I've been asked so many times whether OCD counts as neurodivergent, especially with mental health issues becoming common among children and teens.For years, I've worked with neurodivergent individuals and those facing mental health challenges in many different settings. While it is a fascinating question, there is no simple and straightforward answer.

What Does it Mean to Be Neurodivergent?

The term neurodivergent was first introduced in the late 1990s.Instead of seeing things like ADHD, autism, or OCD as “problems,” the neurodiversity view reminds us these are simply natural brain differences; that your child isn’t broken—they just experience the world in a way that falls outside the typical mold.From the clinical perspective, Neurodivergence refers to variations in the human brain regarding sociability, learning, attention, mood, and other mental functions. It includes conditions like:

• Autism Spectrum Disorder (ASD)
• Attention Deficit Hyperactivity Disorder (ADHD)
• Dyslexia
• Dyspraxia
• Tourette Syndrome

These are not "disorders" to be fixed but differences to be understood and supported. Neurodivergent individuals often have unique strengths and challenges that require tailored approaches.

Is OCD Considered Neurodivergent?

Obsessive-Compulsive Disorder (OCD) is characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions).While traditionally classified as a mental health disorder, many experts now recognize OCD as part of the neurodivergent spectrum due to its neurological underpinnings.Key points:

• OCD involves atypical brain activity, particularly in areas related to decision-making and behavior regulation.
• Individuals with OCD process information differently, leading to unique patterns of thought and behavior.

Recognizing OCD as neurodivergent emphasizes understanding and accommodation over correction.

How Does OCD Show Up In Kids?

Children with OCD may exhibit:

• Obsessions: Persistent fears (e.g., contamination, harm), intrusive thoughts, or images.
• Compulsions: Repetitive behaviors like excessive handwashing, checking locks, or arranging items.

Real-life example:Daisy, a mom of a 10-year-old named Max, noticed he spent hours arranging his toys "just right" and became distressed if interrupted. He also washed his hands repeatedly, fearing germs. Understanding these behaviors as OCD helped Julia seek appropriate support.

Can a Child Have OCD and Another Neurodivergent Condition?

Yes, co-occurrence is common.For instance:

• Up to 25% of individuals with ADHD also experience OCD symptoms. (Bloch et al., 2016)
• Approximately 37% of individuals with autism also have OCD. (Van Steensel, Bögels, & Perrin, 2011)

Implications:

• Symptoms can overlap, making diagnosis
• Tailored interventions are crucial to address multiple needs.

Also, OCD can show up in many forms, each with its own set of obsessions and compulsions.While some symptoms are internal, outward signs may develop over time. Here are some common types:

• Contamination OCD: Fear of germs or dirt, often leading to excessive cleaning.
• Symmetry and Order OCD: A need for things to be perfectly symmetrical or arranged in a specific order.
• Harm OCD: Fear of causing harm to oneself or others.
• Hoarding OCD: Difficulty discarding items, feeling a strong need to keep them.
• Somatic OCD: Intense focus on bodily sensations or functions.

How Is Emotional Dysregulation Connected to OCD and Neurodivergence?

Children with OCD and other neurodivergent profiles often struggle to regulate their emotional responses because their brains process and respond to stress differently.Let’s calm the brain first—then behavior will follow.Here’s how emotional dysregulation shows up in kids with OCD and neurodivergence:

Common Signs of Emotional Dysregulation:

• Meltdowns after small frustrations (like having to stop a task or switch routines)
• Obsessive thoughts that spiral into anxiety or panic
• Rigid thinking that makes transitions or surprises feel unbearable
• Extreme reactions to sensory input like sounds, lights, textures
• Shame or guilt after an emotional outburst, followed by withdrawal or apologizing

Why It Happens:

• The brain is stuck in “fight, flight, or freeze” mode.
  • The limbic system (especially the amygdala) is on high alert.
  • Executive functioning and self-regulation take a backseat.
• Intrusive thoughts from OCD create internal chaos.
  • The child feels out of control and anxious but doesn’t know how to stop the cycle.
• Neurodivergent kids often have trouble naming and processing emotions.
  • They may feel emotions intensely but lack the tools to express or soothe them.

How Can I Support My Child with OCD?

Here are the treatment options and Strategies:

• Educate yourself: Understand OCD's nature and its impact on your child.
• Create a supportive environment: Maintain routines and reduce stressors.
• Encourage open communication: Let your child express fears without judgment.
• Seek professional help: Therapies like Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) are effective.

When Should I Seek Professional Help?

Consider consulting a professional if:

• Obsessions and compulsions interfere with daily life.
• Your child shows signs of distress or anxiety.
• Behaviors persist for more than a few weeks.

Remember: Early intervention can make a significant difference.

Parent Action Steps:

Observe and keep track of patterns in your child’s behaviorEducate your child (and yourself) on emotional regulation skillsWork with a specialist who understands BOTH OCD and neurodivergenceTake our free quiz to assess Neurodivergence symptoms

FAQs

Can OCD go away on its own?

OCD symptoms may fluctuate, but without intervention, they often persist. Early treatment is beneficial.

Is medication necessary for treating OCD?

Not always. Therapies like CBT and ERP are effective. Medication may be considered in some cases.

How can I differentiate between normal childhood behaviors and OCD?

If behaviors are repetitive, cause distress, and interfere with daily life, consult a professional for evaluation.

Citations:

Bloch, M. H., Panza, K. E., Landeros-Weisenberger, A., & Leckman, J. F. (2009). Meta-analysis: Treatment of attention-deficit/hyperactivity disorder in children with comorbid tic disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 48(9), 884–893. https://doi.org/10.1097/CHI.0b013e3181af8239Van Steensel, F. J. A., Bögels, S. M., & Perrin, S. (2011). Anxiety disorders in children and adolescents with autistic spectrum disorders: A meta-analysis. Clinical Child and Family Psychology Review, 14(3), 302–317. https://doi.org/10.1007/s10567-011-0097-0Paul, S., Gruner, P., Mothes-Lasch, M., & Hennig-Fast, K. (2014). Neural substrates of obsessive-compulsive disorder: A review of neuroimaging findings. Clinical Neuropsychiatry, 11(2), 55–64.Dr. Roseann Capanna-Hodge is a licensed mental health expert that is frequently cited in the media:

• Single Care Controlling the uncontrollable: Living with OCD during a pandemic
• Holistic Counseling Podcast: Effective Treatments for OCD
• Epidemic Answers: Neurofeedback for ADHD, anxiety, OCD and mood

Disclaimer: This article is not intended to give health advice and it is recommended to consult with a physician before beginning any new wellness regime. *The effectiveness of diagnosis and treatment vary by patient and condition. Dr. Roseann Capanna-Hodge, LLC does not guarantee certain results.

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