Obsessive-compulsive disorder (OCD) and depression frequently co-occur, with many people experiencing both conditions at the same time.
The distress and impairment caused by OCD can lead a person to isolate themselves from their family and friends, as people may avoid situations that provoke their obsessions and compulsions.
While OCD and depression present with distinct symptoms, they may also have overlapping symptoms like feelings of guilt, hopelessness, or diminished interest in activities. Depression and OCD can bring about overwhelming feelings, but with appropriate treatment and support, symptom management is possible.
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.
Do you have OCD or depression?
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.
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Can OCD lead to depression?
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.
Some people also wonder whether OCD can cause mood swings. While mood swings aren't a core symptom of OCD, the stress of living with intrusive thoughts and compulsions can cause emotions to shift throughout the day. For example, someone may feel anxious when obsessions appear, temporarily relieved after completing a compulsion, and discouraged or emotionally drained when the cycle starts again.
Can depression cause OCD?
Depression usually doesn’t cause OCD. Most people with both conditions say their OCD began before any depression symptoms appeared.
However, the two conditions often occur together and can make each other worse. Living with OCD can increase the risk of depression, while depression can make it harder to manage OCD symptoms or stay engaged in treatment.
Researchers believe this overlap may be related to shared risk factors, like childhood trauma, genetics, and differences in brain function. For example, the amygdala — a part of the brain involved in processing emotions — may be more active in people with OCD and depression.
Overcoming obsessions, compulsions, and depression
Both OCD and depression are treatable. The right treatment plan depends on your symptoms, but it often includes one or more of the following approaches:
Cognitive behavioral therapy (CBT): CBT helps you recognize unhelpful thought patterns and replace them with more balanced, realistic ones. For example, someone with OCD may believe that if they don't touch every light switch before leaving the house, something bad will happen. CBT helps people challenge these thoughts and develop healthier ways of responding.
Exposure and response prevention (ERP): ERP is a specialized type of CBT and the gold standard treatment for OCD. It involves gradually facing situations that trigger obsessions while resisting the urge to perform compulsions. Over time, this helps reduce anxiety and weaken the OCD cycle.
For example, someone with contamination OCD may gradually touch a surface they consider “dirty” without immediately washing their hands. While this can feel uncomfortable at first, the process happens gradually and with the support of a trained therapist.
Treatment for depression: Depression is also highly treatable. Many people benefit from talk therapy, medication, or a combination of both. If you have both OCD and depression, your provider will recommend a treatment plan based on your symptoms. In some cases, treating OCD first can also improve symptoms of depression. However, if depression is severe, it may need to be addressed first.
Medication: Some people benefit from medication, especially if their symptoms are moderate to severe. Medication is commonly prescribed for both OCD and depression and may be used alongside therapy.
Healthy daily habits: Getting enough sleep, staying physically active, managing stress, and maintaining social connections won't cure OCD or depression, but they can support recovery and improve overall well-being.
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I help clients handle discouragement about their progress in treatment for OCD and depression by reminding them that healing takes time and celebrating even small victories along the way.
Brandy Chalmers, LPC
Clinical reviewer
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Obsessive-compulsive disorder (OCD) and depression are two mental health conditions that benefit from professional treatment. If you’re experiencing distressing symptoms, consider speaking with a qualified provider like a therapist or psychiatrist. With the right strategies and support, you can learn to manage symptoms and regain a sense of happiness and control.
At Rula, we’re here to help you feel better. Rula makes it easy to find a licensed therapist or psychiatric provider who takes your insurance. That way, you don’t have to choose between great care and a price you can afford.
Rula patients pay about $15 per session with insurance, and 93% say they feel better after getting care through Rula. We have 21,000+ providers, and appointments are available as soon as tomorrow. We’re here to help you take the next step — wherever you are in your mental health journey.
Siobhan Neela-Stock
Siobhan Neela-Stock is a writer and journalist who focuses on health, particularly mental health. She earned her master's in journalism from Northwestern University in 2018 and worked at Mashable for over two years where she focused on social good reporting.
Her writing has appeared in the New York Times, SELF, Fortune, Verywell Health, among other publications. Neela-Stock also teaches writing and journalism at several universities.
She enjoys traveling, dancing, playing dodgeball, and spending time with her loved ones.
Brandy Chalmers, LPC
Having faced challenges like childhood abuse, neglect, and the loss of her father to suicide, Brandy Chalmers is deeply passionate about providing compassionate care. She is a Licensed Professional Counselor, Nationally Certified Counselor, and Registered Play Therapist with a Master’s Degree in Clinical Counseling and Marriage and Family Therapy.
Brandy also teaches at a university, sharing her expertise with future mental health professionals. With over a decade of experience in settings like inpatient care and private practice, she specializes in helping clients with perfectionism, trauma, personality disorders, eating disorders, and life changes.
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