Depression and OCD: Understanding the Connection

The short answer is yes. Because depression often begins after OCD symptoms develop, researchers think the difficulties of living with OCD can lead to depression symptoms.

Depression can develop because of:

  • the nature of your compulsive thoughts
  • difficulties caused by compulsive actions
  • the problems OCD causes in your life and relationships

Obsessions and depression

OCD sparks repetitive, unwanted, and upsetting thoughts. For many people, the very nature of the thoughts is enough to cause shock, fear, and eventually depression. Here’s an example of how that progression can work.

A new parent might have sudden, unwanted thoughts of harming the baby. About half of all parents (fathers and mothers) have intrusive thoughts exactly like these.

The thoughts can be frightening and cause enormous shame, even though the baby may never be in any actual danger. A parent who doesn’t realize how common these thoughts are might feel that something is wrong with them.

OCD causes intrusive thoughts like these and others. Not all intrusive thoughts involve violent imagery, but most are disturbing or unsettling.

Still, intrusive thoughts do not automatically indicate an increased risk of harm. But that risk may increase if the thoughts occur along with anxiety, depression, and OCD.

Distressing thoughts can also lead to depression over time because an individual having intrusive thoughts may feel out of control of their mind, which can be quite depressing and debilitating.

Studies from 2018 also show that ruminating — thinking the same worrisome, depressing, or negative thoughts over and over — is a key contributor to depression and OCD.

In a 2017 study, researchers asked people with OCD and depression questions to determine whether they were prone to anxious or depressing thoughts. Researchers found that having anxious and depressing thoughts was common in people with these two disorders.

In an older study, researchers found that people with OCD experienced fewer depression symptoms when they showed three common patterns:

  • thought their actions could change an outcome
  • thought themselves capable of taking those actions
  • thought they had control in a given situation, so they could take the necessary action

Compulsions and depression

In response to intrusive thoughts, people with OCD usually perform specific actions in the mistaken belief that their behaviors will either make the thoughts go away or prevent something bad from happening.

These compulsive behaviors must be performed flawlessly every time — a standard that is hard to meet.

Researchers say this kind of relentless perfectionism, the hallmark of OCD, is also a key factor in depression.

Functioning and depression

OCD and depression can adversely impact your ability to function in a healthy way. Obsessions affect your state of mind. Compulsions can interfere with your schedule.

When your relationships, social life, therapy, and performance on the job or in school are affected, you may begin to experience symptoms of depression. Researchers have found that the more severe obsessions and compulsions are, the more they impact your daily functioning, worsening depression symptoms.