It’s not uncommon for adults to have both obsessive-compulsive disorder(OCD) andautistic spectrum disorder (ASD). As is the case with any such co-morbidity, this can result in misdiagnosis. There is an overlap of symptoms with OCD and ASD. (OCD overlaps with several disorders, in fact.) They can look similar and this increases the risk that one or the other remains undiagnosed.

Adding to the potential confusion is the reality that some people with ASD have communication issues. If they cannot articulate what they’re feeling, the presence of OCD can be missed. Obviously, recognizing the overlapping traits is essential.

Identifying Both Disorders

To accomplish this important task, you’ll be connected with an interdisciplinary team of medical professionals. They’ll use specific measures and tools to do away with any diagnostic uncertainty. These practitioners must have proper knowledge so do not hesitate to talk openly with them about this process to make sure you’re comfortable with their experience.

How and Where Autism and OCD May Overlapphoto of a man sitting on a bench near a city park

Of course, every case and every person is different. However, most likely, the team will focus on these three general areas of assessment and observation:

Communication Style

It’s not breaking news that a person with OCD, ASD, or both might struggle with social interactions. When viewed from the outside, the behaviors associated with ASD and OCD can be confusing. This only adds to the anxiety.

Obsessions (Intrusive Thoughts, Etc.)

The “O” in OCD stands for obsessive. A hallmark of the disorder is the presence of intrusive thoughts that become frightening obsessions. Less known is the reality that people with autism also struggle with obsessions. The causes are very different but to the people around you, the outcomes appear the same. Even a trained professional can find diagnosis challenging until the origin of the obsession is discerned.

Self-Stimulating Behaviors

If you know nothing else about autism, you probably recognize behaviors like finger or foot tapping, rocking, and other repetitive actions. These are forms of self-stimulating or “stimming.” However, people with OCD will also engage in repetitive behavior which can be misunderstood as a sign of ASD. The reasons they partake in the behavior are different but the outward manifestation is very similar.

All of the above is further complicated if it happens to a child.

Helping Someone with OCD and/or ASD

While medical professionals work to identify which condition is present, it’s important for someone displaying such symptoms to receive support and maintain safety. Here are some general suggestions:

  • Establish forms of communication that work for both of you. ASD, in particular, can hamper attempts at clear expression. It might, for example, be something very visual, e.g. hand signals or pictures.
  • You’ll need steady communication to help yourself or your teen handle changes and stick to a very structured schedule. In the name of describing stress and preventing outbursts, be sure to be transparent about anything that might create a feeling of uncertainty.
  • Learn your triggers or those of your child. This can empower you to act preemptively before the anxiety of OCD and/or ASD takes hold. Keeping a journal is highly suggested.

Most Importantly, Ask for Help

If you’re helping a child, you’ll want to work hand-in-hand with their care team. Teachers, counselors, etc. — all of them can play a positive role. Similar advice is given to adults who feel they might be dealing with an ASD-OCD overlap. Connect with clinicians who bring the proper experience and know-how to the table. You need their expertise, of course, but they need your perspective just as much. To navigate this intersection of issues, I invite you to reach out to learn more.