What Does it Mean to be Neurodivergent?
To be neurodivergent means that a person’s brain develops and functions differently from what is considered typical or “neurotypical” by societal norms. A range of cognitive, sensory, and social differences characterises neurodiversity. Neurodivergent people may process information, perceive the world, and interact with others differently from the majority. This umbrella term includes neurological differences, such as autism spectrum disorder (ASD)(https://uniquecs.co.uk/blog/what-is-asd-autism-spectrum-disorder/), attention deficit hyperactivity disorder (ADHD), dyslexia, etc. Each neurodivergent person has unique strengths and perspectives.
For example, some neurodivergent people may experience heightened or reduced sensitivity to sensory stimuli, which impacts how they perceive and react to things like light, sound, touch, or taste. Other neurodivergent people may have distinct learning styles or face challenges in social interactions, such as difficulty understanding social cues. Autistic people may have repetitive behaviours or intense fixations on specific interests. It’s vital to know that neurodivergent individuals contribute their different perspectives and talents to society, and everyone is different.
The concept of neurodiversity advocates for not only recognising brain differences but also embracing and respecting these differences. It emphasises the importance of acceptance and accommodation for individuals with diverse neurological profiles, highlighting the value and unique contributions they can make to various fields and communities. By promoting a culture of inclusivity, the neurodiversity paradigm seeks to create a society that appreciates and harnesses the strengths inherent in neurological diversity.
What is OCD?
Obsessive-Compulsive Disorder (OCD) is a mental health challenge characterised by recurring obsessive thoughts and compulsive behaviours. While many people living with OCD experience both obsessions and compulsions, it’s possible to have only one or the other. Common obsessions include fears of contamination, causing harm or a need for symmetry. Compulsions often involve behaviours like excessive cleaning, checking, counting, or arranging items in a specific order.
Treatments for OCD include cognitive-behavioral therapy (CBT), particularly exposure and response prevention (ERP). These treatments aim to help people manage and reduce their symptoms, improving their quality of life.
Is Obsessive Compulsive Disorder Considered a Form of Neurodivergence?
While OCD is primarily recognised as a mental health challenge, its classification within the neurodivergent spectrum is a subject of ongoing discussion. Obsessive-compulsive disorder (OCD) is characterised by unwanted, intrusive thoughts (obsessions). To ease the distress these thoughts create, people engage in compulsive behaviours or repetitive actions. So, is OCD considered neurodivergent?
It’s important to recognise that neurodivergence is a broad and evolving concept, and perspectives on which conditions it encompasses can vary. OCD has similarities in functioning to neurodivergence, as seen in studies revealing unique brain activity related to mirroring social communication difficulties, planning, judgment, and movement in people with OCD. Sometimes, besides OCD, several conditions are included under the neurodivergent umbrella alongside conditions like speech and language disorders, acquired brain injury and learning disabilities.
OCD as a Difference Rather Than a Disorder
Viewing obsessive-compulsive Disorder (OCD) as a difference rather than a disorder aligns with the principles of neurodiversity. Neurodiversity recognises and respects variations in human cognition and behaviour as natural aspects of diversity rather than pathologising them.
Many health organisations propose a shift towards understanding OCD through a neurodiversity lens and not as a mental health condition. People with OCD may experience the world differently, and these differences can contribute to unique strengths and perspectives. It’s important to note that while this approach offers a more inclusive understanding of OCD, it doesn’t negate the real and often distressing experiences of those living with OCD. Supportive interventions, when desired by the person, remain valuable. The goal is to balance recognition of the unique attributes associated with OCD with appropriate support, promoting acceptance and well-being.
The Neurological Basis of OCD
Research into the neurological basis of OCD has identified several contributing factors, such as brain function and structure and neurotransmitter systems.
Brain Structure and Function:
- Cortico-Striato-Thalamo-Cortical (CSTC) Circuit: A comprehensive guideline by the National Institute for Health and Care Excellence (NICE) suggests that OCD involves abnormalities in the CSTC circuit, which connects brain regions responsible for movement and behavior regulation. Disruptions in this circuit may lead to the repetitive behaviors observed in OCD.
- Habitual vs. Goal-Directed Actions: Emerging neurobiological models propose that compulsions in OCD may result from an imbalance between brain systems governing goal-directed behaviours and habitual actions. This imbalance could favour habitual responses, leading to maladaptive behaviours characteristic of OCD.
Neurotransmitter Systems:
- Serotonin: Alterations in serotonin levels and functioning have been implicated in OCD. While it’s unclear whether these changes are a cause or result of the disorder, they are believed to play a significant role in its manifestation.
- Glutamate and Dopamine: Research indicates that other neurotransmitters, such as glutamate and dopamine, may also contribute to OCD. Imbalances in these systems could affect brain regions involved in reward processing and habit formation, further influencing OCD symptoms.
Key Considerations
Being able to understand the neurological basis of Obsessive-Compulsive Disorder (OCD) involves examining both neurological differences and the co-occurrence of other challenges or conditions.
Neurological Differences
A study from NICE indicates that people with OCD may experience structural and functional differences in specific brain regions. These differences often involve the areas of the brain associated with decision-making, emotional regulation, and habit formation. Such neurological variations are believed to contribute to the characteristic obsessions and compulsions observed in OCD.
Co-occurrence
OCD frequently co-occurs with other neurological conditions, which can influence its presentation:
- Autism
- Attention Deficit Hyperactive Disorder (ADHD)
- Tourette Syndrome (TS)
- Anxiety and Depression
Behaviours Associated With Neurodivergence and OCD
While the classification of OCD as neurodivergence is a matter of ongoing debate, it can co-occur with behaviours associated with neurodivergence.
OCD and autism share a notable overlap, supported by recent studies indicating that 5-17% of autistic people may also exhibit OCD characteristics. Additionally, 30% of children and adolescents with OCD may also experience ADHD. The diverse nature of neurodivergence suggests that symptoms can vary widely among people, making it challenging to compile a comprehensive list of specific traits common to all people with neurodivergent differences. Recognising the co-occurrence of OCD with neurodivergence underscores the importance of tailored and comprehensive approaches to support people who may experience a combination of these challenges.
| Characteristics often linked with neurodivergence | Do the symptoms of OCD align with these characteristics? |
| Challenges in social interaction | Typically Yes |
| Rare physical behaviours | Typically Yes |
| Sensitivity to noisy environments | Sometimes |
| Speech and language challenges | Typically No |
| Difficulty adapting or shifting interests | Typically Yes |
| Learning challenges (focus, reading, etc.) | Sometimes |
| Sensory processing differences | Typically Yes |
| Preference for routines and rituals | Typically Yes |
| Difficulty maintaining eye contact | Typically No |
| Intense focus on individual interests | Typically Yes |
| Remarkable observation abilities | Sometimes |
| Diverse and creative problem-solving | Typically Yes |
| Unique pattern recognition skills | Typically Yes |
| Proficiency in music, art, design, and technology | Sometimes |
| Diverse creativity and expression | Typically Yes |
| Proficiency in visual-spatial skills | Typically No |
Arguments Against Classifying OCD as Neurodivergent
While some health organisations include OCD under the neurodivergent umbrella, others distinguish it from neurodevelopmental conditions. Arguments against classifying OCD as neurodivergent include:
1. Distinction Between Neurodevelopmental and Mental Health Disorders
Neurodivergence typically refers to variations in neurodevelopmental conditions present from birth or early childhood, such as autism and ADHD. OCD, however, is primarily recognised as a mental health disorder that can develop at any point in life. This distinction is highlighted by the Royal College of Psychiatrists, which differentiates between autism – a neurodevelopmental condition – and mental health disorders like OCD.
2. Differences in Origin and Manifestation
Neurodevelopmental conditions involve atypical brain development affecting communication, behavior, and learning. In contrast, OCD is characterised by intrusive thoughts and repetitive behaviours, often arising from anxiety. According to a resource provided by The Royal College of Nursing, they emphasise that neurodivergent people usually have strengths in problem-solving and empathy. In contrast, OCD is associated with distressing obsessions and compulsions.
3. Treatment Approaches
The management of neurodevelopmental conditions focuses on support and accommodations to harness individual strengths. Conversely, OCD treatment often involves medications to reduce symptoms. This difference in treatment strategies further distinguishes OCD from neurodivergent conditions.
How to Support a Loved One with OCD
Supporting a loved one with OCD or any form of neurodivergence requires an empathetic and understanding approach. Actively listening and encouraging open communication without judgment allows them to express their feelings and thoughts freely. Being patient and understanding during difficult times is also vital, as well as education about OCD, enabling others to understand the symptoms, triggers, and challenges individuals face.
Promoting a healthy lifestyle, reducing mental health stigma, involving people in social activities, and offering reassurance that they are not alone in their challenges are additional ways to provide consistent and understanding support. It’s important to note that these treatments, especially therapy like ERP, should be conducted under the guidance of a trained professional.
By offering a supportive environment that acknowledges individual differences, provides tailored communication, and respects varied treatment needs, loved ones can significantly contribute to the well-being of people with OCD.
About Unique Community Services
Unique Community Services provides Care Quality Commission (CQC) -regulated support across the UK for people in complex situations with multiple needs, with offices in Manchester and Leeds. We encourage anyone seeking support for OCD to get in touch with us. We emphasise creating a supportive environment that fosters people’s full potential while ensuring they receive the specialised care they need.
Contact us to explore how our services can be tailored to assist you or your loved ones best.
