OCD Comorbidity: The Disorders Alongside OCD

Obsessive-compulsive disorder (OCD) is a chronic and fairly common anxiety condition. OCD is characterized by a variety of symptoms, but the pressing ones involve unrelenting and intrusive thoughts, urges, doubts, fears, beliefs, emotions, mental images (obsessions), and/or repetitive behaviors, like rituals or routines (compulsions).

Although OCD is a mental health condition, it can occur alongside mental health conditions, such as body dysmorphic disorder (BDD), panic disorder, generalized anxiety disorder (GAD), and major depressive disorder (MDD) or depression.

Unfortunately, however, a comorbid or dual diagnosis can make developing an effective treatment plan a bit more challenging, primarily because all conditions must be addressed for a full OCD recovery. Finding the right treatment involves gaining a good understanding of OCD, and comorbid conditions that can occur alongside an OCD diagnosis. Properly diagnosing OCD, and other mental health conditions, can improve the treatment odds, so you can live a healthy, happy, and productive life.

If you are looking for more information on OCD and the mental health conditions that can occur alongside it, you have come to the right place – this article can help you receive a proper diagnosis, and get the treatment you need to live a life free of obsessions and compulsions.

What is the Definition of “Comorbidity?”

In the mental health field, “comorbidity” occurs when a person simultaneously exhibits multiple mental health conditions. For instance, OCD and anxiety, and OCD and depression are often –dually-diagnosed (diagnosed at the same time). With comorbid conditions, one mental health condition can trigger another – or each condition can “feed off” of the other at the same time. As result, most medical professionals and psychotherapists prefer to jointly address all comorbid conditions.

What Does OCD Involve?

Obsessive-compulsive disorder (OCD) is a common “catchphrase” nowadays. It is often thrown around as a term to describe a person, who is extremely neat, organized, or has a “Type A” personality as “being OCD.” As a result, OCD, the actual condition, is often misunderstood or not taken seriously. Joking about and endorsing myths surrounding OCD is not only dangerous, but also isolating, and/or anxiety-provoking or depressing.

The truth is OCD is a life-altering mental health condition that can cause extreme emotional distress, especially when it is inaccurately portrayed in movies and in society. It is also hurtful to people, who do not have OCD, but who exhibit perfectionistic tendencies or who like things to be orderly, clean, and/or neat.

In reality, OCD is a serious mental health condition that exists within various categories of anxiety conditions. Although OCD is linked to “perfectionism” and magical thinking or superstitions, just because someone exhibits one or both of these behaviors, does not automatically suggest that he or she is struggling with OCD.

As mentioned above, OCD obsessions typically involve intrusive thoughts, fears, urges, mental images, and/or emotions that stem from stress, anxiety, fear, and/or a subconscious need for control. Obsessions can cause turmoil in the sufferer’s life. What most people do not understand or realize is that OCD is not only isolating but also powerful.

Obsessions can include:

• Fear of dirt, germs, and contamination
• Scary or upsetting thoughts, urges, fears, etc. that involve harming one’s self or other people
• A need for symmetry and orderliness 
• Upsetting and frightening violent and sexual thoughts
• Extreme religious beliefs
• Hoarding
• Urges to pull your hair (hair-pulling)

Compulsions typically involve specific actions, behaviors, and “habits,” triggered by obsessions. 

Compulsions may include:

• Checking behaviors (i.e., checking to ensure that the windows are closed, the doors are locked, the oven is off, and work assignments have been completed).
• Cleaning behaviors (i.e., excessively cleaning the house, car, or your body and continuously washing your hands)
• Constantly praying, and/or repeating certain words, phrases, and mantras until you feel calmer and more at peace) 
• Avoidance
• Replaying scenarios in your mind 
• Rumination
• Reassurance

In general, an OCD sufferer is unable to control his or her obsessions and/or compulsions to the point of significant emotional distress and harm. And, although there are a host of effective self-help OCD natural remedies, most people with OCD need conventional OCD treatments to wrangle OCD symptoms under control.

Note: It is possible to experience just obsessions, just compulsions, or both obsessions and compulsions.

What Are Some OCD Comorbidities?

Sometimes, OCD sufferers have been diagnosed with other mental health conditions, in addition to OCD – this is referred to as comorbid conditions. In fact, approximately 90% of OCD sufferers have comorbid conditions.

These comorbid conditions may include:

• OCD and anxiety
• OCD and depression or another mood disorder (i.e., bipolar disorder)
• OCD and post-traumatic stress disorder (PTSD)
• OCD and attention-deficit hyperactivity disorder (ADHD)
• OCD and eating disorders (i.e., binge-eating, bulimia, anorexia nervosa, or overeating)
• OCD and panic disorders
• OCD and phobias
• OCD and social anxiety
• OCD and body dysmorphic disorder (BDD)

Keep in mind that these are just some of the common OCD comorbid conditions that can complicate the treatment process. Learning the symptoms of OCD can help keep you on the path to OCD recovery.

OCD & Anxiety Conditions

There are a variety of anxiety conditions that can occur with OCD, such as GAD, social anxiety, panic disorder or panic attacks, phobias, etc. Understand, however, that many people with OCD suffer from more than one other anxiety condition.

Although the signs, symptoms, and triggers for each anxiety condition vary, the most common ones include the following:

• Excessive nervousness
• Constant worry
• Extreme concern
• Unrelenting fears
• Relentless doubts

Keep in mind, that a person with OCD may not realize that he or is suffering from more than one anxiety condition, like OCD and social anxiety, or OCD and GAD. Thus, it is up to family, a partner, and/or friends to learn the signs and symptoms of OCD and voice their concerns if they suspect that something else is occurring (in addition to OCD).

OCD & Depression (Or Another Mood Disorder)

“Mood disorders” are often used to describe a variety of mental health conditions that affect your mood, such as:

• Major depressive disorder (MDD)
• Postpartum depression
• Bipolar disorder
• Chronic depression

Although the signs, symptoms, and triggers for each mood disorder vary, the most common ones include the following:

• Low mood
• Mood swings
• A loss of interest in previously loved activities
• Feelings of helplessness, hopelessness, and/or worthlessness
• Self-harm and/or suicidal ideation (i.e., suicidal thoughts and attempts)

Some people not only struggle with OCD but also with mood disorders, like depression. Thus, people with OCD (and their loved ones) should pay attention to low mood, mood swings, disinterest in things the person used to enjoy, etc., so the OCD sufferer can address the signs and symptoms with his or her doctor. According to researchers, approximately 60% of OCD sufferers will experience at least one bout of depression, bipolar disorder, etc.

Note: Bipolar disorder can be especially harmful to people with OCD, primarily because mania (manic episodes) may prevent people with OCD from following their treatment plan and taking their SSRI antidepressants. Moreover, studies suggest that bipolar disorder is the most common anxiety condition coupled with OCD.

OCD & PTSD

OCD and PTSD have several symptoms in common, such as intrusive thoughts, avoidance tendencies, chronic stress, and non-stop anxiety when exposed to certain triggers. Also, both OCD and PTSD can stem from trauma.

Although there is also a notable difference between the two anxiety conditions (OCD and PTSD), people, who have experienced one or more traumatic events, have a higher risk of developing PTSD than people, who have not experienced a traumatic event. As a result, this paring (OCD and PTSD) are common comorbid conditions.

Note: If you are currently receiving OCD treatment, but are still experiencing upsetting, intrusive thoughts, urges, fears, images, and doubts, contact an OCD therapist for a PTSD evaluation.

OCD & Eating Disorders

OCD sufferers, who become “fixated” on food, have a high risk of also developing an eating disorder, such as:

• Anorexia nervosa – an eating disorder that involves extremely restricting the amount of food you consume

• Binge-eating – an eating disorder that involves consuming excessive amounts of food – anorexia is often accompanied by restrictive eating practices. 

• Bulimia – an eating disorder that eating normally or overeating and then vomiting, excessively exercising, or using a laxative to get rid of the consumed food

• Overeating – an eating disorder that involves eating way too much food at each meal.

Even though these eating disorders have diverse presentations – one element is the same = all of them involve an obsession with food. Symptoms of OCD and eating disorders can overlap. Both OCD sufferers and people with eating disorders can be “fixated on” or “obsessed with” food. But, unlike, people with OCD, people with eating disorders “obsess” over the types of foods they eat, how much they eat, and when they eat.

These individuals tend to become stressed and anxious if they “veer off path” from their typical eating patterns. Conversely, an OCD sufferer, who develops an obsession or compulsion around food, may also have an eating disorder.

OCD & Panic Disorder

Because OCD is included in a subset of various anxiety conditions, other anxiety conditions can occur alongside it. Panic disorder is one such anxiety condition. Panic disorder is characterized as panic attacks or an extreme fear real or imagined danger is possible or imminent. Keep in mind that OCD compulsions stem from a fear of an obsession. An extreme fear or an unrelenting obsession can trigger chronic panic attacks and panic disorder.

OCD & Body Dysmorphic Disorder (BDD)

Body dysmorphic disorder (BDD) shares many symptoms in common with OCD. One such symptom is a constant need or urge to “check” things. BDD involves an unhealthy “fixation on” their appearance (i.e., looks, body, teeth, hair, etc.). Understand that people, who have this condition, are not vain.

Rather, the urges and fears associated with their bodies are involuntary, upsetting, and relentless. People with BDD tend to target certain “defects,” “blemishes,” and flaws” they find on their bodies, such as too wide or too narrow hips, acne, fine lines or wrinkles, birthmarks, etc.). People with OCD can also be “fixated on” “bodily imperfections,” similar to people with BDD.

OCD & ADHD

Both OCD and attention-deficit hyperactivity disorder (ADHD) can make it difficult for people to pay attention to details, thereby, preventing them from functioning at an optimal level at school or work. Researchers have found that OCD and ADHD involve similar brain regions and neurotransmitters, serotonin and dopamine.

Moreover, both OCD and ADHD can cause a person to take a longer time (than those without these conditions) to complete tasks, especially timed tasks. These conditions can also cause problems in relationships (romantic and non-romantic).

OCD and ADHD can lead to inattention, which can make loved ones, friends, and partners feel neglected, unheard, and unloved. Although there are similarities between OCD and ADHD, there are also some differences, for instance, ADHD is commonly diagnosed during early childhood, while OCD is commonly diagnosed during adolescence. Keep in mind, however, that OCD symptoms can overlap with ADHD symptoms, making comorbidity hard to diagnose.

OCD & Social Anxiety

Studies suggest that OCD sufferers have an increased risk of developing social anxiety disorder (SAD). In fact, researchers have found that OCD and SAD are fairly common comorbid conditions. Like people with SAD, only a small percentage of OCD sufferers actually seek help for the condition. When these conditions are left untreated, they can severely diminish your quality of life.

OCD and SAD are similar in that both people with OCD and those with SAD can be excessively fearful of or obsessed with social occasions, such as parties, crowded rooms, etc. As a result, both groups of people will avoid social situations out of fear of being shunned, ignored, or something bad happening. Lastly, both OCD and SAD are commonly diagnosed during adolescence.

How is OCD Comorbid Conditions Treated?

When OCD is combined with another mental health condition, the standard treatment approach involves treating both conditions at the same time. In some cases, once an OCD sufferer begins to work on his or her OCD symptoms, the other condition also improves. Because OCD overlaps with a variety of other mental health conditions, the treatment of comorbid conditions is usually the same or very similar.

For instance, most, if not all OCD treatments can be used to help other conditions as well. The go-to treatment for OCD is exposure-response prevention (ERP) therapy, a form of cognitive-behavioral therapy (CBT). ERP therapy and CBT can be used for other mental health conditions that occur alongside OCD. Other OCD therapies that could work for comorbid conditions like OCD and anxiety or OCD and depression are acceptance and commitment therapy (ACT), TMS “trauma” therapy, EDMR therapy, couples therapy, addiction therapy, individual therapy, family therapy, and/or group therapy.

In cases of comorbidity, OCD therapies may be combined with OCD medications, like SSRIs (i.e., Paxil, Zoloft, Prozac, etc.), SNRIs, tricyclic antidepressants, antipsychotics, etc. Natural remedies that may work for comorbid OCD conditions include mindfulness meditation, hypnotherapy/hypnosis, CBD, yoga, developing healthy coping skills and strategies, vitamins and minerals, OCD forums and support groups, and online OCD treatment programs, like Impulse Therapy. The good news is that with the right comorbid treatment plan, you can address all of your mental health conditions at once, putting you directly on the path to OCD recovery.

References

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