When someone has two or more mental health conditions simultaneously, it’s termed as comorbidity. In OCD, comorbidity is common. For instance, it’s not rare for someone with OCD to also experience depression. These conditions can either exist independently or influence each other, sometimes making symptoms more complicated.
WebMD has a more detailed explanation of the term comorbidity if you want to read in more depth.
Research indicates1 that a staggering 90% of those with OCD also meet the criteria for another psychiatric condition at some point. Anxiety disorders, mood disorders, impulse control issues, and even substance use disorders rank high on the list of comorbid conditions.
OCD at a Glance
OCD is marked by invasive, repetitive thoughts that can conjure up distressing images, even when everything’s seemingly fine. These thoughts often lead to compulsions—mental or physical actions aimed at easing the distress. While people with OCD recognize these obsessions as irrational, they often can’t help but act on them. Take, for instance, someone overwhelmed with thoughts of harm coming to a family member. They might repetitively envision positive outcomes or constantly check on the person’s well-being.
Some widespread OCD obsessions involve fears of self-harm, contamination, religious perfection, relationship doubts, and more.
Highlighting Some Common Comorbidities:
- OCD and Depression: Many with OCD also report depressive episodes2. The symptoms can vary, from persistent sadness to feelings of worthlessness and even suicidal thoughts. The relationship between OCD and depression is intricate, often necessitating a nuanced approach to diagnosis and treatment.
- OCD and ADHD: These two conditions might seem distinct, but they share a lot in terms of symptoms and even brain activity. Both can manifest as attention issues, distractibility, and heightened anxiety3.
- OCD and Anxiety: The spectrum of anxiety disorders encompasses conditions like panic disorder, generalized anxiety, and PTSD. Many with OCD also grapple with another form of anxiety, further amplifying their distress4.
- OCD and Eating Disorders: Anorexia and body dysmorphic disorder often interplay with OCD. Both disorders revolve around rigid thinking patterns and a heightened need for control.
- OCD and Personality Disorders: OCPD and OCD can be especially challenging to distinguish when an individual is in the throes of an OCD episode. However, once OCD symptoms are better managed, underlying personality traits become more apparent.
I shall give some clinical examples from my practice, with names changed for anonymity that should help explain comorbidity better.
Case Study 1: Anna’s Battle with OCD & Depression
Anna, a 28-year-old teacher, self-referred with complaints of repetitive thoughts about accidentally harming her students, leading her to check and recheck her actions. Alongside, she expressed feelings of persistent sadness, disinterest in hobbies, and isolation.
Discussion:
Anna’s case exemplifies the coexistence of OCD and depression. While her repetitive thoughts and behaviours align with OCD, the persistent sadness and loss of interest point towards depression. The avoidance behaviour, a hallmark of OCD, can result in isolation, often leading to depression.
Case Study 2: Jake’s Struggle with Attention and Obsessions
Jake, came to see me due to his constant need to tap objects repeatedly and his inability to focus on his university. He was easily distracted and often daydreaming.
Discussion:
Jake’s repetitive tapping is indicative of OCD compulsions, while his distractibility resonates with ADHD symptoms. The overlap between the two disorders is evident here, as both OCD and ADHD manifest in certain shared behaviours and are linked to abnormal brain activities in similar regions.
Case Study 3: Mia’s Anxiety Overload
Mia, a 35-year-old accountant, expressed her constant state of heightened anxiety. She described panic attacks, obsessive thoughts about germs, and fears of social interactions.
Discussion:
Mia’s myriad symptoms encompass various anxiety disorders. Her panic attacks point towards panic disorder, the obsessive thoughts are consistent with OCD, and her fear of social interactions indicates social anxiety. This case highlights how different anxiety disorders, including OCD, can coexist in an individual.
Case Study 4: Sarah’s Weight and Obsessions
Sarah, a 20-year-old college student, showed signs of severe weight loss. She revealed strict calorie counting, fear of gaining weight, and an obsession with body symmetry.
Discussion:
Sarah’s calorie counting and fear of weight gain are classic symptoms of anorexia nervosa, an eating disorder. Her obsession with body symmetry aligns with OCD. Such a case demonstrates how OCD can intertwine with eating disorders, with both conditions sharing themes of control and rigid thinking.
Living with OCD and Its Comorbidities
Having multiple conditions can take a toll on one’s quality of life. However, with dedication and the right treatment approach, one can reclaim a fulfilling life. Regular therapy sessions can offer invaluable support, especially when life throws curveballs.
Some holistic lifestyle changes that can aid in managing OCD and its comorbid conditions include sticking to a consistent sleep routine, engaging in regular physical activities, maintaining a balanced diet, and practicing stress-relieving techniques.
Seeking Help
Thankfully, many treatments cater to both OCD and its related conditions. ERP, in particular, stands out as a highly effective therapy for OCD. It’s crucial to find the right healthcare professional familiar with the nuances of these conditions. The rise of virtual therapy means that specialized care is now more accessible than ever.
Juggling OCD and another condition can be tough, but with the right care, recovery is achievable. The key lies in finding a knowledgeable therapist and being proactive about your mental health. The digital age has expanded access to quality care, ensuring that everyone gets the help they deserve.
- Ruscio, A. M., Stein, D. J., Chiu, W. T., & Kessler, R. C. (2010). The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Molecular psychiatry, 15(1), 53-63.https://doi.org/10.1038/mp.2008.94 ↩︎
- Adam, Y., Meinlschmidt, G., Gloster, A. T., & Lieb, R. (2012). Obsessive-compulsive disorder in the community: 12-month prevalence, comorbidity and impairment. Social psychiatry and psychiatric epidemiology, 47(3), 339-349. ↩︎
- Abramovitch, A., Dar, R., Hermesh, H., & Schweiger, A. (2012). Comparative neuropsychology of adult obsessive-compulsive disorder and attention deficit/hyperactivity disorder: Implications for a novel executive overload model of OCD. Journal of Neuropsychology, 6(2), 161-191. ↩︎
- Torres, A. R., Prince, M. J., Bebbington, P. E., Bhugra, D., Brugha, T. S., Farrell, M., … & Singleton, N. (2006). Obsessive-compulsive disorder: prevalence, comorbidity, impact, and help-seeking in the British National Psychiatric Morbidity Survey of 2000. The American Journal of Psychiatry, 163(11), 1978-1985. ↩︎