Can You Have OCD and Other Types of Neurodivergence?
OCD can and does overlap with other forms of neurodivergence, including applied, clinical, and acquired neurodivergence. With this in mind, individuals must pursue a diagnosis for all their symptoms. Different conditions can reveal similar symptoms, and this overlap can result in misdiagnosis or underdiagnosis.
To help with understanding the types of symptoms, let’s review the similarities between OCD and other neurodivergent conditions.
OCD and Autism (ASD)
Studies suggest up to 36% of individuals with ASD also have OCD. And while both conditions are neurodivergent, OCD is a mental health disorder while ASD or autism spectrum disorder is a neurodevelopmental condition. ASD indicates a difference in brain function whereas OCD reflects differences in behaviour and thinking.
Symptoms of OCD and ASD will overlap. Both conditions may feature the following:
- Repetition of sounds or actions
- Fixation on specific rituals, routines, and order
- Focused, intense interest in a particular subject or object
- An inability to start or maintain a conversation
- Difficulty with changing plans, routines, or aspects of their lives
Differences in Behavioural Motivation
OCD behaviours are born out of emotions and the fear that something bad will happen if they don’t carry out certain actions. The distress caused by such actions can exacerbate a sense of fear or urgency for sufferers.
For people with autism, motivations will differ. Their routines and order help them feel comforted, soothed, and more in control of their response. Anxiety in someone with autism is likely to come about from a disruption to preferred routines or instances of sensory overwhelm. This differs from someone with OCD who can experience fear or obsessional thinking from their anxieties.
OCD and ADHD
While both OCD and ADHD are associated with neurotransmitter brain chemistry, OCD has links to serotonin while ADHD relates to dopamine. Both disorders are heritable and have some overlaps.
ADHD can show up in the form of persistent ADHD or symptomatic ADHD. The persistent form tends to reveal itself in childhood whereas symptomatic ADHD can decrease with age. In 2020, around 140 million adults had persistent ADHD while 360 million had the symptomatic form globally.
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UK statistics suggest around 750,000 people suffer from OCD at any one time while around 1% of the global population experiences OCD – roughly 80 million.
Symptoms of OCD and ADHD can overlap and the presence of both can exacerbate symptoms in individuals. For instance, comorbid OCD may ramp up hyperactivity in some ADHD patients or show up as hoarding or repetitive body-based behaviours.
Differences in Behavioural Motivation
The root causes of behaviours can differ between individuals with OCD and ADHD and we’ve outlined some of these below.
- ADHD has motivations rooted in impulsivity whereas OCD is a defence mechanism based on over-thinking.
- People with ADHD may hoard items after a phase of impulse buying whereas OCD sufferers tend to avoid giving items away, seeing it as wasteful.
- Repetitive behaviour can offer stress relief and improved focus for people with ADHD while people with OCD can be stuck in behavioural loops that exacerbate their anxiety.
- Behaviours in people with ADHD can be goal-oriented whereas people with OCD tend to lean towards perfectionism and impaired inhibitions.
OCD and Depression
There is a close link between OCD and depression. Studies show up to 50% of people with OCD will also experience depression in the form of MDD (Major Depressive Disorder) or Dysthymia. This results in a common dual diagnosis of depression and OCD.
Scientists are still unsure of the exact reasons behind the frequency of this comorbid diagnosis but some suggest there may be structural differences in parts of the brain for people.
It’s also likely that people who experience OCD are dealing with depression since they may become more isolated. Symptoms can overlap, but it’s worth noting the following symptoms for people who experience MDD:
- Extreme lethargy, low energy, and trouble sleeping
- Loss of or lack of interest in their usual activities
- Feeling worthless or hopeless about life
- Eating-related disorders such as binge eating or not eating enough
- Brain fog and an inability to make decisions
Differences in Behavioural Motivation
Depression can develop in people with OCD because of the disruption to their lives from compulsive and intrusive thoughts and unwanted behaviours. This can create problems in their personal and professional lives and lead to isolation.
Both OCD and depression are mood disorders. But motivations will differ where, for instance, people with OCD will feel compelled to carry out actions as part of their compulsions or obsessions. In contrast, individuals with depression may engage in negative actions because of how low they feel. This may result in self-destructive behaviours rather than compulsive actions as a result of the anxiety that OCD attempts to reduce.