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2 CE Webinar: Ketamine – History and Considerations for Clinicians. 6/28 – 12 – 2pm

Are OCD and Depression Linked? How Are They Treated?


Obsessive-compulsive disorder (OCD) and depression are two separate, distinct mental health disorders, but they’re not always mutually exclusive from each other. Although one is classified as an anxiety disorder and the other as a mood disorder, it is possible to have OCD and depression at the same time. 

An estimated 1.2% of the American population suffers from OCD, and an estimated 8.4% suffer at least one major depressive episode in a year. About one-half of people diagnosed with OCD also experience depression, but before understanding the correlation, it’s imperative to understand their individual causes and symptoms.

OCD Symptoms and What Causes OCD

There are a lot of assumptions and fictional representations of OCD, so it’s important to understand exactly what it may look like and what might cause a person to develop this disorder.

First, a person may be diagnosed with OCD when obsessions and compulsions:     

  • Take up at least 1 hour every day
  • Cause disruption to the person’s personal and/or professional life
  • Cause emotional and mental distress to the person

What are obsessions? Obsessions are unfounded thoughts, fears, or worries that occur frequently and cause severe anxiety. While the person may know that the thoughts or worries are unreasonable, knowing is not enough to make them stop. Examples of typical obsession symptoms are:

  • A strong fixation with dirt and/or germs
  • A strong need to have things kept or done in a very specific order
  • A strong fixation with order and symmetry – and feeling anxiety when things are out of sync
  • Repetitive doubts (e.g. about locking the door or turning off the iron) and troubling anxiety or fear with those doubts
  • Spending long periods of time counting or touching things in patterns
  • Persistent thoughts about losing control and hurting someone or yourself
  • Persistent thoughts of awful sexual acts or violence
  • Troubling thoughts that go against one’s religious beliefs

What are compulsions? Compulsions are repetitive, ritualized acts meant to reduce the anxiety caused by obsessions. These acts can become excessive and disruptive to one’s daily life and relationships, both personally and professionally. Examples of compulsive behaviors are:

  • Checking and re-checking to make sure that a door is locked, lights are turned off, or appliances are unplugged – just to cite a few examples.
  • Repetitive hand-washing even when your skin becomes raw – can be up to or over 100 times a day.
  • Repeating the same word, phrases, or prayers over and over again
  • Following rigid rules or habitual processes like dressing in the same order every day, setting items in an exact order every time, organizing drawers and cabinets a particular way – and becoming upset if the order is changed or disrupted.

What causes OCD? The causes of OCD are still not fully understood but are thought to have origins in biology, genetics, or learning behaviors from others. Risk factors for developing OCD include a person’s family history, stressful or traumatic life events, and the comorbidity of other mental health disorders.

Depression Symptoms and What Causes Depression

Depression (or major depressive disorder) is typically marked by persistent feelings of sadness and loss of interest. It can cause emotional and physical problems, and it’s not something you can just snap out of. 

Some people may experience an isolated episode of depression, but most experience multiple episodes that last most of the day, every day. Their symptoms may often interfere with their daily lives and relationships. Here are some symptoms of depression:

  • Feeling sad, empty, or hopeless
  • Having angry outbursts or showing irritability or frustration – even over seemingly little things
  • Experiencing a loss of interest in most or all of one’s normal activities
  • Frequent or recurrent thoughts of death, suicide, or suicide attempts
  • Feelings worthless or guilty
  • Fixating on past failures or blaming one’s self
  • Anxiety, agitation, or restlessness
  • Lack of sleep, including insomnia, or sleeping too much
  • Feeling tired or lacking energy so that even small tasks take a lot of effort
  • Slowed thinking, speaking, or body movements
  • Trouble thinking, concentrating, remembering things, and making decisions
  • Reduced appetite and weight loss 
  • Increased food cravings and weight gain
  • Physical problems with no physical explanation, such as back pain or headaches

What causes depression? As with OCD, the causes of depression are not fully known. But biology, genetics, hormones, and brain chemistry are all thought to be factors in developing major depressive disorder. Risk factors for depression include a family history of depression, experiencing a traumatic event, substance abuse, chronic illnesses, certain prescription medications, and comorbidity of other mental health disorders.

Is There a Link Between Depression and OCD?

Yes, there is a correlation between OCD and major depressive disorder. Suffering from obsessive-compulsive disorder can cause other mental health illnesses, including depression. As we noted previously, about half of people diagnosed with OCD are also diagnosed with depression. Another study found that those with OCD are 10-times more likely to develop depression symptoms than those without.

And it’s not hard to see why. People with OCD are struggling with obsessive thoughts and compulsive behaviors that seemingly never end. Some of these thoughts may be very troublesome or scary, and the thoughts and behaviors can often cause significant negative impact and disruption to their lives. It can easily become isolating, lonely, overwhelming, exhausting, and…depressing. 

Studies confirm this, showing that people burdened by repetitive, negative thoughts are often suffering from both OCD and depression. The good news is that these same studies also demonstrate that medical intervention, in particular, cognitive-behavioral treatments, improve symptoms in patients.

OCD and Depression Treatment

While there are established prescription medication treatments for major depressive disorder, cognitive behavioral interventions are vital and beneficial for those suffering from OCD. One particular cognitive behavioral therapy (CBT) called exposure therapy is heavily used in the clinical treatment of patients with OCD. 

Exposure therapy involves confronting the negative thoughts a patient suffers from or the situations, environments, or objects that trigger these thoughts (exposure) and then learning how to not react with their normal compulsive behaviors. A qualified therapist helps the patient retrain their thought patterns and responses until the person can apply the exposure therapy strategies on their own.

Other types of cognitive behavioral therapy for OCD include progressive muscle relaxation, deep breathing exercises, and cognitive restructuring.

CBT is also highly effective for treating depression. Professional therapists can treat many different types of depression by helping the patient challenge negative or irrational thoughts and behaviors. One usually influences the other, and so by focusing on the treatment of both, the patient can see noticeable improvements and a better quality of life.

Some typical types of CBT for depression include: 

  • ABC analysis 
  • thought journaling
  • activity scheduling (which involves rewards for accomplishments)
  • successive approximation (which involves breaking down larger goals into smaller ones)
  • cognitive restructuring

Local Treatment for OCD and Depressive Disorders

The Ross Center has three locations in D.C., Northern Virginia, and New York, NY. Our medical professionals are highly qualified and experienced in evidence-based therapies for both OCD and depression. We want you to realize that you are not alone and that help is readily available. 

Our staff can help you learn strategies and find solutions that will help you overcome your symptoms and improve your quality of life. Please contact us with questions or to schedule an appointment today.

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