Many people are aware that both Obsessive Compulsive Disorder (OCD) and Autism exist. What many may not know is that it is possible to experience a co-occurrence of OCD and Autism. Understanding the connection between OCD and Autism is essential for individuals and families navigating both conditions. While they are two distinct diagnoses, research shows they can often overlap—leading to unique challenges with routines, rigidity, anxiety, and sensory sensitivities. Managing both requires compassion, tailored support, and a clear understanding of how they interact.

What Is the Connection Between OCD and Autism?

OCD and autism can co-occur, (just as OCD and ADHD can co-occur, or autism and depression can co-occur); there are a variety of interactions between mental health disorders and neurodevelopmental conditions. Obsessive-Compulsive Disorder (OCD) and Autism Spectrum Disorder (ASD) are different conditions, but they can share some surface-level similarities—like repetitive behaviors, need for sameness, and intense focus. However, the reasons behind those behaviors are often different, and recognizing this distinction is key to effective support.

Shared Features (But Different Roots)

• Repetitive behaviors:
  • OCD: Driven by intrusive thoughts (obsessions) that cause anxiety.
  • Autism: Often self-soothing or part of sensory regulation.
• Need for routine/sameness:
  • OCD: To prevent feared outcomes.
  • Autism: To feel safe, calm, and in control.
• Rigidity in thinking: Difficulty with change, or inflexibility in both conditions.
• Co-occurrence: Studies suggest that up to 17–37% of individuals with ASD may also meet criteria for OCD.

3 Strategies for Managing Both OCD and Autism

1 – Create Clear, Supportive Routines

Those who see us for OCD Therapy in Woodland Hills find that their routine works best when it’s akin to scaffolding. There is a structure of certain deadlines, chores, errands, and hobbies to work around, with space between events for self-care, projects, and fun. It is not about keeping a routine down to the minute, but more having predictable patterns that reduce the stress of the unknown.

• Invest in a framework, not an attempt to control. Structure helps reduce anxiety for both OCD and Autism—but make sure routines are flexible, not rigid rules. Because there is no way to control all outcomes of all situations, banking on things going “your way” is a recipe for disappointment. Instead, put your energy into a routine that has some flexibility. This can look like activities with a window of arrival, such as going to the gym and planning to arrive within a certain space of time – enough structure for a framework, but not so rigid that bad traffic will cause you to be “late”. It also involves regular sleeping and eating patterns, perhaps a routine as to what you eat for breakfast or lunch.
  
• Expose yourself to breaks in the routine. Build in small, low-stakes changes (e.g., try a new breakfast once a week) to increase tolerance for uncertainty. When the stakes are low, you are not only more willing to do something, but the disruption isn’t as severe. Over time, you can raise the stakes a little, as an exercise, if and when you feel ready to. You may find that some of the changes you try feel positive, and you add them to your routine. You may also find that those that don’t work for you serve the purpose of exposure therapy only, and that’s okay. Being able to withstand breaks in your routine can desensitize you to unforeseen disruptions, and/or events beyond your control.

2 – Use Thought-Behavior Mapping

Understanding whether it’s OCD or autism being triggered by an event or circumstance helps you to determine the best approach in dealing with what you feel. There may be times when you struggle to determine which is which, and other times when it feels very straightforward.

• Do your best to determine which it is. Help identify whether a repetitive behavior is OCD-driven (linked to fear/anxiety) or Autism-related (linked to comfort/sensory needs). In our Woodland Hills OCD therapy sessions, we hear a lot that it can be hard to discern the difference between anxiety being an intrusive thought versus the discomfort in one’s body when there is a sensory issue. It takes practice, patience, and guidance; it also takes an awareness that there is no such thing as “getting it right” 100% of the time. All you can do is aim for the majority of the time, and be kind to yourself.
• One behavior can have two different reasons. Example: Is handwashing about contamination fears (OCD) or calming sensory input (ASD)? It can be helpful for you to understand what the driving force is, not only for your own benefit, but to help others understand what you are experiencing as well. Parents of children or teens with OCD or autism might not have ever considered the difference between a tactile aversion versus an intrusive thought. They might not feel the same discomfort on their hands after touching something dusty, or metallic. What could be perceived from the outside as OCD might actually be autism, and vice versa.
• Determining the cause leads to the appropriate tools. This clarity helps guide the right intervention—like ERP (Exposure and Response Prevention) for OCD, or sensory tools for Autism. ERP involves a real or imagined exposure to a distressing trigger, and working on changing the response to said trigger. If an intrusive OCD thought has you coping in an unhealthy way, it is important to learn and practice a different response. If your trigger is sensory, then rectifying the stimuli will require a different tactic, such as touching something else, washing your hands, changing your shirt, or another sensory adjustment. Sensory adjustments aren’t always possible, and so it is always good to have emotional regulation tactics and skills in place to fall back on.

3 – Practice Emotional Regulation Skills

I see the benefits of emotional regulation practice as an OCD counselor in Woodland Hills. Everyone on earth can get something out of being in tune with their feelings and utilizing tools and skills to regulate, but those who have OCD and autism particularly feel the positive impact of being able to take control of negative emotions and re-calibrate.

• Emotional regulation is key to managing OCD and autism. Both OCD and Autism can come with emotional intensity and overwhelm. Feeling overwhelmed is made worse by feeling as though you won’t be able to get back to a regulated state. Regular regulation tactics and tools can decrease anxiety overall; when your anxiety is already high, and you become overstimulated, the dis-regulation is only that much higher. When your anxiety is lowered, you may still experience an increase in disruption, but that increase is less likely to be off the charts.
• Utilize different tactics. Try emotion labeling (“I feel anxious and overstimulated”), grounding techniques, or body-based tools like deep pressure or movement breaks. These tactics can help you to re-calibrate when you are triggered, but can also help you maintain a lower state of anxiety when utilized throughout your day. Depending on what is distressing you, you may feel more empowered by being able to label what you are experiencing, as opposed to connecting with your breathing, or vice versa. Not all tactics are best for all experiences, which is why it is best to try different ones.
• Lean in to your sense of sight. Visual tools (mood thermometers, calming kits) can be especially helpful for those who process best nonverbally. You can use a mood thermometer not only to help you identify your own feelings, but to communicate them to others. If you find it difficult to express yourself, or to speak at all, when you are distressed, having a visual tool can help you to communicate. A calming kit can also assist you in getting back on track once you have identified the issue, or calming enough to focus on determining the issue.

Key Takeaways

• Both OCD and Autism can come with emotional intensity and overwhelm, and practices and plans to help with emotional regulation are beneficial.
• You may choose to explore management of your autism and OCD by attending in-person or Online OCD Therapy or therapy tailored toward those with ASD.
• There is no one way to manage OCD and autism, nor is there a perfect way. There are only tools, practice, honesty, and patience.
• Sticking to a routine can help you maintain emotional regulation, thereby reducing the stress of everyday life, as well as the impact of emotional triggers when they do occur.
• Identifying if it is your OCD or your autism that is triggered will enable you to deal with what you are experiencing.
• Both OCD and autism can lead to a rigidity in thinking and aversion to change. Managing your emotional response to unpredictable situations and surprises can ease some of your mental fatigue and frustration. It can also be helpful to expose yourself to disruption and practice confronting it.
• Both OCD and Autism are lifelong; symptoms can be managed, but there is no “cure” via medication, etc. Be kind to yourself.

OCD Treatment at Embracing You Therapy

When left unmanaged, OCD symptoms can significantly impact various areas of adult life, including work performance and personal relationships. At our Woodland Hills office, we offer OCD treatment tailored to the unique ways your brain functions. Together, we’ll identify your specific challenges and develop practical, actionable strategies that fit seamlessly into your daily life. 

Contact us today for your complimentary 20-minute phone consultation with our Admin Team today!