Understanding the intricate relationship between obsessive-compulsive disorder (OCD) and autism spectrum disorder (ASD) is crucial for accurate diagnosis and effective treatment. These two conditions, while distinct, often intertwine in complex ways, posing challenges for individuals and clinicians alike.

The overlap of symptoms between OCD and autism can lead to misdiagnosis. When they co-exist, it’s not uncommon to have one of the conditions go undiagnosed. With all that in mind, one must understand both the similarities and the differences. 

The Overlap of OCD & Autism

Generally speaking, three primary categories of overlap can cause confusion:

Intrusive Thoughts/Obsessions

Intrusive thoughts are the norm for people with OCD. But it’s lesser known that obsessions are not uncommon with anyone dealing with ASD. With OCD, they may manifest as, for example:

• Fear of embarrassing oneself by what they say or do

• Unwelcome thoughts that are distressing, violent, or inappropriate

• Rumination related to harmful events happening to someone they love (including themselves)

Autism notoriously leads to obsessions. Someone with ASD may focus on a specific topic or interest. While the causes are very different, an outsider may just see obsessions and not be able to discern the origin. Once again, this can complicate diagnosis. 

Stimming

Self-stimulating behaviors or stimming are almost always associated with autism. Rocking oneself, repetitive actions, and finger or foot tapping are common examples. Therefore, if someone with OCD engages in very repetitive behavior, it can be mistaken as ASD. Once again, the underlying purpose of the action (in this case, stimming) is very different. That said, without an assessment, it can be very tough to discern which disorder is present.

Social Interactions 

As you might imagine, someone with either ASD or OCD can struggle in social settings. People don’t understand the obsessions or repetitive actions. The person with ASD or OCD can tell that they’re being judged, but this typically just adds to the anxiety — and thus, the behaviors. Yet again, others are unsure what’s happening and why.

Unless and until observation and evaluation have been performed, the presence of a mental health disorder can be missed or misdiagnosed. Then, of course, there is the fact stated up top: 25 percent of kids between the ages of 4 and 17 with OCD have been diagnosed with ASD.

When OCD & ASD Are Co-Morbid 

Obsessive-compulsive disorder is often tough to diagnose. Its symptoms overlap with many other conditions. When an autistic person has OCD, things get even trickier. For this reason, certain tools and measures have been designed to help ease the confusion. The process is comprehensive and involves practitioners from multiple disciplines. That said, a lot hinges on the experience and knowledge of the clinicians. 

Another crucial factor is the potential that someone with ASD will have issues with communication. Of course, each case is unique, but it’s not unusual for an autistic individual to struggle with articulating what they are feeling. This can obscure OCD symptoms and leave them unaddressed.

What Are Your Options?

If you or someone you know might be dealing with the overlap of ASD and OCD, you’re not alone. This means there are clinicians out there with the skills and experience to screen for both disorders effectively. Obtaining such information is the critical first step toward addressing and managing the intertwined symptoms.

Don’t struggle in silence or try to self-diagnose. I invite you to contact me today to learn more about the steps available to you.

Learn more about OCD Treatment.