If you’ve received a dual diagnosis of OCD and depression or have symptoms of both, you’re not alone. The two are often linked, but support is available.
If you live with obsessive-compulsive disorder (OCD) you may feel exhausted, overwhelmed, or like you’re in the passenger seat while you watch your impulses take the wheel.
On top of that, if you add common depression symptoms such as hopelessness and lethargy, it may take things to a new level.
Though more research is needed, studies suggest that depression most commonly co-occurs with OCD. Understanding how the two are connected may help you identify treatment and coping strategies that best support your needs.
Whatever you’re feeling right now, know that it’s all valid. With the proper support and treatment plan, it’s possible to manage both conditions.
OCD and major depressive disorder are mental health conditions listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).
Between 1% and 3% of people live with obsessive-compulsive disorder. Of those, 50% would meet the diagnostic criteria for major depressive disorder as well.
Obsessive-compulsive disorder
OCD is an anxiety disorder with two main components: obsessions (persistent thoughts) and compulsions (urge to perform certain behaviors).
Common symptoms include:
- counting or checking objects
- excess grooming
- intrusive thoughts
- rearranging objects
- repeating rituals
Major depressive disorder
Major depressive disorder (MDD) is a complex and common mental health condition. It’s usually diagnosed after you’ve had symptoms for at least 2 weeks.
Common symptoms include:
- sadness (different than “the blues”)
- less joy in your usual activities
- difficulty with focusing
- irritability
- altered sleep patterns
- changes in your appetite
- unexplained body aches
- thoughts of self-harm
Suicide prevention
If you’re considering suicide, you’re not alone. Help is available right now:
- Call the National Suicide Prevention Lifeline 24 hours a day at 800-273-8255.
- Call a crisis hotline, such as the National Suicide Prevention Lifeline at 800-273-8255.
- Text HOME to the Crisis Textline at 741741.
One
The exact cause of this common dual diagnosis is still up for debate among experts.
Some studies have found that the part of the brain that helps regulate mood — the hypothalamic-pituitary-adrenal axis (HPA axis), which helps regulate mood, is structurally different for those living with depression and OCD.
There are many similarities between OCD and depression, with some key differences.
| Symptoms | OCD | Depression |
| Impact on mood | X | X |
| Challenges in relationships | X | X |
| Negative thinking patterns | X | X |
| May be managed with therapy | X | X |
| May be managed with medication | X | X |
| DSM-5 classification | Anxiety disorder | Mood disorder |
| Compulsions | May feel compelled to perform specific actions repeatedly, like washing your hands many times | May feel compelled to |
Can OCD cause depression?
Living with obsessions and compulsions can severely impact a person’s quality of life, says Katie Lear, a licensed clinical mental health counselor in Charlotte, North Carolina, who specializes in anxiety disorders, particularly OCD.
“Those living with symptoms of OCD may find that they aren’t able to participate in activities, socialize, or even relax at home in the way they’d like to because their symptoms can be so debilitating,” she explains.
“Over time, this lack of social time or positive, rewarding activities can increase the risk of becoming depressed,” Lear added.
If you have a dual diagnosis of OCD and depression, professional support can help you manage both conditions.
Exposure and Response Prevention (ERP)
ERP is considered the gold standard for OCD treatment, says Ben Eckstein, a licensed clinical social worker in Durham, North Carolina, who specializes in OCD and anxiety disorders.
If you live with depression, you might find it challenging to start here, though.
“ERP is really challenging. In order for it to be effective, you must be motivated and able to follow through consistently with homework assignments,” Eckstein says. “Depression can make it difficult to practice ERP in an effective way, as decreased motivation, interest, and energy can get in the way of consistent practice.”
Other therapy modalities, such as cognitive behavioral therapy (CBT), may help with this.
Cognitive behavioral therapy (CBT)
If you live with both OCD and depression, you might want to consider CBT first before trying other treatments, Eckstein says.
“CBT can be helpful in addressing feelings of hopelessness and other negative beliefs, allowing you to more fully engage with OCD treatment,” he says.
Medication
In some cases, your doctor or a psychiatrist may suggest selective serotonin reuptake inhibitors (SSRI), antidepressant medications recommended in the treatment of OCD and depression.
If you’re experiencing symptoms of OCD and depression, a doctor or mental health professional can talk with you about helpful medication.
Support groups
Connecting with others with similar experiences can also be helpful to you. Some options include:
OCD and depression are commonly diagnosed together, with the former presenting first most of the time. Treatment can be a challenge, but there is always hope.
“If you are living with OCD, you may feel hopeless about overcoming your symptoms, and depression can make your feelings of hopelessness even more intense, but you should know that you’re not alone,” Lear says.
“These diagnoses may be difficult to handle at times, but many people are able to enjoy fulfilling, happy lives even with depression and OCD,” she adds.
The first step is seeking support from a professional who can offer a listening ear and provide tools to help you cope. They’ll help you take things one day at a time.