Understanding Obsessive-Compulsive Disorder: Is There A Link Between OCD And Depression?

One of the complications of a mental health diagnosis is that it can often lead to other mental health conditions, such as depression. For example, research shows that there is a strong link between obsessive-compulsive disorder (OCD) and depression. In these situations, it may be important for both mental health disorders to be treated together to achieve the best results.

Below, we’ll explore OCD and depression, the symptoms of both conditions, and effective treatments.

What is obsessive-compulsive disorder (OCD)?

According to the National Institute of Mental Health, obsessive-compulsive disorder (OCD) is “a common, chronic and long-lasting disorder in which a person has uncontrollable, reccurring thoughts (obsessions) and behaviors (compulsions)” that they “feel the urge to repeat over and over."

OCD can be diagnosed in both children and adults. It can interfere with daily life, including school or work. It can also cause difficulties in personal and professional relationships.

Common obsessions may include things like wanting to have everything in perfect order, having a fear of contamination, or having unwanted thoughts. People with OCD may also have thoughts about harming themselves or have aggressive thoughts about other people.

Compulsive behaviors tend to be repetitive. A person with OCD may feel that they need to do a specific behavior, such as double-checking that doors are locked, frequently washing one’s hands, keeping things in a certain order, or counting compulsively.

People with OCD or obsessive-compulsive disorder

While it's not uncommon for people to experience some of these symptoms to a smaller degree, people with OCD tend to experience them to the point that they interfere with life. They often experience difficulty controlling their obsessions and/or compulsions and feel that they must continue doing certain behaviors. If they don’t, they tend to experience anxiety that builds until they can participate in the behavior.

Most people with OCD realize that their behaviors aren't helpful. They don't necessarily want to participate in them, but they feel they can’t stop because the anxiety that they experience feels like too much.

Risk factors for people with OCD

Researchers have not been able to identify the exact causes of OCD. However, they have identified some risk factors. The first is genetics. It's believed that if you have a first-degree relative who has been diagnosed with OCD, your chances of also having it may be higher.

Research is being conducted to discover if there is a connection between OCD and brain development abnormalities. Some studies have pointed toward a connection, but they haven't established a definitive connection at this time.

Finally, there may be a connection between OCD and childhood trauma, as well as Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS).

Treatment options for OCD

Several treatments are available for OCD. Many patients benefit from a combination of medication and psychotherapy. However, some OCD patients use just one form of treatment or the other.

Exposure and response prevention 

Research has found exposure and response prevention therapy to be beneficial for treating OCD. This method focuses on gradual exposure to thoughts, images, or situations that an individual finds distressing, during which the individual refrains from engaging in compulsive behaviors under the guidance of a mental health professional. Over time, an individual may habituate to the distressing stimuli and learn that they can tolerate feelings of discomfort without having to engage in compulsions.

Many people find complete relief from their symptoms when seeking treatment. However, some continue to experience some OCD symptoms.

What is depression?

There are many different types of depression. The one that perhaps most people are familiar with is clinical depression, or major depressive disorder.

Being depressed is more than being sad or feeling down. Depressed patients may experience regular symptoms that make it difficult for them to function in their daily activities. Symptoms need to be present for at least two weeks for a person to be diagnosed.

Seeking treatment for depression

Without treatment, depressed people may not be able to improve their symptoms, and this may last for months or even years. This is why it can be crucial for people experiencing signs of depression to seek treatment. In many cases, the disorder is highly treatable, and there are many forms of treatment available.

Symptoms of depression

During a major depressive episode, an individual may experience the following symptoms:

• A tendency to feel down, irritable, and/or angry
• Overwhelming feelings of sadness
• Feelings of worthlessness and hopelessness
• Changes in appetite
• Changes in sleep habits
• A desire to be alone
• Difficulty focusing
• Low energy, fatigue, and low motivation
• Physical symptoms like digestive problems, headaches, and back pain

Risk factors for depression

The risk factors for depression include having a family history of depression and experiencing traumatic events in life, among others. High stress levels and anxiety can also lead to depression.

A person may also have a higher risk of being diagnosed with depression if they have other mental or emotional disorders (such as anxiety disorders).

Treatments for depression

Depression is often treatable, and there are many forms of treatment available, including therapy, antidepressants, and even holistic options. The right treatment for you may depend on your specific depression symptoms and their severity.

Selective serotonin reuptake inhibitors (SSRIs)

Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), can be effective in helping people manage their depression symptoms. However, it sometimes takes trying a few options before they find the right medication or dosage that works for them. 

Therapy for depression

Research shows that several forms of therapy can be effective for depression. These may include cognitive behavioral therapy, dialectical behavior therapy, and interpersonal therapy. Some therapists focus on getting to the root cause of where the depression is coming from. They may look back at past trauma or negative situations in a person’s life. Others may focus less on the cause and more on skills that can be developed to manage depression symptoms. 

Brain stimulation therapies

If an individual is experiencing severe depression that does not improve with psychotherapy or medication, other treatment methods, such as brain stimulation therapies, may be considered. These include electroconvulsive therapy, transcranial magnetic stimulation, and vagus nerve stimulation. 

The OCD and depression connection

Understanding the links between OCD and depression

Because of this timeline, they believe that depression is related to OCD. However, there are also some theories that posit that the chemicals present in the brain when someone has OCD may make them more susceptible to experiencing depression as well.

Researchers believe there is a connection, but just because a person is diagnosed with OCD does not mean that they will automatically have depression as well. When there is an overlap, it tends to be more with negative and controlling thoughts.

The importance of the OCD and depression connection

Having two disorders can make treatment complex. Some of the forms of therapy that are the most effective for one condition may push the boundaries of someone who is experiencing another. In the case of this specific comorbidity, the first-line medication tends to be an SSRI for both conditions. However, depression may discourage a person from believing in the treatment process that they need to follow for OCD.

Psychiatrists and therapists may have to carefully balance how to treat both conditions and their symptoms in a way that allows the person to make improvements in both areas. 

Seeking support and treatment: Finding a therapist for OCD and depression

If you are experiencing symptoms of OCD, depression, or both, a therapist may be able to help. The most effective treatment or therapy for you may depend on your symptoms and whether it improves depression for you.

One of the most popular forms of therapy for treating depression is cognitive behavioral therapy (CBT), which tends to teach patients how to reframe their problematic thoughts and behaviors. Research is offering promising results for treating depression and OCD together using exposure and response prevention (EX/RP) and cognitive therapy, often in conjunction with medication. EX/RP therapy is a type of cognitive behavioral therapy designed for treating OCD. 

With EX/RP therapy, individuals with OCD are typically exposed to the concerns that trigger their OCD compulsions. This exposure usually starts small, and the person with OCD is usually taught methods for resisting their usual compulsive response. With time, the brain usually begins reducing the threat of the trigger and experiences less anxiety. Often, this can help reduce depression symptoms, as they may be brought on by the stress of obsessions and compulsions.

Online therapy

Dealing with depression can often make it difficult to get out of bed, let alone get out the door and drive to a therapist’s office. If you experience this, you might consider trying online therapy, which allows you to connect with a counselor online from the comfort of your own home or office via audio, video, or live chat—or a combination of these modalities that is comfortable for you. 

Research has found that online therapy is effective for several mental health conditions, including anxiety, depression, and OCD. Also, BetterHelp has a network of thousands of therapists, so you can be matched with a therapist who has experience treating both depression and OCD.