Why do people keep calling OCD neurodivergence instead of a mental illness? This question collected 230 upvotes and 120 comments on Reddit.
This shows that OCD, although becoming normalized, is still a “mysterious condition” for those who need rituals in their lives. While OCD is traditionally classified as a mental health disorder, many people with OCD also relate strongly to the concept of neurodivergence.
Let’s dive deeper to find out whether OCD is a form of neurodivergence.
What Is OCD?
Obsessive-Compulsive Disorder (OCD) is an anxiety-driven mental disorder and is typified by repeating thoughts and feelings (called obsessions) and the repetitive behaviors intended to reduce the repeating thoughts and feelings (called compulsions).
People with OCD commonly experience the following situations:
- overthinking
- repeated checking (especially bags, keys, appliances, switches, instructions)
- skin picking, lip biting, hair pulling
- avoiding contact with the surroundings due to germophobia
- arranging personal belongings in a “system”
- mentally preparing for worst-case scenarios
- intrusive violent, sexual, or religious thoughts
- excessive self-doubt and fear of making mistakes
8,5 million people worldwide have OCD. The condition typically appears in childhood around the age of 7, but can also appear in young adulthood, early 20s [1].
People with OCD are often laughed at as “clean freaks” or even praised as “very organized young people.” But OCD puts a strain on an individual’s mental health: it can lead to exhaustion, poorer life quality, isolation, low self-worth, etc.
Is OCD Considered Neurodivergent?
Yes, OCD is generally considered to be a neurodivergent as well as a mental health condition.
There is no absolute universal agreement, but people with OCD and many professionals believe it fits within the broader neurodiversity framework. Why? Two reasons:
- OCD appears due to changes in neurodevelopment. So, it changes the way the brain functions, which is a definition of neurodivergence.
- OCD symptoms fit many neurodivergent symptoms and frequently co-occur with other neurodivergent conditions.
Considering OCD on the neurodivergent spectrum is freeing and validating for some people. Some people keep wondering, “What kind of neurodivergent am I?” and never find the description that would describe what goes on inside them. When correctly diagnosed with OCD, these people can find better treatment and, hence, live more authentic lives.
Is OCD Neurodivergent or a Mental Illness?
People who themselves have OCD have differing opinions on whether OCD is a form of neurodivergence or a mental condition [2].
People’s arguments why OCD is neurodivergent:
- The label “mentally ill” is uncomfortable, and most people feel more relaxed when described as neurodivergent.
- OCD generally can’t be fully cured; hence, it can’t be an illness.
- OCD can be inherited due to genetics.
Arguments why OCD is a mental illness:
- OCD is much more treatable than neurodivergent conditions, and its impact can be minimized almost to zero.
- Genetic tendencies to OCD can be minimized.
Considering these arguments, OCD is a neurodevelopmental (neurodivergent) condition that also impacts mental health. Because OCD is neurodivergent, it doesn’t exclude the possibility that it can develop independently, even if a person didn’t have a history of neurodivergent conditions beforehands.
Is OCD Neurological or Psychological?
OCD is both neurological and psychological. However, neurological changes “required” to trigger the onset of OCD can also appear due to psychological factors.
Let’s uncover the neurological and psychological roots of OCD.
Neurological Factors
- Cortico-Striato-Thalamo-Cortical (CSTC) Circuit Dysfunction
This brain region is responsible for detecting threats, evaluating risks, and planning actions to diminish the risk. A person can be born with hyperactivity in this brain region or develop hyperactivity if they were in danger for a prolonged time (childhood trauma, abuse in relationships, traumatic event, etc.)
- Genetics impact 65% of OCD symptoms [3].
A twin study found that up to 65% of OCD symptoms occur due to genetic reasons. But OCD cannot be inherited by a single gene. OCD is a polygenic condition, meaning that many genetic variants each contribute small effects that come together as OCD.
Psychological Factors
- Learned unhealthy coping mechanisms
Many people with OCD struggle with intolerance of uncertainty, catastrophic thinking, overestimation of danger, and fear conditioning. In simple terms, the brain starts treating uncertainty as danger.
As a result, people learned to protect themselves by either constantly checking something or by completing a ritual (like praying, spinning, counting, etc.) that may not even relate to what they were trying to control. But this coping mechanism soothes and relaxes them.
- The environment can trigger OCD onset.
Let’s take two kids who are at higher risk of developing OCD due to genetics. The one who was brought up in a calm environment, received emotional validation, and got timely medical/mental health assistance is less likely to develop coping strategies associated with OCD.
Overlap of OCD and Other Neurodivergent Conditions
OCD frequently co-occurs with other neurodivergent conditions, which is one reason it’s considered a neurodivergent condition. It’s common for different neurodivergent disorders to co-occur and overlap because the symptoms are frequently triggered by the same brain changes.
OCD and Autism
About 25% of children diagnosed with autism will also be diagnosed with OCD [4].
OCD and autism can appear similar on the surface because both may involve repetitive behaviors, routines, and strong preferences for predictability.
The key difference is often the function of the behavior: for people on the autistic spectrum, repetitive behaviors are soothing. While OCD compulsions are usually performed to reduce fear or try to control the future.
OCD and ADHD
Approximately 11% of people who have OCD also have ADHD [5].
OCD and ADHD share the same main symptom: executive dysfunction. It appears due to similar changes in the brain, but these cause hyperalertness in OCD and inattention and impulsivity in ADHD.
OCD and Tic Disorder (Tourette’s Syndrome)
Approximately 60% of people with a tic disorder have either overlapping OCD, ADHD, or autism [6].
Of course, OCD’s compulsions are intentional, compared to the involuntary tics of Tourette’s syndrome. But OCD can also involve “just right” urges or symmetry concerns that resemble tic-like repetition, which is one reason the two can be hard to separate clinically.
There is also a concept sometimes called “Tourettic OCD,” where compulsions feel more sensory or urge-driven rather than purely fear-based. It’s not an official condition (yet), but many specialists consider it for diagnosing OCD.
OCD and Learning Difficulties
Since OCD is on a neurodivergent spectrum, it can sometimes adopt neurodivergent symptoms associated with learning difficulties like dyslexia, dyscalculia, and learning disabilities.
Intrusive thoughts and compulsions can interfere heavily with:
- concentration
- school performance
- information processing
Many people with OCD experience cognitive overload because so much mental energy goes toward managing intrusive thoughts and compulsive behaviors.
Final Words: It’s All Relative
As much as we’d like to, it’s impossible to name OCD only a neurodivergent or mental health condition. Depending on genetics, previous illness history, and coping mechanisms, OCD can be either one of them.
For example, a person was born inclined to OCD, experienced stress, and has a deep reliance on obsessions/compulsions now. OCD became a part of their identity. It’d be impossible to cure fully, only manage. In this case, OCD is more of a neurodivergent condition.
However, some people first experienced OCD stressors after major stress or taking certain medications. They do remember life before OCD, so it’s a temporary thing for them. OCD, in this case, is a mental condition, something that can be overcome with the progression of life.
Whether a person identifies OCD as neurodivergence is partly personal. You feel more comfortable with OCD being neurodivergent? That’s fine. The main thing is to always refer to a specialist when you feel that your obsessions/compulsions take over.
