Key Takeaways
- Obsessive-compulsive disorder (OCD) and autism spectrum disorder (autism) are conditions that can impact the way people think and behave.
- OCD and autism can both involve repetitive behaviors but for different reasons. OCD compulsions are actions intended to reduce distress caused by intrusive thoughts, while repetitive behaviors can be purposeful and self-soothing for people with autism.
- Learning about the similarities and differences between OCD and autism can help you receive the right resources and support to prioritize your mental health and well-being.
Repetitive thoughts and behaviors are often associated with obsessive-compulsive disorder (OCD), but they can also be a sign of autism spectrum disorder (autism). OCD and autism share some overlapping symptoms, but they’re two distinct conditions that can occur separately or together.
Autism is a neurodevelopmental disorder that affects how people learn, communicate, and behave. OCD is a mental health condition that causes a distressing cycle of obsessions and compulsions. Learning about each condition can help you find the right resources and support to manage your symptoms, cope with challenges, and improve your quality of life.
Recognizing differences between OCD and autism
Working with a mental health provider who has experience with OCD and autism can help you make sure your symptoms aren’t missed, misunderstood, or misdiagnosed as the wrong condition.
OCD and autism share some traits, like sensory sensitivities, communication challenges, and difficulty accepting change. But while these symptoms may seem similar at first glance, there are several distinguishing features.
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1. Obsessions
OCD causes people to experience intrusive thoughts or mental images. These obsessions are often unwanted, distressing, and not based on reality or hidden desires. A fear of germs, being harmed or hurt, or losing something or someone important are examples of OCD obsessions.
People with autism can also develop obsessions, but they involve an intense fixation on specific interests rather than relating to intrusive thoughts. Autistic people may become an expert on their special interest or form a strong attachment to a certain object.
2. Repetitive behaviors
OCD obsessions are typically followed by repeated behaviors called compulsions. They may provide some temporary relief but are part of a distressing cycle of unwanted thoughts and behaviors. Autistic people may engage in repetitive behaviors (also known as stimming), but they’re often purposeful or self soothing.
Let’s say you repeatedly turn your bedroom fan on and off. Someone with OCD might do this because they think something bad will happen if they don’t. But for someone with autism, the sound of the fan or the light breeze on their skin may provide comfort.
3. Social difficulties
Social situations can be uncomfortable for many people with autism. You may find it difficult to express your emotions or have a hard time understanding how other people think and feel. OCD can also lead to social challenges. People with OCD may struggle to recognize social cues or regulate their emotions because they’re often preoccupied with intrusive thoughts or anxiety. This mental load can make it harder to stay present in social situations or respond flexibly to emotions.
What it’s like when autism and OCD coexist
Having autism may increase your chances of having a co-occurring mental health condition like OCD. Approximately 17% of autistic people are diagnosed with OCD, and people with OCD are more likely to have autism than the general population. Both conditions are associated with a range of genetic, environmental, and neurobiological risk factors.
Living with OCD and autism can create some unique challenges. Autism exists on a spectrum — meaning it affects everyone differently — but many autistic people experience troubles with communication, emotional regulation, and sensory overwhelm. If you have autism and OCD, you may feel stressed when you have to change your daily routine. Or your obsessive and compulsive behaviors may worsen sensory challenges.
Research shows that autistic young people with co-occurring OCD may experience reduced functioning at home, at school, and in their interpersonal relationships. This can result in issues like loneliness, self-doubt, and low self-esteem.
How to manage autism and OCD together
People with OCD and autism benefit from different types of support, so it’s best to meet with a mental health professional for a comprehensive evaluation and accurate diagnosis. If you’ve been diagnosed with both conditions, your provider may start by treating the symptoms that are creating more challenges and concerns.
OCD is typically treated with talk therapy, medication, or a combination of the two. A type of cognitive behavioral therapy (CBT) called exposure and response prevention (ERP) is considered a first-choice approach for OCD. With the support of your therapist, you’ll learn to address the situations that trigger your unwanted thoughts without engaging in your usual compulsions. Some people also benefit from medication, but it’s best to review your specific symptoms and challenges with your provider.
When managing a neurodevelopmental condition like autism, treatment can involve skills training, lifestyle accommodations, and/or applied behavior analysis (ABA). Your provider may also suggest talk therapy, like CBT, to help you cope with stress and other difficult emotions — especially if you have a co-occurring condition like OCD. Therapy is tailored to each person’s needs and strengths.
Various self-help strategies can help people manage the impact of co-occurring autism and OCD. For example, you might benefit from practicing mindfulness exercises or keeping a daily journal to track possible triggers, compulsions, or overwhelming stimuli. Establishing a regular routine and having a strong support system may also help improve daily functioning.
OCD compulsions aim to ease distressing thoughts, while autism-related repetitive behaviors help with calm and focus. Understanding this difference can guide you toward the right support. A therapist can provide the tools you need to manage these behaviors in a way that fits your unique needs.
Find care with Rula
Autism and OCD can both involve obsessive thoughts, repetitive behaviours, and difficulty with change. If these symptoms are impacting your life, consider meeting with a mental health professional. They can help you understand which resources and treatment methods are best for your symptoms, challenges, and strengths.
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we’re here to help you make progress — wherever you are on your mental health journey.
About the author
Alex Bachert
Alex Bachert is a freelance copywriter and mental health advocate. Since earning her masters degree in public health, she has focused her career on creating informative content that empowers people to prioritize their health and well-being. Alex has partnered with organizations like Ro, WellTheory, and Firsthand, and her work has been recognized by the Digital Health Association.
When she’s not writing about mental health, Alex is usually playing pickleball, meeting with her local board of health, or enjoying time with her three kids.
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