The Link Between PTSD and OCD

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Posttraumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD) are anxiety disorders that commonly co-occur in people with a history of trauma. Research shows that the likelihood of a person diagnosed with PTSD developing OCD within a year is about 30%.

Between 19% and 41% of people with PTSD also have a diagnosis of OCD. This figure is much higher than the current occurrence of OCD in the general population, which is around 1%.

The treatment for OCD may vary if it occurs with PTSD, so it is important to discuss any trauma with your therapist. Before delving into the link between PTSD and OCD, it's important to understand the basics of these mental health conditions.

Understanding PTSD

PTSD may occur in people who have experienced or witnessed trauma. Trauma is an event that causes physical, emotional, or psychological distress to a person. Examples may include:

  • Abusive relationship
  • Being victimized
  • Car accident
  • Death of a loved one
  • Natural disaster
  • Relationship problems (for example, a divorce)

A person with PTSD has persistent and disturbing thoughts about the trauma, often relived through flashbacks or nightmares.

Diagnosing PTSD

In order to be diagnosed with PTSD, a person must be exposed to a traumatic event and have symptoms for one month. These symptoms may include:

  • Avoiding reminders of the trauma
  • Experiencing reactive symptoms (for example, being easily startled or having angry outbursts)
  • Intense, repetitive memories
  • Negative thoughts (for instance, feeling detached from others)

Understanding OCD

While many people have repetitive behaviors or driven thoughts, the thoughts and behaviors of a person with OCD are persistent and disruptive to daily functioning.


Obsessions are recurring and persistent thoughts, impulses, and/or images that are viewed as intrusive and inappropriate. The experience of obsessions causes considerable distress and anxiety for a person.

It's important to understand that the obsessions in OCD are not just worries about real-life problems.

People will try (often unsuccessfully) to ignore or "push away" these recurrent thoughts, impulses, or images, usually knowing that they are unreasonable and from their own mind. Yet people with OCD cannot suppress or ignore their obsessions.


Compulsions are repetitive behaviors (for example, excessive hand washing, checking, hoarding, or constantly trying to put things around you in order) or mental rituals (for example, frequently praying, counting in your head, or repeating phrases constantly in your mind) that someone feels like they have to do in response to the experience of obsessive thoughts.

Compulsions are focused on trying to reduce or eliminate anxiety or prevent the likelihood of some kind of dreaded event or situation. Like obsessions, a person with OCD knows that these compulsions are illogical, which causes further distress.

Diagnosing OCD

To be diagnosed with OCD, a person must experience more than one hour per day of intrusive and uncontrollable obsessions and/or compulsions. In addition, these obsessions and/or compulsions must cause considerable distress and impair functioning such as at work, school, or spending time with friends.

Connection Between PTSD and OCD

With both PTSD and OCD, a person has intrusive thoughts and then engages in neutralizing behaviors to reduce their anxiety from these distressing thoughts.

In PTSD, a person often tries to neutralize their thoughts by suppressing them or engaging in other behaviors like isolation and avoidance.Compulsions are the neutralizing behaviors in OCD.

While compulsive behaviors (like checking, ordering, or hoarding) may make a person feel more in control, safe, and less anxious in the short run, in the long run, these behaviors do not only inadequately address the source of the anxiety, they may even increase the amount of anxiety someone experiences.

Symptoms of Post-Traumatic OCD

People with OCD that develops after trauma show a different pattern of symptoms, including more severe symptoms such as suicidal thoughts, self-mutilation, panic disorder with agoraphobia, hoarding, compulsive spending, and greater anxiety or depression.

Treating Trauma-Related OCD

Psychotherapy is often used to treat both OCD and PTSD. Some types that may be used include:

  • Exposure therapy: OCD is classically treated with exposure therapy, in which a person is exposed to the stimuli that cause them anxiety and then prevented from engaging in their normal compulsion. But with trauma-related OCD or OCD that is co-occurring with PTSD, you may need a different type of therapy.
  • Cognitive-behavioral therapy (CBT): Some experts use cognitive-behavioral therapy (CBT) for trauma-related OCD. In this type of therapy, a person is taught how to redirect intrusive thoughts about the traumatic event.
  • Other therapies: Other forms of trauma-focused therapy, including eye movement desensitization and reprocessing (EMDR) therapy and trauma-focused CBT, may also be useful.

A Word From Verywell

There is a blurred boundary between OCD and PTSD. If you have PTSD and/or OCD, it's very important to seek treatment from a mental health professional. Be sure to mention any history of trauma to your psychologist or therapist, as this may affect your treatment plan. 

If you or a loved one are struggling with PTSD and/or OCD, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

8 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Matthew Tull, PhD
Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder.