Distinguishing the Negative Thought Patterns of OCD

by Jules Washington

The negative thought patterns associated with OCD are often similar to those associated with depression. Additionally, while we're all prone to occasionally ruminating on negative events or obsessing over issues, that doesn't necessarily indicate OCD. So how can we distinguish between OCD and depression? And when is rumination or obsession an indicator of OCD?

Negative Thoughts Tied to OCD Are More Severe and Frequent

Obsessions are recurrent intrusive thoughts, images, or urges that typically cause anxiety or distress. For example, some people with OCD report being overwhelmed by a fear of harming someone else. Others are preoccupied with thoughts of contamination from germs or household chemicals, while others repeatedly imagine violent or taboo scenes.

Recurrent negative thoughts occur in both depression and OCD, but there are some key differences:

  • Negative thoughts caused by OCD tend to be more frequent, more severe, and more intrusive than those caused by depression.
  • Negative thoughts caused by OCD may seem more illogical or irrational than negative thoughts associated with depression. Someone with depression might ruminate over a real-life concern, such as an elderly parent becoming unwell. In contrast, a person with OCD might develop an obsession with the notion that all of their neighbors will die unless they step over cracks in the sidewalk.
  • Finally, negative thoughts associated with OCD are often linked to compulsions, which is not usually the case with depression.

Compulsions Are Not Typically Seen in Depression

Compulsions are repetitive behaviors or acts that people with OCD perform to neutralize or get rid of obsessions and reduce the emotional distress associated with their obsessions. Some people tap or touch objects, often a specific number of times, while others check things repeatedly (e.g. locks, switches), excessively clean or wash their hands, count to a specific number constantly, or repeat words silently. These behaviors are typically not associated with depression.

A person with OCD may feel disgusted about their obsessions and know that their compulsions are extreme or illogical. Nonetheless, they might feel uneasy, incomplete, or overwhelmed by anxiety and distress until they have satisfied certain compulsions.

If you are experiencing symptoms of OCD, you may be inclined to judge yourself too harshly. But remember that obsessions and compulsions do not define you. They do not reflect who you truly are.

Is Rumination OCD? Are All Obsessions OCD?

Rumination and obsession are not necessarily indicative of OCD. These behaviors can be maladaptive at times, but occasionally they might also feel enjoyable or bring relief. If you have certain quirks or idiosyncrasies, such as the desire to organize books by color or line up stationary in a certain way, that doesn't mean you have OCD. Instead, you may have simply identified approaches that bring order to your environment and give you a sense of control.

In contrast, people with OCD experience extreme anxiety and distress about their obsessions and compulsions. These intrusive fixations can consume hours of their day, even if they try to ignore them, and they can interfere with their daily lives.

Your Next Steps to Positive Health

Treatment for OCD usually starts with cognitive behavioral therapy and medication, with 40 to 60 percent of patients achieving a partial response to these treatment approaches.

Transcranial magnetic stimulation (TMS) is an FDA-cleared treatment choice for when OCD symptoms do not respond fully to psychological therapy and medication. TMS is a non-invasive treatment that applies gentle magnetic pulses to brain regions associated with OCD. TMS has been shown to improve the negative thought patterns of OCD significantly.

Whichever empowering treatment avenue you choose to follow, know that there is hope.

If Covid-19 and social isolation are heightening your symptoms of depression, Greenbrook TMS therapy may be able to help. At Greenbrook, we specialize in TMS therapy — an FDA-cleared, non-invasive treatment for treatment-resistant depression and OCD without harmful side effects. See if TMS therapy is right for you by clicking here to take a brief assessment:

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