OCD and Depression, OCD and Anxiety, OCD and ADHD
OCD and anxiety, OCD and depression, and OCD and ADHD often run together. Did you know people with obsessive-compulsive disorder run a high risk of having comorbid (simultaneous) illnesses, such as OCD and anxiety? Doctors typically check for comorbid disorders in OCD patients. It's critical that they identify each problem to ensure the best possible treatment outcomes.
OCD and Anxiety
In the DSM-IV, OCD and Anxiety appeared together in the chapter on anxiety disorders. The manual treated OCD as a sub-type of anxiety disorder. The recently updated DSM, Fifth Edition, treats obsessive compulsive disorder as a condition separate from anxiety, giving it a chapter of its own.
OCD and anxiety have similar manifestations, so it presents a challenge for physicians when attempting to diagnose a patient that has both disorders at once.
People with anxiety experience excessive worry, dread, and distress that occurs both with or without the presence of psychological stress. People with an anxiety disorder may exhibit restlessness, fatigue, muscle tension, and problems with concentration. They may sweat, feel faint, hyperventilate due to the unreasonable worry they experience over a small issue or upcoming event.
OCD symptoms include severe anxiety brought on by the repetitive obsessive thoughts. The obsessive thoughts, images, or urges drive the person with OCD to perform nonsense rituals and compulsive behaviors to alleviate the anxiety (Read about OCD obsessions and compulsions). Those with an anxiety disorder have no urge toward compulsive behaviors or repetitive thoughts that will not go away.
About 25 percent of those with OCD also have generalized anxiety disorder (GAD) or some other anxiety disorder. The comorbid anxiety disorder may occur due to worry and dread over the onslaught of obsessive thoughts and compulsions that the person knows are imminent.
OCD and Depression
OCD and depression have a clear link in that many people diagnosed with OCD also have depression. Major depressive disorder involves a chronic sad and depressed mood, a loss of interest in favorite activities, for at least two weeks. People with depression also have the following symptoms during that period:
- Over or under eating
- Sleep too much or have insomnia
- Act overly fidgety or feel very sluggish
- Trouble focusing
- Thoughts of suicide or death
- Feel worthless
- Have excessive, unfounded guilt
Over 60 percent of people with OCD have one major depressive episode at some point in their lives. Typically, the depression occurs after OCD symptoms have begun. This indicates that the depression may occur as a result of the continual distress caused by the OCD symptoms. Research also indicates that the link between OCD and depression could also result from similar biological, psychological and environmental triggers for both conditions.
OCD and ADHD
OCD and ADHD appear similar at first glance. Both can cause symptoms of impaired attention span, memory issues, and impulse control. It's important for the physician to determine whether the patient has OCD or ADHD, or both. The stimulant medications used to treat ADHD do not work for OCD and commonly exacerbate OCD symptoms. Likewise, the SSRI antidepressant medications commonly prescribed to help control OCD do nothing for ADHD.
Doctors recommend treating the OCD first in persons with both conditions. Once the person has OCD symptoms and behaviors under control, he or she may then get relief from ADHD symptoms through stimulant medications.
ADHD, anxiety, and depression represent only the three most common disorders that can occur simultaneously with OCD. When picking a health care professional to evaluate symptoms of possible mental disorders, it's critical to choose one with understanding and experience in treating simultaneously occurring disorders.
Last Updated: 03 February 2017
Reviewed by Harry Croft, MD