Why OCD and depression can feel overwhelming and how to find relief

When obsessive thoughts take over your time and energy and it feels like the only way to find relief is by repeating actions (like touching every light switch before you leave the house), it can be exhausting. Many people living with obsessive-compulsive disorder (OCD) go through this, and you’re not alone in these challenges.

People with OCD often have one or more additional mental health diagnoses — most commonly, depression. In fact, studies show these two mental health conditions occur together in up to 50% of people.

Are your symptoms OCD, depression, or both?

You might be wondering if you have OCD or depression or both. While no two people with OCD behave exactly the same, OCD’s hallmark symptoms look like:

• Obsessions: These are intrusive, unwanted thoughts or images that are frequent and often distressing. No matter what you try, these thoughts are difficult to dismiss. 
• Compulsions: You feel compelled to repeat behaviors or mental acts in an attempt to rid yourself of the distress caused by the obsessions. Any relief you experience is usually temporary, and the cycle often repeats itself.

Some people with OCD may recognize that their obsessions are irrational and that their compulsive behavior won’t stop the feared outcome. Others may not realize that their obsessions are irrational and believe their compulsions are truly necessary to prevent something bad from happening, even if it’s not logical. 

Depression, on the other hand, can show up in the following ways: 

• Feeling like nothing will improve
• Loss of interest and pleasure in activities you usually enjoy
• Changes in your sleep cycle, like sleeping too much, trouble sleeping, or waking up too early
• Appetite or weight changes
• Irritability and feelings of annoyance 
• Isolating oneself
• Greater impulsivity 
• Suicidal thoughts or suicide attempts

Just because the symptoms of OCD and depression look different doesn’t mean they don’t overlap. In fact, they sometimes do. 

One key symptom that people with OCD or depression can share is anxiety. For example, someone with OCD may constantly fear putting themselves around people and in situations that could trigger an obsessive thought. This, understandably, can induce a lot of anxiety. 

In turn, this anxiety may be so debilitating that they skip class and say no to hangouts with friends — all in an attempt to avoid these potentially triggering scenarios. Anxiety and isolation are also both symptoms of depression. 

Is your OCD causing depression, and does it work the other way around?

OCD can significantly restrict a person’s life because of the unwanted thoughts and compulsions that are getting in the way of their daily functioning. 

For example, a person with OCD may find themselves avoiding social situations or daily activities, like going to work or school, to prevent triggering their obsessions. This can lead to depression because everything else, like relationships and hobbies, is pushed out of the way. In fact, more than 50% of people who experience OCD meet the criteria for major depressive disorder or persistent depressive disorder. 

However, depression usually doesn’t cause OCD. Most people with both conditions say their OCD began before any depression symptoms appeared. 

Experiencing trauma as a child can increase the likelihood that someone will develop both OCD and depression. How the brain is structured can also have an impact. The amygdala, which helps process emotions, is more active in people with OCD and depression. 

Overcoming obsessions, compulsions, and depression

While both OCD and depression are challenging mental health conditions, there is effective treatment available. Cognitive behavioral therapy (CBT) is one such tool. 

When treating OCD with CBT, you’ll learn to recognize that your obsessive and intrusive thoughts are distorted and replace them with more realistic ones. For example, you might be convinced that if you don’t touch all the lights in your house before you go out, it will catch fire. CBT helps people challenge this cognitive distortion and develop more helpful thoughts and beliefs.

Exposure and response prevention therapy (ERP) is a type of CBT, and it’s the gold standard for treating OCD. It involves exposing people with OCD to things and scenarios that trigger their obsessions. The goal here is for the anxiety attached to the obsessions to gradually lessen, along with the compulsive behavior. 

For example, some people with OCD have an intense fear of germs. So they often wash their hands to the point that their skin turns red and becomes painful. For someone with this obsessive thought pattern, a therapist may instruct them to touch a dirty surface and not wash their hands afterward. While this might feel intimidating at first, it’s a gradual process that helps people learn to tolerate their anxiety and challenge their fears in a safe and supportive environment.

Depression, while incredibly common, is very treatable. A common approach includes talk therapy and, in some cases, medication. If you have both conditions, some clinicians may recommend that you treat your OCD first. That’s because, by treating your OCD, your depression may get better or completely disappear. As mentioned, depressive symptoms can follow OCD, while it happens less frequently the other way around. But, in cases where someone has severe depression, a therapist might tackle your depression first.

Find care with Rula

Both OCD and depression can significantly impact your life, but it’s important to remember that there are effective treatment options available. Many people find that, with the right support and strategies, they can regain a sense of control and enjoyment in their lives.

With Rula, you can meet with a therapist via a convenient virtual appointment as soon as tomorrow. The skills you’ll learn will help you release the hold OCD and depression have. Medication management services are also available with a qualified psychiatric provider.

Find a therapist with Rula