When my son Dan’s obsessive-compulsive disorder was severe, he was barely functioning. He isolated himself from his friends, and could barely move from point A to point B. He’d spend hours at a time either sitting in his “safe” chair or just lying on the floor. Eating a morsel was a struggle.
Not surprisingly, he was diagnosed with depression. Even on a “good” day, when he was somewhat able to go through all the motions of normal living, he was tormented nonstop by obsessions. Who wouldn’t be depressed living like this?
Thankfully, even though he was battling depression, he was still totally invested in beating OCD, and was able to commit himself fully to exposure and response prevention (ERP) therapy, the evidence-based psychological treatment for obsessive-compulsive disorder. As his OCD improved, his depression lessened, and eventually dissipated. This is not an uncommon sequence of events for those suffering from both depression and OCD.
But what if you are dealing with OCD and depression, and your depression overtakes you so much that it hinders your ability to participate in ERP therapy? While the depression might still be a byproduct of living with obsessive-compulsive disorder, treating the OCD before the depression is just not feasible and will likely set you up for failure. In this case, the depression needs to be treated first so that engaging in therapy can be possible.
A good health-care provider can work with you to discuss the best ways to treat your depression, whether it involves psychotherapy, medication, or lifestyle changes (which of course might be difficult for those dealing with the restrictions of severe OCD).
The frequent co-occurrence of OCD and other brain disorders such as generalized anxiety disorder (GAD) or social anxiety disorder underscores the importance of having a health care provider who is knowledgeable about OCD and experienced in treating it and co-occurring conditions. While in some cases the treatment process might seem straightforward enough, comorbid illnesses can potentially impede a correct diagnosis and treatment. In other words, it gets complicated.
If depression isn’t recognized as the reason for ineffective therapy, those with obsessive-compulsive disorder might believe their illness is treatment-resistant, and become convinced that ERP therapy just won’t work for them. They give up and are left with no hope at all, which might possibly lead to an even deeper depression. It becomes a vicious cycle where OCD is likely to garner even more strength.
The bottom line is OCD is treatable, as is depression. A competent therapist will be able to formulate the best plan for the successful treatment of both disorders. Of course if you are working on fighting your OCD and feel your depression is getting in the way of your ERP therapy, make sure to let your health care provider know. Beating OCD and depression can be tricky, but it is possible, and those suffering from both can go on to lead happy, productive lives. My son is living proof of this.