The Relationship Between PTSD and OCD

Posttraumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD) are anxiety disorders often co-occurring in people with a history of trauma. Research suggests that individuals diagnosed with PTSD have about a 30% chance of developing OCD within a year.

Approximately 19% to 41% of individuals with PTSD also meet the diagnostic criteria for OCD. This figure is significantly higher than the general population's current prevalence rate of OCD, which is around 1%.

The treatment approach for OCD may differ if it co-occurs with PTSD. Therefore, it is crucial to discuss any history of trauma with your therapist. Before exploring the link between PTSD and OCD, let's delve into the fundamentals of these mental health conditions.

Understanding PTSD

PTSD may manifest in individuals who have experienced or witnessed traumatic events. Trauma encompasses events that cause severe physical, emotional, or psychological distress. Examples may include:

• Experiencing an abusive relationship
• Being victimized
• Involvement in a car accident
• Dealing with the death of a loved one
• Witnessing a natural disaster
• Facing relationship problems (e.g., divorce)

Individuals with PTSD often experience persistent and disturbing thoughts about the traumatic event, which may be relived through flashbacks or nightmares.

Diagnosing PTSD

To receive a diagnosis of PTSD, an individual must have been exposed to a traumatic event and exhibited symptoms for at least one month. These symptoms may include:

• Avoiding reminders of the trauma
• Experiencing reactive symptoms (e.g., being easily startled or having angry outbursts)
• Intense, repetitive memories
• Negative thoughts (e.g., feeling detached from others)

Understanding OCD

While many individuals experience repetitive behaviors or intrusive thoughts, the thoughts and behaviors of an individual with OCD are persistent and disrupt their daily functioning.

Obsessions

Obsessions are recurring and persistent thoughts, impulses, and/or images that are perceived as intrusive and inappropriate. The experience of obsessions causes significant distress and anxiety for the individual.

It's crucial to understand that the obsessions associated with OCD are not merely concerns about real-life problems. Individuals often attempt (often unsuccessfully) to ignore or "push away" these recurrent thoughts, impulses, or images, usually recognizing that they are unreasonable and stem from their own minds. However, individuals with OCD find it challenging to suppress or ignore their obsessions.

Compulsions

Compulsions are repetitive behaviors (e.g., excessive hand washing, checking, cleaning, or constantly arranging objects in order) or mental rituals (e.g., frequent praying, counting in one's head, or repeating phrases repeatedly in one's mind) that an individual feels compelled to perform in response to the experience of obsessive thoughts.

Compulsions focus on attempting to reduce or eliminate anxiety or prevent the likelihood of some future event or situation. Similar to obsessions, individuals with OCD recognize that these compulsions are irrational, which causes further distress.

Diagnosing OCD

To receive a diagnosis of OCD, an individual must experience more than one hour per day of intrusive and uncontrollable obsessions and/or compulsions. Furthermore, these obsessions and/or compulsions must cause significant distress and impair functioning in various aspects of life, such as work, school, or spending time with friends.

Connection Between PTSD and OCD

Both PTSD and OCD involve intrusive thoughts followed by neutralizing behaviors aimed at reducing anxiety associated with these distressing thoughts.

• In PTSD, individuals often attempt to neutralize their thoughts by suppressing them or engaging in behaviors like isolation and avoidance.
• Compulsions serve as the neutralizing behaviors in OCD.

While compulsive behaviors (e.g., checking, ordering, or cleaning) may provide a sense of control, safety, and reduced anxiety in the short term, in the long run, these behaviors not only fail to address the root cause of the anxiety but may also intensify the level of anxiety experienced by the individual.

Symptoms of Post-Traumatic OCD

Individuals with OCD that develops after trauma exhibit a distinct pattern of symptoms, including more severe manifestations such as suicidal thoughts, self-mutilation, panic disorder with agoraphobia, flashbacks, nightmares, and heightened anxiety or depression.

Treating Trauma-Related OCD

Psychotherapy is commonly employed for the treatment of both OCD and PTSD. Some therapeutic approaches that may be utilized include:

• Exposure therapy: OCD is typically treated with exposure therapy, which involves exposing the individual to the stimuli that trigger anxiety and then preventing them from engaging in their customary compulsion. However, individuals with trauma-related OCD or OCD co-occurring with PTSD may require a different type of therapy.
• Cognitive-behavioral therapy (CBT): Some experts utilize cognitive-behavioral therapy (CBT) for trauma-related OCD. This type of therapy teaches individuals how to redirect intrusive thoughts about the traumatic event.
• Other therapies: Additional forms of trauma-focused therapy, including eye movement desensitization and reprocessing (EMDR) therapy and trauma-focused CBT, may also prove beneficial.

A Word From Verywell

There is an indistinct boundary between OCD and PTSD. If you are experiencing PTSD and/or OCD, it is essential to seek treatment from a mental health professional. Make sure to disclose any history of trauma to your psychologist or therapist, as this may impact your treatment plan.