Is OCD Neurodivergent?

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18 October 2024

Imagine you’re sitting at your desk, and you need to focus on a very important task but an annoying keep popping into your head. You cannot ignore it; you can try as much as possible, but it persists, demanding your attention and you are compelled to act on it, do something, maybe tap your pen so many times or check a locked door three more times just in an effort to calm the anxiety. Does this sound familiar? Can this be a sign of Obsessive-Compulsive Disorder (OCD)? And more importantly, can OCD be considered neurodivergent?

The term neurodivergence has emerged in recent years as a way to talk about individuals whose brains function differently from what is considered typical. Arguably, we have become increasingly satisfied with the idea that conditions such as autism and ADHD are accepted forms of neurodivergence (so-called because they describe ways in which our brains differ from this norm) and even celebrated for distinct influence the afford human cognition or behaviour. But what about OCD? Traditionally seen as an anxiety disorder, could it also fall under the umbrella of neurodiversity?

In this article, we will explore these questions and will be exploring what neurodivergence and OCD are, the overlap between the two, and why many experts and advocates are beginning to recognize OCD as part of the neurodivergent spectrum.

What is Neurodivergence?

Neurodiversity was actually a term first developed by sociologist Judy Singer back in the late 90s to work for legitimacy of all neurological conditions such as autism and ADHD saying they weren't really mental illnesses or disorders but normal variations of human neurology. It now has expanded to include other conditions like dyslexia, dyspraxia, and Tourette syndrome. Let's explore about all of these conditions that are recognized as part of neurodivergence:"

Autism: Those with autism spectrum disorder often have difficulty in social communication and sensory processing but may be hyper-focused or gifted with a superb memory.

ADHD (attention deficit hyperactivity disorder): ADHD involves challenges with attention, hyperactivity, and impulsivity, but strengths in creativity and multitasking.

Dyscalculia: While dyscalculia affects the ability to comprehend numbers and mathematical ideas, often people with this disorder perform well in non-numerical regions

Dysgraphia: People with dysgraphia often excel in verbal exchanges, as well as creative activities but writing and spelling.

Dyslexia: Although dyslexia do affect reading and language processing, some although not all still have strong verbal skills and creativity.

Dyspraxia: While those with dyspraxia struggle more than the average individual do when it comes to doing physical things, they usually make up for all of that because their brains are way more developed in other areas like figuring out solutions and finding alternative ways to engage themselves into a certain activity.

Tourette Syndrome: Tourette syndrome is a condition that causes involuntary tics, but daily life is adapted to and the individual shows awareness about it.

According to the National Institutes of Health, neurodiversity is “the idea that people experience and interact with the world around them in many ways, with no one ‘right’ way of thinking, learning, and behaving, and differences are not deficits.'' In simple words Neurodivergence is a variation in the way that our brains are structured or how they function from one another, resulting in differences of thought and cognition different ways with sensory input, managing emotions. The neurodiversity movement, instead of depicting these brains as “disordered” or suffering from deficits in function, views the difference as natural among humans.

Recently, the number of neurodiverse people worldwide remains uncertain; however, researchers estimate it to be as many as 15–20%. And a 2020 report discovered that 32% of UK employers working within industries such as engineering, manufacturing and construction had some level of negativity towards being willing to hire someone on the spectrum. In that same survey, about 60% of respondents with ASD said the sort of workplace they worked at did not include neurodivergent employees and only 28% their fellow human lost souls agreed. And this, in addition to the plethora of other reasons not least a basic human right for people to articulate what they think is best for themselves, reiterates how imperative it is that neurodiversity movements are both led and inspired by those who have been through these experiences.

What is Obsessive-Compulsive Disorder (OCD)?

Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by two key features:

Obsessions: Intrusive, unwanted thoughts, images experienced as intrusive and unwanted by the individual that cause marked anxiety or distress

Compulsions: Repetitive behaviours or mental acts that an individual feels driven to perform to neutralize the distress caused by obsessions, often according to rigid rules or rituals.

For example, a person with OCD may fear they will hurt someone else if they do not repeatedly check to see that the stove is off or have an overwhelming need for much hand washing in order to avoid germs. These compulsions do not help, and often only provide a short-term relief while coming in way of daily function, relationships and well-being. Since the intrusive thoughts and compulsions are anxiety-based, OCD is usually classified as an Anxiety disorder. However, its impact on thought patterns, behaviour, and sensory experiences brings it into alignment with some of the characteristics seen in neurodivergent conditions.

Can OCD Be Considered Neurodivergent?

Even though OCD is most commonly seen as a mental health or anxiety disorder, there was also an increasing trend within the neurodiversity community to consider if we can view it as being part of our atypical wiring. This viewpoint is supported by many overlapping features of OCD with known neurodivergent conditions, including difficulty processing information through the brain (think autism), handling sensory stimuli or emotional regulation. Some Reasons OCD comes under the Neurodivergent umbrella:

While OCD is conventionally viewed through the lens of mental health and anxiety disorders, a growing number of people within the neurodiversity community argue that OCD can be considered neurodivergent. This perspective stems from several shared traits between OCD and other recognized neurodivergent conditions, particularly in how the brain processes information, sensory inputs, and emotional regulation. Here are some reasons why OCD may fall under the neurodivergent umbrella:

Neurological Differences:

OCD, just like autism and ADHD is based on neurological differences where cognitive functioning is affected. The records confirm people with OCD proportion numerous symmetric mind activation styles in components of the brain concerned about decision making, emotion regulation and conduct formation. For example, in the case of OCD areas of brain involved in error detection and correction (e.g., basal ganglia and orbitofrontal cortex) appear to be hyperactive. Can this pervasive "error detection" contribute to the never-ending quest for surety and perfection, characterized by compulsive making-right of invisible wrongs?

In this sense, the neurological underpinnings of Synaesthesia are not unlike those now-recognized in conditions like ASD and ADHD that have a basis in differences between brains, leading to different experiences with stimuli but similar understandings of thought process.

Ritualistic and Repetitive Behaviours:

A defining feature of neurodivergence, especially autism, is that the individual exhibits repetitive behaviour and resistance to change. People with OCD engage in the same types of compulsions, but they are much more ritualistic and repetitive generally as a means to try putting things right or gaining control. And the external appearance is not always that different either with autistic people seeking comfort through routine and rigid behaviour patterns, while those diagnosed with OCD perform rituals in order to reduce anxiety.

However, the presence in both neurodivergent individuals and OCD patients of an urge towards structure, predictability and specific routines, a phenomenon still under debate as to whether it represents a potential overlap or merely arises out of comorbidity-like symptomatology indicates that this may not be so straightforward.

Sensory Sensitivities:

Some people who are neurodivergent have sensory sensitivities, which means they may experience more intense reactions to stimuli like loud noises or bright lights. Likewise, those with OCD frequently describe sensory experiences as very unsettling. For instance, someone with contamination-related OCD may feel overwhelming revulsion or fear at the idea of touching certain things or surfaces.

This tendency for hyperactive sensory data correlates with the experiences of neurodivergent individuals but supported what Bethlem (2016) reported, that most autistics were not only affected by sound information.

Executive Functioning Challenges:

Organization, time management, and cognitive flexibility are facets of executive functioning; difficulties in these areas can be common among neurodivergent individuals as well people with OCD. These are all executive functioning issues from which people with OCD often suffer, indecision, focus on small details and inability to shift from and remain stuck in thoughts. Similarly, those with ADHD or autism may find these areas difficult but for different reasons beneath the surface.

This second part in the title suggests a commonality between OCD and acknowledged neurodiversity diagnostic labels, through comorbid executive functioning issues.

The Intersection of OCD and Neurodivergence: A Broader Perspective

OCD is not an official neurodivergent condition, its nature as a mental health diagnosis puts it in the same league, traditionally speaking, with something of interest to people who study that kind of thing. This is especially the case for people with comorbid OCD and neurodiversity, such as those on the autism spectrum or from ADHD backgrounds who also have an ED diagnosis. Research indicates that people with autism, for example, are more likely to have co-occurring OCD, which can complicate diagnosis and treatment.

The neurodiversity movement sees differences in brain function as normal variations of the human genome, rather than pathologies to be treated or cured. Now, one way to look at OCD is that it represents a unique sore-thumb type of brain diversity in the human population.

Treatment for OCD in Neurodivergent Individuals

OCD, combined with neurodivergent conditions requires a modified approach when treating someone. Common OCD treatments like cognitive-behavioural therapy (CBT) and SSRIs medications are useful but altered versions may be necessary. Thus, if someone has an Autism Spectrum Disorder, they may require visual supports and for those with either ADHD or OCD it can be helpful to address attention difficulties alongside the treatment of their OCD.

Conclusion

Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by two key features; Obsessions that are intrusive, unwanted thoughts, images experienced as intrusive and unwanted by the individual that cause marked anxiety or distress, and Compulsions that are repetitive behaviours or mental acts that an individual feels driven to perform to neutralize the distress caused by obsessions, often according to rigid rules or rituals. The term neurodivergence has emerged in recent years as a way to talk about individuals whose brains function differently from what is considered typical. Neurodivergence is a variation in the way that our brains are structured or how they function from one another, resulting in differences of thought and cognition different ways with sensory input, managing emotions.

Even though OCD is most commonly seen as a mental health or anxiety disorder, there was also an increasing trend within the neurodiversity community to consider if we can view it as being part of our atypical wiring. This viewpoint is supported by many overlapping features of OCD with known neurodivergent conditions, including difficulty processing information through the brain (think autism), handling sensory stimuli or emotional regulation. While OCD is conventionally viewed through the lens of mental health and anxiety disorders, a growing number of people within the neurodiversity community argue that OCD can be considered neurodivergent.