obsessions are difficult to ignore, making the individual uncomfortable until they eventually act on them. Those with OCD struggle to cope with these thoughts and may develop strange behaviors in response.

Compulsions are the behaviors that people with OCD exhibit while trying to relieve themselves of their obsession. Compulsions are often unnecessary or illogical actions, like washing your hands repeatedly even though they are clean, turning lights on and off repeatedly, or repeating certain phrases.

OCD treatments

There is no cure for OCD, but you can manage how much your symptoms affect your life. This is done with medications, various forms of therapy, or a combination of the two. Common treatments for OCD include:

Psychotherapy

In cognitive behavioral therapy, a therapist helps the patient to change unhealthy thought patterns. This form of therapy has been found to be beneficial for those with OCD and other mental disorders. 

Another type of therapy used for OCD is exposure therapy. This involves exposing the person to their trigger while they do their best to refrain from giving in to their compulsion.

Medications

Psychiatric drugs can help to control OCD-related obsessions and compulsions. Common drugs for OCD include citalopram, fluoxetine, and sertraline, which are antidepressants known as selective serotonin reuptake inhibitors (SSRIs).

How are OCD and PTSD related?

Intrusive thoughts, or thoughts a person can’t control, are key symptoms of both OCD and PTSD. Because these intrusive thoughts feel so terrible, people often try to avoid them to obtain some relief. This is known as “neutralizing.” 

People with PTSD often do this by ‘pushing down their feelings, avoiding certain people or places, or isolating themselves to feel safer.

For those with OCD, the neutralizing behavior is their compulsion. Checking and rechecking, repeating phrases in their head, or putting everything “in order” gives people with OCD a sense of control and relief.

Any of these neutralizing behaviors will only provide short-lived relief. If the underlying cause of the intrusive thought is not addressed, it will likely happen again.

Is there a link between OCD and PTSD?

Yes, up to 30%³ of those with PTSD will experience OCD-like symptoms within a year of their PTSD diagnosis. If you are concerned you may have one or both of these conditions, you should speak to your doctor.

Trauma-related OCD

A traumatic experience can lead to OCD-like symptoms that can develop in those with a PTSD diagnosis, and while trauma-related OCD is similar to other types of OCD in terms of its symptoms, the treatment is different.

For people who develop OCD on their own, exposure therapy is often the first choice of treatment. However, for people with trauma-related OCD, exposure therapy is less likely to be helpful. Instead, focusing on treatments that address the trauma will help to reduce OCD-like symptoms. Many therapists use methods like cognitive behavioral therapy to help people with trauma-related OCD.

Can OCD be brought on by trauma?

Yes, OCD-like symptoms are well established as a possible result of a traumatic experience. A 2020 study⁴ found that more than 60% of people with OCD had experienced a significant stressful life event before their diagnosis, and for more than 30%, this was a traumatic event.

The lowdown

OCD and PTSD can overlap in their symptoms. In addition, experiencing trauma can lead to PTSD and OCD, and many people have both at the same time. While they are different conditions, they share many of the same treatments, such as cognitive behavioral therapy and medications.

Management of symptoms is possible for both these disorders, enabling people living with these conditions to live fulfilling and happy lives.