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  • Mental Health Issues
    • Anxiety
    • ADHD
    • Bipolar Disorder
    • Depression
    • Grief
    • OCD
    • Personality Disorders
    • PTSD
  • Relationships
    • Dating
    • Marriage
    • Sex & Intimacy
    • Infidelity
    • Relationships 101
  • Wellness
    • Anger
    • Burnout
    • Stress
    • Sleep
    • Meditation
    • Mindfulness
    • Yoga
  • Therapy
    • Starting Therapy
    • Types of Therapy
    • Best Online Therapy Services
    • Online Couples Therapy
    • Online Therapy for Teens
  • Medication
    • Anxiety Medication
    • Depression Medication
    • ADHD Medication
    • Best Online Psychiatrist Options
  • My Mental Health
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  • What Is DepressionWhat Is Depression
  • What Is OCDWhat Is OCD
  • What's the LinkWhat's the Link
  • Can Depression Cause OCDCan Depression Cause OCD
  • Can OCD Cause DepressionCan OCD Cause Depression
  • SimilaritiesSimilarities
  • OCD Vs. DepressionOCD Vs. Depression
  • TreatmentTreatment
  • CopingCoping
  • ConclusionConclusion
  • ResourcesResources
  • InfographicsInfographics

OCD & Depression: Understanding the Connection

Headshot of Erica Laub, LICSW

Written by: Erica Laub, LICSW

Rajy Abulhosn, MD

Reviewed by: Rajy Abulhosn, MD

Published: July 11, 2023

Obsessive compulsive disorder (OCD) and depression are mental health conditions that share overlapping symptoms, such as struggling with intrusive thoughts, poor self-esteem, and loneliness. Due to these similar experiences, those with OCD may also develop depression at some point in their life. Despite this association, these disorders are two very different diagnoses.

Depression & OCD Treatment

Exposure And Response Prevention Therapy (ERP) – Do live video sessions with a therapist specialized in ERP, the gold standard treatment for OCD. Treatment from NOCD is covered by many insurance plans. Start With A Free 15 Minute Call

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What Is Depression?

Depression is a common mental health disorder that includes symptoms such as a loss of energy, disinterest in normal activities, hopelessness, and increased irritability.1 Someone with depression may also experience less observable behavioral changes, making it difficult for others to recognize signs of the condition. According to the DSM-5TR, there is a difference in diagnosable depression and general sadness. While sadness is a normal human experience, depression involves a low mood that has persisted for at least two weeks.2

Common symptoms of depression include:

  • Irritability or changes in mood
  • Changes in sleep or inability to sleep
  • Loss of appetite
  • Low self-esteem and poor feelings of self-worth
  • Difficulty concentrating, making decisions, or performing daily routines (like proper hygiene)
  • Hopelessness, intense sadness, or melancholy
  • Poor thoughts about the present or future
  • Frequent thoughts about death, dying, or even suicide

What Is OCD?

Obsessive compulsive disorder (OCD) is characterized by obsessions and compulsions. Compulsions are thoughts or behaviors that are created as a response to unwanted, intrusive thoughts (obsessions). The DSM-5TR describes compulsions as being repetitive or ritualistic, and are performed to “neutralize” or soothe anxiety.2

Is There a Link Between Depression & OCD?

Due to the potentially distressing nature of OCD, it is common for depressive symptoms to also occur and impact someone’s ability to function.3 Seeing as avoidance, anxiety, and fear are characteristic emotional traits of OCD, it is understandable that a person with OCD may become sad about the quality of their life.

Certain negative or pessimistic views of oneself can easily translate into negative thoughts or hopelessness about the future.3 Therefore, it is likely that a person with OCD may develop a co-occurring depressive disorder. The comorbidity rate of these two disorders is quite high, as about half of those with diagnosable OCD also meet criteria for major depressive disorder.4

Can Depression Cause OCD?

Current research suggests that depression does not cause OCD. The cause of OCD is not definitively known, however research points to several known risk factors.

Risk factors for OCD include:11,12

  • Having an immediate family member with OCD
  • Differences in the brain’s frontal cortex and subcortical structures
  • Childhood trauma
  • Streptococcal infection

Can OCD Cause Depression?

OCD is not a direct cause of depression, but it can play a role in the development and persistence of depressive symptoms. For instance, when someone experiences frequent, intrusive thoughts that take up a significant amount of their time, they may lose out on opportunities that maintain a healthy mindset, such as social or physical activities.

Additionally, someone with OCD can have “bouts” of triggers followed by response behaviors, similar to the experience of “bouts” of depression. When these strike unexpectedly, the development of depressive symptoms can follow, especially if the OCD is triggered by trauma, stress, or abuse.5

Obsessions & Depression

Intrusive thoughts can cause significant distress, often leading to poor self-esteem, or even disgust with themself and their thoughts. It is common for those with OCD to feel angry about having their obsessions, wishing the thoughts would go away.

A person’s level of insight into the legitimacy of these obsessions may also play a role in how much distress it causes them. For example, someone may understand and recognize that their OCD obsessions are extreme and irrational. Another person might truly believe they are causing harm to others by not performing their ritualized behavior to stop something bad from happening. This level of anxiety and worry about harm to themselves or others can induce intense feelings of guilt and shame. In turn, depressive symptoms may develop.

Compulsions & Depression

Compulsions can look like repetitive hand washing, putting things in a specific order, or repeated checking.2 They can also include thought-based or mental acts such as praying, counting, or repeating words to oneself silently.2

People with OCD may also be perfectionistic, applying rigid rules to themselves and their behaviors. By going above and beyond to put their world back in order, they might believe they can prevent something bad from happening. As having control over many circumstances is not guaranteed, it is common for a person with OCD to become depressed or hopeless about the future.

Depression Related to Ability to Function

Intrusive thoughts and compulsions can inhibit a person’s ability to function in daily life. In fact, studies have shown that the more severe obsessions and compulsions are, the more they interfere with daily functioning, leading to worsening depressive symptoms.13 As intrusive thoughts and compulsive rituals interfere with a person’s schedule, they are less able to keep up with daily responsibilities, such as personal hygiene, caring for their home environment, fulfilling work commitments, and spending time on hobbies and interests.

Impacts on Relationships

OCD affects a person’s life in many ways, but the potential loss of relationships can be so anxiety-provoking for some that they start to shut down and internalize these fears. For those with OCD, it can be difficult to ask for help or engage with other people, especially if social engagement is at the root of their fears. For example, those who obsessively worry about contamination are likely going to avoid other people.

OCD, Anxiety, & Depression

If OCD continues without being addressed, anxiety symptoms can manifest and lead to other issues like depression. Untreated anxiety can have major, long-term effects on the brain and impact areas of memory, attention, and executive functioning.6 Additionally, guilt commonly associated with anxiety disorders can result in the development of depressive symptoms, such as low self-worth and poor self-esteem.7

Treatment For OCD

NOCD: Online OCD Treatment Covered By Insurance – Regain your life from OCD. Do live video sessions with a licensed therapist specialized in treating OCD. Treatment from NOCD is covered by most major insurance plans. Learn how you can use your insurance benefits. Visit NOCD


Talkiatry: Virtual psychiatry – Get OCD help from a real doctor that takes your insurance. Talkiatry offers medication management and online visits with expert psychiatrists. Take the online assessment and have your first appointment in days. Free Assessment


Choosing Therapy partners with leading mental health companies and is compensated for marketing by NOCD and Talkiatry.

Similarities Between OCD & Depression

Both OCD and depression can include a fixation on unhelpful, negative thoughts that are often about the future or one’s inability to control the present.8 From a biological perspective, the amygdala (the part of the brain responsible for emotional processing) responds to overactive levels of distress, producing similar symptoms.9

OCD and depression share many overlapping symptoms, including:

  • Frequently experiencing fear, worry, or hopelessness
  • Feelings of failure
  • Negative self-talk or negative beliefs about oneself
  • Catastrophic thinking
  • Increased agitation, apprehension, or nervousness
  • Feeling lonely or wanting to isolate, despite increase in loneliness
  • Overall poor life-satisfaction
  • Increased anger and low mood

OCD Vs. Depression

Although similar, the two disorders are distinct as OCD is ritualistic, repetitive, and patterned whereas depression is more generalized. While intrusive, ruminating thoughts are a hallmark trait of both OCD and depression, those with OCD will experience these at an excessive, extreme frequency compared to those with depression—and respond with specific compulsive behaviors.8

Some differences between OCD and depression include:

  • Frequency and intrusiveness of thoughts: While those with depression experience thoughts that are common to them, a person with OCD experiences repetitive thoughts until something is done about them.
  • The presence of compulsions in OCD: While someone with depression may say their negative thoughts don’t let up, they don’t respond to them with compulsions in the same way people with OCD must complete an action in response to their intrusive thoughts.
  • OCD-related disorders: The DSM-V suggests that body dysmorphic disorder, hoarding disorder, trichotillomania (hair-pulling disorder), and excoriation (skin-picking) disorder are OCD-related disorders (not caused by OCD).
  • OCD can be a predictor of depression: There is a high chance someone with OCD might experience depression but depression itself cannot “cause” OCD.

Do I have OCD?

The first step to getting help is an accurate clinical assessment and diagnosis. NOCD’s therapists will provide a comprehensive assessment of your experience. If they find that you do not meet the criteria for OCD, they will still help assist you in identifying what you may be experiencing. Get Started With A Free 15 Minute Call

Choosing Therapy partners with leading mental health companies and is compensated for marketing by NOCD.

Visit NOCD

How Are OCD & Depression Treated?

Treatment for depression often involves cognitive behavioral therapy (CBT). With OCD, some components of CBT can be helpful. However, directly confronting an OCD thought is not enough. Rather, specialized treatments for OCD often focus on utilizing exposure therapy methods instead. In some cases, medications may also be prescribed as a part of someone’s treatment plan.

Therapy for Depression

CBT for depression is usually the front line treatment, in which one’s thoughts, feelings, and behaviors are confronted in order to make healthy changes. If you are wondering whether you need therapy for your depressive symptoms, the answer is probably yes.

Therapy for OCD

An OCD therapist receives specialized training that not every provider may have. Unlike with depression, OCD requires a very specific kind of treatment that is not as generalizable. Most commonly, exposure and response prevention (ERP) is recommended in these cases. CBT includes thought-stopping techniques that may not be as beneficial for those with OCD as they are for other disorders.10 With ERP exposures, a person is slowly taught how to respond to and overcome their fears. Exposures may be “in vivo,” meaning in real life, or “imagined.”

If you think you have OCD, finding the right therapist is the first step. You should consider one who has the knowledge and skills to assess, diagnose, and treat OCD. You do not have to have a referral from a doctor to start therapy and can easily look for therapists in your area through an online therapist directory.

Medications

In addition to seeking therapy, medications may be helpful in the management of symptoms. However, medications will not simply stop obsessive thoughts and compulsive behaviors. It is important to discuss all benefits and risks of a prescription with a medical healthcare provider.

Some medications for OCD are also designed to target symptoms of depression. Seeking a consultation with a doctor will ensure that you are recommended the best options based on your personal experiences, pre-existing conditions, and genetic factors.

Deep TMS

Deep transcranial magnetic stimulation (dTMS) was FDA approved for OCD in 2018. Deep TMS is a non-invasive treatment that uses magnetic fields that activate neural networks in the brain to relieve symptoms of OCD and depression.16 During treatment, an electromagnetic coil is placed against the scalp in order to activate regions of the brain that have decreased activity in those with OCD and depression.

The research in support of dTMS is promising, showing improvement in the majority of OCD patients receiving dTMS treatment, most often within 20 treatment sessions.14 Experts suggest that dTMS may be a beneficial alternative for patients who do not respond favorably to therapy and medication, as is sometimes the case in treating OCD. 15

Support Groups

For some, finding a support group to supplement individual and/or group therapy can make all the difference in finding community and peer support. Support groups typically involve a small group of people coming together regularly to offer empathy, resources, and information.They are sometimes facilitated by a therapist, but often are peer-led by a nonprofessional person. Support groups and group therapy options can be beneficial in reducing stigma and feelings of isolation, and can often be helpful as a supplement to one-on-one therapy and medication.

How to Cope If You Have OCD & Depression

Just like you would do when you have a cold or the flu, spend time finding things that help heal your mental health. Making certain lifestyle changes can improve your symptoms, such as focusing on controlling what you can. While these changes alone are not enough, they can support you throughout treatment.

Here are some tips for coping with OCD and depression:

  • Seek support: Seek professional support and support from friends, family, or loved ones who you trust. Building a team of allies goes a long way, even if you choose to focus on your relationship with a therapist first.
  • Practice meditation: Meditation for depression or meditation for OCD can help you build a healthier connection with your thoughts, emotions, and behaviors.
  • Try journaling: Journaling can be a helpful tool to utilize when you are hesitant to share your symptoms with others.
  • Determine your priorities: Determine areas of your life that need the most attention or are in urgent need of addressing. This is something that can be done with your therapist or on your own.
  • List your fears: For individuals with OCD, it is important to identify, list, and arrange your fears from greatest to least worrisome. This is an important component of exposure therapy, but writing them down on your own can also be insightful.
  • Be patient with yourself: As with any major life change, starting therapy and addressing your mental health can be tiring, even frustrating at times. Be patient with and forgiving of yourself as you make this journey.
  • Set reminders: Remind yourself of the progress that has been made, whether this looks like starting treatment or feeling motivated to make necessary changes.

Final Thoughts

OCD and depression are difficult to deal with, but there are effective treatments available. If you have OCD, make sure your provider asks the right questions to determine if you also have depression, as you may require treatment for both. Change is possible when you reach out for help. Allow yourself to trust in the process of breaking down what aspects of your life have been contributing to your challenges.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

OCD Therapy

NOCD: Effective, Affordable, & Convenient OCD Therapy Do live, face-to-face video sessions with a therapist that specializes in treating OCD and get 24/7 support between sessions. NOCD is covered by many insurance plans and is available nationwide. Visit NOCD

Virtual Psychiatry

Talkiatry Get help from a real doctor that takes your insurance. Talkiatry offers medication management and online visits with expert psychiatrists. Take the online assessment and have your first appointment in days. Free Assessment

OCD Newsletter

A free newsletter from Choosing Therapy for those impacted by OCD. Get helpful tips and the latest information. Sign-Up

Choosing Therapy partners with leading mental health companies and is compensated for marketing by NOCD and Talkiatry.

For Further Reading

  • 10 Best OCD Books
  • 21 Books on Depression
  • Best Online OCD Resources
  • International OCD Foundation 
  • Peace of Mind Foundation

Stories You Might Like 


Why OCD Thoughts Feel Real

Every day, from the time I wake up to the time I go to bed, I’m overwhelmed by disturbing thoughts that I don’t want to have. They’re usually about things that matter a lot to me, and I’ve started doing specific things (sometimes over and over) just to make sure the thoughts won’t come true. I’ve also been avoiding situations that might bring the thoughts back. Why do I feel like this all the time? If you’re asking yourself this, you’re not alone. Read More

What is Exposure & Response Prevention Therapy?

ERP therapy alters OCD’s pattern by addressing both obsessions and compulsions. In ERP, an individual is encouraged to confront the stimuli that trigger distress related to their obsessions while also resisting the urge to perform compulsions in an attempt to reduce their distress. Read More

Here is What A Typical Journey Through ERP Therapy Looks Like

If you’ve looked into help for obsessive-compulsive disorder (OCD), you’ve probably seen references to exposure and response prevention. ERP is the gold standard for OCD treatment. ERP therapy teaches you how to manage your OCD thoughts, images, and urges so they eventually stop bothering you as much. This lets you overcome your fear responses and regain the control that OCD tries to take away. Read More

This content is sponsored By NOCD.

OCD & Depression Infographics

Is There a Link Between Depression and OCD  Can OCD Cause Depression  Similarities Between OCD and Depression How are OCD and Depression Treated

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Sources Update History

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • World Health Organization. (2021) Depression. Retrieved from https://www.who.int/news-room/fact-sheets/detail/depression

  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.

  • International OCD Foundation (2010). OCD and Depression. Retrieved from https://iocdf.org/expert-opinions/ocd-and-depression/

  • Ruscio, A.M., et al. (2008). The epidemiology of obsessive compulsive disorder in the national comorbidity survey replication. Mol Psychiatry 2010; 15:53e63. https://doi.org/10.1038/mp.2008.94.

  • Dykshoorn, K. L. (2014). Trauma-related obsessive–compulsive disorder: a review. Health Psychology and Behavioral Medicine: an Open Access Journal, 2(1), 517-528. https://doi.org/10.1080/21642850.2014.905207

  • Dotson, V. M., et al. (2014). Unique and interactive effect of anxiety and depressive symptoms on cognitive and brain function in young and older adults. Journal of depression & anxiety, Suppl 1, 22565. https://doi.org/10.4172/2167-1044.S1-003

  • Jones, P. J. et al. (2018). A network perspective on comorbid depression in adolescents with obsessive-compulsive disorder. Journal of anxiety disorders, 53, 1–8. https://doi.org/10.1016/j.janxdis.2017.09.008

  • Wahl, K., et al. (2011). Differences and similarities between obsessive and ruminative thoughts in obsessive-compulsive and depressed patients: A comparative study. Journal of Behavior Therapy and Experimental Psychiatry, 42(4), 454-461. https://doi.org/10.1016/j.jbtep.2011.03.002

  • Goodwin, G. M. (2022). The overlap between anxiety, depression, and obsessive-compulsive disorder. Dialogues in clinical neuroscience. https://www.tandfonline.com/doi/full/10.31887/DCNS.2015.17.3/ggoodwin?scroll=top&needAccess=true&role=tab

  • International OCD Foundation. (2019). Ineffective and Potentially Harmful Psychological Interventions for Obsessive-Compulsive Disorder. Retrieved from https://iocdf.org/expert-opinions/ineffective-and-potentially-harmful-psychological-interventions-for-obsessive-compulsive-disorder/

  • National Institute of Mental Health. (2020). Obsessive-Compulsive Disorder: When Unwanted Thoughts or Repetitive Tasks Take Over. Retrieved from https://www.nimh.nih.gov/health/publications/obsessive-compulsive-disorder-when-unwanted-thoughts-take-over

  • National Institute of Mental Health. (2019). PANDAS – Questions and Answers. Retrieved from https://www.nimh.nih.gov/health/publications/pandas

  • Altintaş, E., & Taşkintuna, N. (2015). Factors Associated with Depression in Obsessive-Compulsive Disorder: A Cross-Sectional Study. Noro psikiyatri arsivi, 52(4), 346–353. https://doi.org/10.5152/npa.2015.7657

  • Roth, Y., Tendler, A., Arikan, M. K., Vidrine, R., Kent, D., Muir, O., MacMillan, C., Casuto, L., Grammer, G., Sauve, W., Tolin, K., Harvey, S., Borst, M., Rifkin, R., Sheth, M., Cornejo, B., Rodriguez, R., Shakir, S., Porter, T., Kim, D., … Zangen, A. (2021). Real-world efficacy of deep TMS for obsessive-compulsive disorder: Post-marketing data collected from twenty-two clinical sites. Journal of psychiatric research, 137, 667–672. https://doi.org/10.1016/j.jpsychires.2020.11.009

  • Carmi, L., Tendler, A., Bystritsky, A., Hollander, E., Blumberger, D. M., Daskalakis, J., Ward, H., Lapidus, K., Goodman, W., Casuto, L., Feifel, D., Barnea-Ygael, N., Roth, Y., Zangen, A., & Zohar, J. (2022). Efficacy and Safety of Deep Transcranial Magnetic Stimulation for Obsessive-Compulsive Disorder: A Prospective Multicenter Randomized Double-Blind Placebo-Controlled Trial. Focus (American Psychiatric Publishing), 20(1), 152–159. https://doi.org/10.1176/appi.focus.20103

  • Mayo Clinic. (2023). Transcranial magnetic stimulation. Retrieved from Transcranial magnetic stimulation – Mayo Clinic

  • Hirschtritt ME, Bloch MH, Mathews CA. Obsessive-compulsive disorder: advances in diagnosis and treatment. JAMA. 2017;317(13):1358-1367. doi:10.1001/jama.2017.2200

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We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.

July 11, 2023
Author: No Change
Reviewer: No Change
Primary Changes: Updated for readability and clarity. Reviewed and added relevant resources. Added “Can Depression Cause OCD?”, “Depression Related to Ability to Function”, “Deep TMS”, “Support Groups”. New material written by Heather Artushin, LISW-CP and reviewed by Kristen Fuller, MD.
March 15, 2023
Author: Erica Laub, MSW, LICSW
Reviewer: Rajy Abulhosn, MD
Show more

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  • What Is DepressionWhat Is Depression
  • What Is OCDWhat Is OCD
  • What's the LinkWhat's the Link
  • Can Depression Cause OCDCan Depression Cause OCD
  • Can OCD Cause DepressionCan OCD Cause Depression
  • SimilaritiesSimilarities
  • OCD Vs. DepressionOCD Vs. Depression
  • TreatmentTreatment
  • CopingCoping
  • ConclusionConclusion
  • ResourcesResources
  • InfographicsInfographics
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