In the past, DSM-5 categorised OCD as an anxiety disorder. With growing research studies, OCD has been reclassified under a different category known as “Obsessive-Compulsive and Related Disorder.”
So, the question that arises is, “Is OCD neurodivergent or an anxiety disorder?”
From a neurodivergent perspective, OCD aligns with the neurodivergent trait, i.e., the natural variation in how people’s brains work. In contrast, OCD is also associated with anxiety-driven symptoms, which directly links it to anxiety disorders. This dual nature of OCD requires a deeper level of understanding.
What is Neurodivergence?
Neurodivergence is the idea that all human brains come in variations, having distinct strengths and weaknesses. It emphasizes that this variation in behavioural and cognitive patterns is not a deficit; it’s rather a difference that offers unique abilities. The conditions that fall under the umbrella of neurodivergence are ADHD, dyslexia, bipolar disorder, Down syndrome, etc.
OCD(Obsessive Compulsive Disorder) is a mental health condition that affects approximately 1 % of the population worldwide. As the name suggests, individuals suffering from OCD get stuck in the cycle of their obsessive thoughts and compulsive behaviours. These individuals have recurring unwanted and unpleasant beliefs that trigger intense distress, driving them to engage in repetitive or ritualistic behaviours.
Even though this ritualistic behaviour is time-consuming, they don’t feel at ease until they perform it. For instance, they repeatedly wash their hands due to their fear of germs, often to the point where their hands become sore and chapped.
Causes of OCD
OCD has a multifaceted origin, with various factors considered as potential contributors to OCD.
Some of these factors are:
Some studies indicate that OCD runs in the family, although genetics is not solely responsible for OCD. Individuals who have parents or siblings with OCD have a higher risk of developing OCD.
Stress is not the direct cause of OCD, but major traumatic or stressful events can trigger OCD in some individuals.
OCD can develop when there is a communication problem between the frontal and deeper parts of the brain. Serotonin, a neurotransmitter, is responsible for transmitting messages between brain cells. Therefore, an imbalance and lower serotonin levels can contribute to the development of OCD.
PANDAS, short for Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection, can trigger OCD in some children. Following a severe streptococcal infection, some children may exhibit OCD symptoms.
Signs of OCD
People without OCD can experience obsessive and compulsive symptoms temporarily. However, for individuals with OCD, these persistent thoughts and behaviours are often time-consuming and lead to intense distress, significantly disrupting their daily lives. OCD neurodivergent symptoms may involve obsession, compulsive behaviour, or a combination of both.
Obsession refers to recurring, intrusive thoughts, urges, or images that induce distress or anxiety. People with OCD are aware that these thoughts are irrational, yet they struggle to control them. In an attempt to alleviate this distress, they engage in ritualistic or compulsive behaviours.
Examples of obsession behaviour:
Excessive fear of germs or contamination
Fear of accidentally harming themself or others
Fear of committing blasphemy
Extreme fear of losing something important
Constantly dwelling on past events and how certain actions could’ve changed the outcome.
These are repetitive behaviours that individuals with OCD perform in response to anxiety or distress resulting from obsession. This behaviour can only provide temporary relief, and it is more likely to repeat the same pattern in the future.
Examples of compulsive behaviour:
Washing hands or household objects excessively
Arranging things in an exact order
The constant need for assurance or approval
Counting while doing a task so it ends in what they consider a “good” or “right” number
Repeatedly checking if the stove is on or doors are open.
Is OCD Neurodivergent?
People often associate OCD with anxiety disorders or view it as a personality trait. That’s why when people think about neurodiverse conditions such as, ADHD, bipolar disorder, autism, dyslexia, etc, they tend to come to mind. While it’s true that there are significant differences between these conditions and OCD, looking at them through the lens of neurodiversity reveals one commonality: differences in how the brain processes information in each condition.
How is OCD Neurodivergent?
OCD falls under the umbrella of neurodiversity because people with OCD think, process, and behave differently from what is considered normal or neurotypical. People with OCD are caught in an endless cycle of obsession and compulsive behaviours. These obsessions are recurring unwanted thoughts or ideas that cause intense distress. They tend to engage in ritualistic and compulsive behaviours to ease discomfort, even if it gives temporary relief.
However, many individuals accept OCD as a part of their personality; for them, it represents who they are. This perception directly impacts the severity and shapes the appearance of OCD. People with OCD actively choose not to label themselves as neurodivergent. Nevertheless, it is important to understand that being neurodivergent is a difference, not a deficit, and it doesn’t need to be cured.
Neurodivergent Perspectives on OCD
There is a lot of debate surrounding whether OCD is considered neurodivergent. When viewed through the lens of anxiety disorders, the symptoms align closely. People with OCD experience persistent and unwanted thoughts, which leads to intense distress. It results in compulsive behaviour to alleviate these thoughts.
When we think of neurodiversity, conditions like ADHD, bipolar disorder, dyslexia, and others often come to mind. However, it’s important to understand the essence of neurodiversity, which involves having a different way of thinking compared to a neurotypical brain. From this perspective, OCD can be classified as a neurodivergent condition.
How to Tell if I’m Neurodivergent?
If an individual suspects that they might be neurodivergent, here are some ways to figure it out:
Neurodivergent is a non-medical term, and to qualify as neurodivergent, it doesn’t require meeting specific diagnostic criteria. Individuals can label themselves as neurodivergent, but they cannot label someone as a neurodivergent. However, there are certain neurodivergent traits one can look out for:
Highly sensitive to environmental stimuli
Difficulty with learning
There are various online quizzes for understanding neurodivergent traits that one can use. It’s important to note that these quizzes do not provide a formal diagnosis but rather serve as indicators of neurodivergence.
Consult a therapist or psychologist for a formal diagnosis rather than relying solely on self-diagnosis. With a plethora of information available on the internet, self-diagnosis has become fairly common, but it carries a risk of getting misdiagnosed.
How do Individuals with OCD Perceive Neurodivergence?
Different individuals have different perspectives when it comes to neurodivergence. Some embrace the concept of neurodivergence, appreciating and celebrating the natural variation of the brain. By identifying as neurodivergent, individuals find comfort and a feeling of belongingness within the neurodivergence community. On the other hand, some prefer not to label themselves as neurodivergent. Therefore, this showcases the diverse perceptions when it comes to neurodivergence.
Can you have OCD and Other types of Neurodivergence?
Yes, the existence of OCD and other types of neurodivergence can co-occur. Research suggests that approximately 30% of individuals with ADHD also experience symptoms of OCD, and 5-17% of individuals with autism may experience comorbid OCD.
Is OCD an Anxiety Disorder or Neurodivergent?
In the past, researchers considered OCD to be an anxiety disorder due to its anxiety-driven symptoms. However, from a neurodiversity perspective, OCD involves thoughts and behaviours that significantly differ from what is considered “normal.” Additionally, in recent times, the DSM-5 reclassified OCD, moving it from the category of anxiety disorders to a separate category called ‘Obsessive-Compulsive and Related Disorders.’ This reclassification recognizes OCD as a neurodivergent condition.
Can You have OCD and be Neurotypical?
Yes, it’s possible to be neurotypical and experience symptoms of OCD. However, the intensity of these symptoms can vary significantly. Humans are thinking creatures, so it’s obvious to have these unwanted thoughts. Most people experience obsessive thoughts or behaviours that come and go. For instance, obsessing over a newly released song for days or weeks is normal. Unlike those with OCD, these thoughts do not significantly interfere with their daily life. For people with OCD, these thoughts plague them inside until they perform their ritualistic behaviour. These rituals are often time-consuming and can disrupt their daily life.
Treatment of OCD in Neurodivergent Individuals
Each patient requires a tailored approach to OCD treatment. It depends on their specific symptoms and the intensity of the condition. Some of the most common treatments available for OCD include:
Psychotherapy for OCD
Psychotherapy, or talk therapy, aims to improve an individual’s physical and mental well-being. Therapists often use psychotherapy as the first line of treatment for OCD.
There are different forms of psychotherapy used to treat OCD:
Cognitive Behavioral Therapy
During this therapy, the therapist or psychologist guides an individual with OCD to identify, acknowledge, and change their pattern of thoughts, emotions, and behaviours. Over time, they learn healthier ways to cope with their negative thoughts and feelings.
Exposure Response Therapy
It involves gradually exposing an individual to their fears or obsessions and helping them resist the urge to engage in ritualistic or compulsive behaviours. Over time, they can phase out the anxiety and distress caused by their obsession.
Acceptance and Commitment Therapy
It is action-oriented therapy where individual acknowledges their inner thoughts and emotions without trying to deny or ignore them. To overcome this, they actively choose to make positive changes in their behaviour.
2. Medication for OCD
Mental health professionals use serotonin reuptake inhibitors (SRIs), selective FDA-approved SRIs (SSRIs), and tricyclic antidepressants to treat OCD. This medication works by balancing the level of serotonin in the brain. These medications don’t provide immediate relief, as it takes 8 to 12 months to see a noticeable difference.
How are Neurodivergent People with OCD Treated?
At Thrive Counselling Centre, we understand the challenges that OCD brings. We actively use evidence-based approaches to create tailored treatment plans that accommodate individuals’ needs and challenges. We prioritize the safety and comfort of our patients.
Does being Neurodivergent Impact Treatment?
Neurodivergent people have varying needs and challenges, and what works for one may not work for another. Each requires an individualized approach, even if the diagnosis is the same. In addition, they may have heightened sensitivity to environmental stimuli. So, treatment should be provided in a sensory-friendly setting.
Understanding the correlation between OCD and neurodivergent helps us make strides towards comprehending the condition even better. By embracing these neurological differences, we break free from societal norms. Therefore, it helps to create a society where everybody’s unique differences are appreciated.
Carson Kivari is the Founder and Clinic Director of Thrive Downtown, with years of experience helping individuals and couples overcome anxiety, depression, and burnout. He guides clients on a journey of self-exploration and trauma release to find purpose, connection, and safety. Take the first step towards healing and contact Carson today to schedule a session.