Common Co-Occurring Disorders
Understanding Co-Occurring Disorders: How OCD Interacts with Mood Disorders, Autism, Substance Use, Phobias, Anxiety, and Eating Disorders and How Our Integrated Treatment Helps
Mood Disorders
(Major Depressive Disorder, Bipolar Disorders)
Research suggests that about 25-50% of people with OCD also meet the criteria for major depressive disorder (MDD) at the same time. OCD can be mentally draining. Constant obsessions and compulsions take up time and energy, leading to feelings of hopelessness and sadness. Many people with OCD experience distressing or taboo obsessions, which can lead to self-criticism and depression. OCD can disrupt daily life, work, and relationships, which can contribute to depressive feelings.
At our clinic, we help clients with co-occurring mood disorders by:
Integrating behavioral activation alongside ERP
Reducing perfectionism and self-criticism that fuel both OCD and depression
Teaching emotional regulation strategies
Addressing avoidance cycles that overlap with depressive symptoms
Collaborating with medical providers when medication support is needed
Mood symptoms do not prevent someone from succeeding in OCD treatment but treating them intentionally makes OCD treatment more effective.
Substance Use Disorders
Studies suggest that about 10-27% of people with OCD also experience a substance use disorder at some point in their lives. The rate of alcohol use disorder in individuals with OCD is estimated to be around 24%, while drug use disorders affect about 18%. Substance use can be a way of coping with the distressing symptoms of OCD, however, it can also become one of the compulsions that fuels OCD.
Our integrated approach includes:
Identifying the function of substance use (numbing, avoidance, sleep, panic relief)
Supporting harm-reduction or abstinence-based goals depending on the client
Teaching alternative coping strategies that reduce dependence on substances
Addressing shame, secrecy, or avoidance that reinforce OCD
Coordinating with prescribers, IOPs, or community programs when needed
Clients do not need to be “fully sober” to begin treatment but learning to reduce reliance on substances helps OCD treatment succeed.
Autism Spectrum Disorder (ASD)
Research suggests that adults with OCD have exhibited more symptoms of Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) than adults without OCD.
Our ASD-informed approach includes:
Adapting ERP to respect sensory sensitivities
Breaking tasks into clear, predictable steps
Using visual supports, structure, and concrete language
Teaching flexibility and uncertainty tolerance at a manageable pace
Recognizing the difference between autistic special interests and OCD compulsions
Supporting executive functioning challenges that can impact exposures
ERP works beautifully for autistic clients when delivered with the right modifications, pacing, and clarity.
Eating Disorders
(ARFID, Anorexia, Bulimia, Binge Eating Disorder)
One study found that between 18 - 34% of females who were experiencing OCD scored positively on an inventory measuring disordered eating. Studies indicate that fewer than 5% of men have OCD and an eating disorder while 7% of women likely have both disorders.
We support clients with co-occurring eating disorders by:
Complementing eating disorder treatment, not replacing it
Identifying what behaviors are eating-disorder-driven vs. OCD-driven
Using ERP carefully with food-related fears only when safe and appropriate
Supporting body-based exposures (sensory, interoceptive)
Collaborating with dietitians, medical providers, or higher levels of care
Reducing shame around intrusive thoughts related to food, weight, or body image
Clients do not need to “fix” the eating disorder first but certain medical or nutritional needs may take priority in treatment planning.
Phobia Disorders
The co-occurrence rates of Obsessive-Compulsive Disorder (OCD) and specific phobias do vary across studies. For instance, a study within the Brazilian Research Consortium on Obsessive Compulsive and Related Disorders reported that 31.4% of participants with OCD also had a specific phobia. Phobias can develop from OCD fears. For example, someone with contamination OCD might also develop a full-blown phobia of dirt or public restrooms. Read more about Phobia Disorders here.
Anxiety Disorders
OCD and anxiety disorders frequently co-occur. In fact, OCD was historically classified as an anxiety disorder before being reclassified as its own category in the DSM-5. However, anxiety remains a core component of OCD, and many people with OCD also experience other anxiety disorders. Lifetime comorbidity rates have been reported at 22% for specific phobia, 18% for social anxiety disorder, 12% for panic disorder, and 30% for generalized anxiety disorder. Read more about Anxiety Disorders Here.
How We Treat Co-Occurring Disorders at The OCD Relief Clinic
At The OCD Relief Clinic, we understand that OCD rarely appears in isolation. Many of our clients also experience co-occurring conditions such as mood disorders, substance use disorders, autism spectrum disorder, or eating disorders. These conditions can intensify OCD symptoms, create additional barriers to recovery, or make treatment feel overwhelming without the right support.
Our approach is designed to treat the whole person, not just their OCD. We integrate evidence-based interventions that address each co-occurring challenge while ensuring that OCD remains the central clinical focus because when OCD improves, clients often gain the stability needed to make progress in other areas of their lives.
At The OCD Relief Clinic, we believe:
No one is “too complex” for treatment.
You do not need to be free of other challenges before you start OCD therapy.
We can work on multiple areas at once by being strategic, compassionate, and effective.
Treatment should reduce shame, not increase it.
You deserve evidence-based care that honors your entire experience.
Our therapists are trained in ERP, CBT, ACT, I-CBT, somatic strategies, and neurodivergent-affirming approaches allowing us to tailor treatment to each client’s unique set of symptoms and strengths.
FAQs About OCD and Co-Occurring Disorders
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Co-occurring disorders refer to additional mental health conditions that occur alongside OCD, such as depression, anxiety disorders, autism, eating disorders, or substance use disorders. These conditions influence each other and often require an integrated treatment approach to achieve the best outcomes.
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Yes. Research shows that treating OCD while addressing related conditions, such as mood symptoms, trauma responses, or substance use, leads to stronger long-term recovery. At The OCD Relief Clinic, we tailor therapy so clients can make progress in both areas simultaneously.
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It can. Depression and anxiety can lower motivation, reduce energy, and increase avoidance, making OCD symptoms feel more overwhelming. When mood symptoms are treated alongside OCD, clients often experience faster progress and less relapse.
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Absolutely. Individuals with autism can benefit greatly from ERP when it is adapted to their communication style, sensory needs, and processing differences. We modify exposures, structure, pacing, and language so clients receive support that is affirming and accessible.
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Substances may temporarily numb anxiety, but they make OCD stronger over time by preventing clients from learning to tolerate discomfort. We help clients reduce reliance on substances by building healthier coping skills, addressing avoidance, and supporting harm-reduction or abstinence goals.
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