Obsessive-compulsive disorder (OCD) and autism are commonly mistaken for each other, their similar symptoms making it hard to distinguish one from the other. This has led to many incorrect diagnoses and ineffective treatments.
So, is OCD autism? Is it part of the autism spectrum? How can one differentiate? Based on the latest research, you’ll learn about each condition separately, their similarities, differences, co-occurrence, and treatment.
OCD vs. autism: An overview
Before getting into how OCD and autism relate, we’ll look into each condition independently for a clearer understanding.
What is OCD?
OCD is a disorder that causes unwanted repetitive thoughts (obsessions), leading to impulsive behaviors (compulsions). Between 1.6% and 2.3% of U.S. adults experience OCD throughout their lifetime, and half of those with OCD experience symptoms starting in childhood and adolescence. Of those with OCD, 90% have co-occurring mental health conditions.
OCD signs and symptoms
Signs and symptoms of OCD are commonly categorized into obsessions and compulsions. Obsessions make up any thoughts or mental images that cause anxiety or distress; compulsions are repetitive actions in response to those obsessive thoughts.
To regulate obsessive thoughts, a person with OCD may try replacing them with a particular action, which may become a compulsion as the intrusive thoughts keep repeating.
OCD causes
The exact causes of obsessive-compulsive disorder are unknown, although there are risk factors involved.
Certain gene variations are linked to OCD development. OCD is 7.2 times more prevalent in families with a history of OCD than those without.
Traumatic events — considered an environmental factor — can also trigger OCD, especially in people genetically predisposed to the condition. A recent study on OCD patients showed that 64% had experienced trauma in the past, and 34% had gone through significantly stressful events just before OCD symptoms occurred.
OCD diagnosis
According to the American Psychiatry Association’s latest edition of the Diagnostic Statistical Manual of Mental Health Disorders (DSM-5), to receive a formal OCD diagnosis, a person must have:
- Obsessions and compulsions using up at least one hour of their day or significantly disabling them from doing daily life activities
- OCD symptoms that don’t come from the side effects of a substance such as medication or another health condition
To avoid a misdiagnosis of OCD, a professional must rule out all the symptoms of other mental health disorders with similar symptoms.
OCD treatment
OCD is treated with both therapy and medications. The most common therapy for OCD is cognitive behavioral therapy (CBT), particularly the exposure and response prevention (ERP) technique, during which the patient is exposed to their obsessions in a safe environment while preventing the compulsive response that usually follows.
Medications consist mainly of selective serotonin reuptake inhibitors (SSRIs), also used to treat depression. It may take up to three months for the OCD symptoms to reduce, but it depends on the individual. OCD treatments are often customized to an individual’s needs by a psychologist, psychiatrist, or therapist.
What is autism?
Autism is a developmental disorder called autism spectrum disorder (ASD).
Autism is a spectrum disorder that affects the nervous system and causes impairment of communication and social skills, as well as excessively restrictive and repetitive patterns. Notably, one in 100 people in the general population have autism.
Signs and symptoms
Characteristics of autism are divided into two main categories: social interaction and communication challenges, and restrictive and repetitive habits.
Communication and interaction problems include:
- Difficulties making eye contact
- Problems interpreting and responding appropriately to social cues
- Mismatched facial expressions and gestures
- Lack of interest in typically interesting things
- Struggles understanding other people’s perspectives and behaviors
- Uneasiness in intense social situations
Restrictive and repetitive behaviors include:
- Rigidity in personal plans and way of doing things
- Repetition of words and movements, also known as stimming
- Sensory processing impairments in the form of hypo or hypersensitivity/sensory overload in the five senses
An autistic person would have most of the above signs and symptoms, though in varying degrees depending on the severity of the condition and the support they’re receiving.
It’s important to note that people on the spectrum also have many positive traits that’s others might not, including:
- Extreme focus/intelligence on certain topics
- Often times having almost photographic memory
Autism causes
The causes of autism haven’t been identified, but genetic and environmental factors are considered to be common contributors.
Risk factors such as the conception of a child through senior parents, the mother’s obesity or immune system conditions, the baby’s exposure to harmful chemicals before birth, premature births, and other significant birth difficulties can all potentially contribute to the development of autism.
Autism diagnosis
Autism was a single diagnosis until the DSM-4 classified it under four categories of autism spectrum disorders, which included Autistic Disorder, Childhood Disintegrative Disorder, and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS).
However, the DSM-5 doesn’t consider the disorder in separate diagnoses as DSM-4 did. Now, it consists of three levels of the spectrum: ASD 1, ASD 2, OR ASD 3. The diagnosis is generally based on the severity of the symptoms, which can be observed according to the level of support they need in everyday life.
Those on level one (ASD 1) need minimal support, and this is often called high-functioning autism. They have some social communication deficits but have no learning or language development disabilities.
Level two (ASD 2) individuals need substantial support compared to those on level one, but not as much as those on level three.
Level three (ASD 3) individuals need significant support, including regular follow-up by caregivers and plenty of accommodation for their needs at work, school, home, and in various areas of their lives. Some can’t communicate verbally, and most need supervision.
Treatment of autism
Autism treatment may involve multiple forms of therapy depending on the person’s needs, often including cognitive behavioral therapy (CBT), speech-language therapy, and applied behavioral therapy.
Other common options include educational therapies in school settings, social skills training involving family and peers, and medications to help alleviate symptoms and comorbid disorders. Treatments may also extend to complementary interventions such as mindfulness, animal therapy, and art therapy.
The similarities between OCD and autism
The overlap between OCD and autism may confuse as they can share signs and symptoms. “For those with autism, the question is, where do the OCD tendencies derive from? Is it truly OCD, or is it a self-soothing task? This is where looking at anxiety and how and if obsessive thoughts start. Furthermore, is the act to solely calm down the anxiety?” says Mindy Hall Czech, a licensed professional counselor with Grow Therapy.
Repetitive behaviors, such as banging the head, tapping fingers, washing hands, and ordering traits among autistic individuals can be mistaken for OCD compulsions. Additionally, both conditions are often associated with restrictive behaviors and difficulty adjusting to change.
People with autism may display intense special interests, like those with OCD have obsessions. People with either condition can spend excessive time on these special interests, which hinders proper daily functioning since they neglect other important things.
Furthermore, autism and OCD symptoms both create social interaction difficulties that make relationships difficult.
The differences between OCD and autism
Fundamentally, autism is a neurodevelopmental disorder one is born with, while OCD is a mental illness that a person generally develops later in life. You can distinguish between OCD and autism if you look more intently at how the symptoms manifest.
“With OCD, there is a need to do things a certain way, or to carry out a compulsion, a behavior, or anxiety continues to increase,” says Czech. “With autism, the desire is looking for something to soothe, not necessarily a behavior that if they don’t do it, anxiety will increase.”
Autism is a neurodevelopmental disorder one is born with, while OCD is a mental illness that a person generally develops later in life.
Compulsions in OCD and repetitive behaviors in autism differ as those with OCD engage in compulsive behaviors to get rid of obsessions, while autistic people have routines and ritualistic behaviors they tend to gain enjoyment from. Those with autism also experience linguistic and cognitive challenges that people with OCD don’t have.
OCD and autism comorbidity and treatment
OCD and autism co-occurrence is very common.
A recent meta-analysis included a study that showed 17.4% with autism meeting the OCD Diagnostic criteria and another with 25% with OCD meeting the autism diagnostic criteria.
Treating OCD and autism co-occurrences is challenging but not impossible. Personalized treatments depend on each individual, but the most commonly used are cognitive behavioral therapy, especially exposure-response prevention therapy and selective serotonin reputake indicators (SSRIs).
A mental health professional, such as a therapist, pediatric clinician, psychologist, or psychiatrist, can help you create and follow through with a treatment plan that works for you.
Seeking help through Grow Therapy
For both OCD and autism, therapeutic intervention serves as a cornerstone for increased quality of life. Qualified therapists have the expertise necessary to create tailored plans to reduce symptoms and strengthen mental wellbeing.
Grow Therapy is home to many vetted therapists specializing in various mental health disorders, including autism and OCD. Our therapist search tool lets you locate a therapist readily available in your region who specializes in your area of need and accepts your insurance type. Try our search tool today.
