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Is OCD A Neurodivergent Condition?

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Whether or not obsessive-compulsive disorder (OCD) is a neurodivergent condition is a complex question. There is no single definition of neurodiversity, and different people — including health care professionals, people living with OCD, and even well-meaning people on the internet — have different opinions on what it means. 

But, in recent years, many have acknowledged that OCD is a neurodiverse condition. If you or a loved one live with OCD and identify as neurodivergent, your identity is valid. We hope this article raises awareness of how OCD fits within the neurodiversity movement.

What is neurodivergence?

The term “neurodiversity” was introduced by sociologist Judy Singer in the late 1990s. Neurodivergence can have different definitions depending on where you go on the internet, but it most often means that no two brains are the same. Because every human brain develops differently, people can experience the world in a wide range of ways. Neurodiversity is an umbrella term, meaning it includes both “neurodivergent” and “neurotypical” people. 

The terms “neurodivergent” and “neurotypical” were later coined by Kassiane Asasumasu, who wrote that neurodivergent means that a person’s brain works differently or in a way that is not expected. In contrast, neurotypical describes a person who thinks and behaves in ways considered “the norm” by the general population. 

In defining a “neurodivergent” person, Asasumasu emphasized that the term was not meant to be a “tool of exclusion — it is specifically a tool of inclusion.” People who are neurodivergent may often feel as though they are excluded from conversations and spaces because our world may not be set up to represent or support them. The aim of Asasumsa and others working in this field is to raise awareness of neurodiversity and ensure neurodivergent people receive the support and understanding they need. 

The neurobiology of OCD

OCD is considered a mental illness or mental health condition. Specifically, it’s a type of anxiety disorder characterized by unwanted or intrusive thoughts (obsessions) and repetitive behaviors or rituals (compulsions). While OCD looks different for every person, OCD symptoms can be debilitating and have a severe impact on a person’s daily life. 

While we do not know what causes OCD or how it develops, researchers have found that people with OCD have higher activity levels in certain brain regions compared to those without the condition. 

How does OCD fit within the neurodiversity movement?

The neurodiversity movement is made up of the voices, advocacy, and rallying of those living with neurodiverse health conditions and their loved ones. Neurodiversity typically refers to attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder, dyslexia, dyspraxia, and dysgraphia, but many other health conditions can be included under this umbrella.

There is a lot of debate as to whether OCD fits within the neurodiversity movement, but in recent years, many people have come to understand that if neurodiverse disorders or conditions are ones where the brain works differently to process or learn things, then a person with OCD could be considered neurodivergent (if they would like to identify in that way). And many people living with OCD do, in fact, consider themselves to be neurodivergent. 

The medical perspective of OCD being part of the neurodiversity spectrum

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is a classification and diagnostic tool published by the American Psychiatric Association (APA). It is the standard reference book for diagnosing mental disorders by clinicians, researchers, and insurance companies in the United States. 

The DSM-5 organizes mental disorders into several broad categories. One of these categories is “neurodevelopmental disorders.” These conditions include intellectual disability (Intellectual Developmental Disorder), communication disorders, autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), specific learning disorder, and motor disorders.

The DSM-5 does not include OCD in this category of conditions but in a separate section titled “obsessive-compulsive and related disorders.” The DSM-5’s definition of OCD includes a series of criteria for obsessions and compulsions. 

So, while the DSM-5 does not list OCD as a type of neurodevelopmental disorder, this does not mean that the medical community does not consider OCD to be part of the neurodiversity spectrum. Many medical providers agree that OCD meets the criteria to be considered part of this spectrum. 

Also, while the DSM-5 is an important tool for understanding and treating mental disorders, it is by no means prescriptive. It is regularly updated to reflect the latest research and ensure that those with mental disorders and mental health conditions receive the best care. 

The OCD community and neurodivergent self-identification

“Neurodivergent” is not a medical term or diagnosis, meaning there are no medical criteria outlining what it means to be neurodivergent. So, people identifying as neurodivergent may have very different signs, symptoms, and diagnoses. Many people in the OCD community choose to self-identify as neurodivergent. Whether you choose to identify as neurodivergent is up to you — your identity is valid no matter how you choose to identify!

Can you have OCD and also have other clearly defined cases of neurodivergence?

Yes, it’s possible to have OCD and other clearly defined cases of neurodivergence. Research has found that people with OCD may be more likely to be diagnosed with ADHD, autism spectrum disorder, or dyslexia. So, if you suspect you may be living with OCD and another condition on the neurodiversity spectrum, you may want to talk to your doctor about your signs and symptoms. And if you are diagnosed with more than one condition, don’t forget to share your diagnoses and any medications you may be taking for your health conditions with your health care team — treatment for OCD may interfere with other treatments you are currently taking for your health. 

Originally published: November 17, 2023
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