OCD & Neurodivergence
Obsessive-compulsive disorder (OCD) is a mental health condition that affects about 1–2% of people in the UK.1 But for neurodivergent people - particularly those with autism, ADHD, or tic disorders - OCD is even more common. And it is often missed or misdiagnosed.
This page explains what OCD is, how it overlaps with neurodivergence, and where to find support.
OCD has two main parts: intrusive thoughts (obsessions) and repetitive behaviours (compulsions). Compulsions are actions we feel driven to do to manage anxiety. They are not habits - they feel urgent and necessary.
What is OCD?
OCD is not about being neat or organised. It is about being trapped in a cycle of unwanted thoughts and actions.
Obsessions are intrusive thoughts, images, or urges that come into your mind and cause distress. They are not something you want to think about - they just appear.
Compulsions are repetitive actions or mental rituals you do to reduce the anxiety the obsessions cause. Common compulsions include checking, cleaning, counting, arranging, or seeking reassurance.
The cycle feels like this: unwanted thought → anxiety rises → you do a compulsion → anxiety drops briefly → the thought returns → you do the compulsion again.
Over time, the compulsions can take up hours each day. They can interfere with work, school, relationships, and wellbeing.
You are not alone. Many neurodivergent people experience OCD. It is treatable - with the right support, most people see real improvement.
OCD and autism
About 9% of autistic people meet the diagnostic criteria for OCD.2 But the overlap is not always obvious.
Both autism and OCD involve repetitive behaviours. The difference is important:
- Autistic repetition often feels comforting and organised. Stimming (repetitive movements or sounds) helps regulate emotion and sensory input. People usually enjoy it, or at least do not find it distressing.
- OCD compulsions feel urgent and anxiety-driven. They are done to prevent something bad happening or to stop distress. They often feel exhausting, not soothing.
Some autistic people experience both: the comfort of autistic routine and the anxiety of OCD compulsions stacked on top.
Autistic traits can also mask OCD. If you are already focused on sameness and order, intrusive thoughts and compulsions might blend into your everyday autistic experience - and both you and healthcare professionals might miss it.
OCD and ADHD
ADHD and OCD can co-occur, and the combination creates a unique experience.
People with both ADHD and OCD often describe:
- Hyperfocus on obsessions: You get stuck on an anxious thought and cannot shift attention, even when you want to.
- Executive function challenges: ADHD makes it harder to break compulsion cycles, even when you know they are unhelpful.
- Impulsivity and intrusive thoughts: Both conditions involve thoughts that feel hard to control, but for different reasons.
The two conditions can amplify each other. ADHD impulsivity might drive compulsions faster. OCD anxiety might make ADHD’s attention problems feel worse.
OCD and tic disorders
If you have Tourette syndrome or another tic disorder, you are at higher risk of OCD.
About 30–50% of people with tic disorders have OCD.3 And roughly 85% of people with Tourette syndrome experience at least one other psychiatric condition - often including OCD, ADHD, anxiety, or autism.3
The connection is neurobiological. Both conditions involve similar brain systems (cortico-striatal circuits) that manage repetition and impulse control.
For people with both tics and OCD, the compulsions can feel similar to tics - sudden, repetitive, urgent. It is easy for one to be mistaken for the other. Professional assessment helps distinguish them.
Why OCD is missed in neurodivergent people
neurobetter exists partly because OCD is underdiagnosed in neurodivergent communities.
Here is why:
- Repetitive behaviour is expected. If you are autistic, your routines and repetitions are seen as part of autism, not as a sign of OCD.
- Masking hides anxiety. Many neurodivergent people mask - hiding their distress. OCD anxiety can be hidden alongside other coping mechanisms.
- OCD language does not fit. You might not call intrusive thoughts “obsessions.” You might just feel persistently anxious or stuck.
- No clear triggers. OCD does not always respond to obvious stressors. Healthcare professionals sometimes dismiss it as neurotypical worry.
The result: OCD goes untreated, and what feels like a mental health crisis gets blamed on neurodivergence alone.
Research shows autism is diagnosed more frequently in people with OCD than in the general population. The overlap is significant - not coincidental.2
Getting support
Starting with your GP
Talk to your GP about intrusive thoughts, anxiety, or compulsions that take up time and cause distress. Be specific: explain what thoughts come, what you do to manage them, and how long they take.
If your GP dismisses your concerns because you are autistic or neurodivergent, ask for a second opinion or request a referral to mental health services.
Specialist OCD support
The NHS offers evidence-based therapy for OCD, usually exposure and response prevention (ERP). ERP involves gradually facing the thoughts and resisting the urge to do compulsions - it is challenging but highly effective.
Some therapists specialise in OCD in neurodivergent people. Adaptations might include:
- Extra time to process and plan
- Written summaries of therapy sessions
- Support for sensory or executive functioning needs
- Recognition that your compulsions might look different from “typical” OCD
neurobetter resources
- Explore our Advice Hub on anxiety
- Learn more about autism and neurodiversity
- Understand ADHD and executive functioning
- Read about tic disorders
Charities and external support
- OCD Action: Specialist OCD support, self-help resources, and community: https://ocdaction.org.uk/
- OCD-UK: Information, peer support groups, and treatment guidance: https://www.ocduk.org/
- Tourettes Action: Support for tic disorders and associated conditions: https://www.tourettes-action.org.uk/
- Mind: Comprehensive information and local mental health services: https://www.mind.org.uk/
neurobetter services
- Our Ask a Counsellor service lets you get advice from a qualified counsellor on managing OCD alongside neurodivergence
- Use our Local Services directory to find NHS and private services near you
- Our Online Community connects you with others navigating neurodivergence and mental health
If you are in crisis
If you are having thoughts of self-harm or suicide, please reach out immediately:
- Samaritans: 116 123 (24/7, free, confidential)
- Crisis Text Line: Text SHOUT to 85258
- NHS 111: Phone 111 for urgent mental health support
- A&E: Go to your nearest hospital if you are in immediate danger
OCD can feel unbearable - but it is treatable. Reach out for help. You deserve support. Get help now
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National Institute for Health and Care Excellence. (2005, updated 2013). Obsessive-compulsive disorder and body dysmorphic disorder: treatment. NICE guideline CG31. https://www.nice.org.uk/guidance/cg31 ↩
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Lai, M.C., Kassee, C., Besney, R. et al. (2019). Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis. The Lancet Psychiatry, 6(10), 819-829. https://doi.org/10.1016/S2215-0366(19)30289-5 ↩
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Hirschtritt, M.E., Lee, P.C., Pauls, D.L. et al. (2015). Lifetime prevalence, age of risk, and genetic relationships of comorbid psychiatric disorders in Tourette syndrome. JAMA Psychiatry, 72(4), 325-333. https://doi.org/10.1001/jamapsychiatry.2014.2650 ↩
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