Young Adults’ Experiences of Depression in the U.S.

Depression and obsessive compulsive disorder (OCD)

Obsessive-compulsive disorder (OCD) is a specific anxiety condition that involves both unwanted thoughts, urges and fears (obsessions) that are connected to repeated behaviors and/or rituals (compulsions) that are used to try to relieve the stress of these feelings. There is often a large delay (over 10 years in some studies) between experiencing symptoms of OCD and getting treatment*. Up to 75% of people with OCD have major depression*1. Because OCD was described in detail by some of the people we interviewed, this part of the website focuses on OCD, its relationship to depression, and potential treatments. (For more information on anxiety, see ‘Depression and anxiety’.)

Noticing obsessive tendencies early in life prior to depression.

Several of our participants noticed that they were particularly concerned with “perfectionism” early in life. Maya said, “I was off… I think part of it was that I’m unusually fixated. I think I was just, you know, more intense as a kid.” Colin also says he had perfectionistic tendencies as a child, but they didn’t “get out of hand” until he reached college. 

OCD behaviors and their impact on everyday life 

People we interviewed talked mainly about compulsions, rather than obsessions. Obsessions can be highly distressing, and often include unwanted thoughts about aggression, harms to self and others, sex, contamination, or order and symmetry. People we talked to described several different behaviors that they associated with their OCD. These included checking things multiple times (such as doors, lights, or ovens), repetitive handwashing, or counting. Leanna says, ”I would pick things up and this was part of the OCD too. I would pick things up, put a different thing down. I would constantly, I still check things, check doors multiple times and lights and especially ovens. I’m terrified of things burning this house down”.

Colin thought his obsessive tendencies and depression are related, describing his issues with OCD as the “driving force of my depression”. Nadina felt these obsessive tendencies were a way to cope with her feelings of not being good enough.
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These symptoms progressed, for Colin, to something he would do when he heard others talking. “I would take the words they were saying,” said Colin, “and I would do the same thing with the syllables. And I would be sitting in lectures the first semester of college, university and just wouldn’t have any idea of what I was listening to. It would just be processing it as numbers and repeating those strings in my head”. His difficulties finishing assignments and exams led him to take a semester off and seek psychiatric help.
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Treatment for OCD

Medications and specific kinds of cognitive behavioral therapy are frequently used to treat OCD, often in combination with each other. Colin went to an intensive outpatient program specifically for OCD treatment. As part of the program, he logged the number of times he experienced symptoms and learned strategies to combat his anxiousness, such as breathing techniques.
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Colin also discusses the medication he was prescribed to help with his obsessive tendencies and how it gave him the control he needed to work past them, but did not help his depression symptoms.
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* Glazier, Kimberly, et al. "High rates of OCD symptom misidentification by mental health professionals." Ann Clin Psychiatry 25.3 (2013): 201-209. *1 Quarantini, Lucas C., et al. "Comorbid major depression in obsessive-compulsive disorder patients." Comprehensive psychiatry 52.4 (2011): 386-393.

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