The Complex Relationship Between OCD and Suicidal Ideation
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Obsessive-compulsive disorder (OCD) is a common mental health disorder that’s often associated with behaviors such as reorganizing, excessive cleaning and counting. OCD can be associated with an increased risk of suicidal ideation in some individuals, but the relationship is complex and multifaceted. Suicidal ideation typically arises from a combination of biological, psychological and environmental factors, and OCD is just one potential contributing factor among many.

We’ll discuss how OCD can be related to suicidal ideation as well as the difference between suicidal OCD and suicidality.

Call or text the 988 Suicide & Crisis Lifeline by dialing 988 if you’re having suicidal thoughts and you’re at risk to yourself or others.

How OCD and suicidal ideation are connected

Before we talk about OCD and suicidal ideation together, let’s take a look at them individually. We’ll start off with basic definitions of each one. 

Obsessive-compulsive disorder is an anxiety disorder that’s characterized by repetitive behaviors, or compulsions. The behaviors can stem from uncontrollable and recurring thought patterns, or obsessions. A person with OCD can have both compulsions and obsessions, or just one without the other.

Suicidal ideation refers to thoughts or plans about ending your life. It’s not a mental health disorder on its own, but it’s often a symptom of others and requires immediate attention. 

Research shows that having obsessive-compulsive disorder increases the risk of developing lifelong suicidal ideation, with rates ranging from 26% to 74%. While individuals with more severe OCD symptoms may be more prone to experiencing suicidal ideation, the presence of suicidal ideation itself does not appear to exacerbate or worsen the severity of OCD symptoms in the long term.

There isn’t one exact reason why people with OCD can have suicidal ideation. For some people, the obsessions and compulsions can be overwhelming to the point where they lose hope for a fulfilling future. Repetitive behaviors and uncontrollable thoughts can impact their productivity and interpersonal relationships.

The relationship between OCD and suicidal ideation is often due to a mix of environmental, psychological, sociological, genetic and biological factors. People with OCD are more likely to have suicidal ideation based on factors including:

  • Co-occurring depression diagnosis
  • Childhood trauma
  • Taboo or unacceptable thoughts as a symptom
  • Significant stress
  • Substance use
  • Self-harm behavior

The type of compulsions and obsessions can also be connected to suicidality. Here’s a list of symptoms and their suicidality prevalence rate:

  • Contamination and cleanliness (57%) 
  • Religious obsessions (45%)
  • Sexual obsessions (33%)
  • Repeated rituals (31%)

The difference between suicidal OCD and suicidal ideation from OCD

It’s important to discuss that there’s a type of OCD that has suicidality as the obsession. Suicidal OCD is a subtype that involves having unwanted thoughts about killing oneself. It’s also known as harm OCD with suicidal obsessions. It can be closely associated with harm OCD, which involves the fear of harming oneself or others due to intrusive thoughts.

Suicidal OCD is not about an obsession with ending one’s life, but actually the opposite. While suicidal ideation from OCD refers to suicidal thoughts due to the overwhelming nature of the disorder, suicidal OCD comes from an unwanted fear of killing oneself. This leads to behaviors where a person tries to protect themselves from harm. 

Symptoms of suicidal OCD include graphic, unwanted thoughts and images of hurting or killing oneself in a specific way. These intrusive thoughts occur in settings where a person could kill themselves, such as driving, standing on a mountain, or while they’re holding a knife. 

Compulsions that can stem from suicidal OCD function as protection from the influence of intrusive suicidal thoughts. Suicidal OCD compulsions include:

  • Seeking reassurance — You reach out to family or friends to ask them if your thoughts are normal or if they have them too. You’re trying to reassure yourself that you don’t actually want to end your life.
  • Comparison — You look up cases of suicide to compare yourself to the victim. You may think about how similarities in age or genetic components could influence your risk of ending your life.
  • Mental review — You’re constantly analyzing your thoughts to prove to yourself that you’re not in danger of killing yourself. This could mean things like asking yourself, “How likely am I to act on these thoughts?”
  • Avoidance — You avoid places that could lead to intrusive suicidal thoughts, such as tall buildings or bridges. You could also get rid of household objects that could lead to harm, such as knives or scissors.

Lightfully can help treat suicidal ideation and OCD, whether they’re connected or not

Whether you’re struggling with suicidal ideation, harm OCD or another mental health challenge, seeking treatment is crucial. Addressing mental health issues early, with professional help can prevent symptoms and related struggles from escalating, leading to better long-term outcomes and a higher quality of life. While suicidal ideation doesn’t always indicate an imminent suicide attempt, it can be a sign that another underlying health issue needs to be addressed.

At Lightfully, we are committed to helping clients heal and learn how to manage their symptoms long-term. However, our primary focus is addressing the underlying processes that are contributing to their mental health conditions. Our deeply compassionate experts will provide you with evidence-based, clearly defined, data-driven and whole-person-centered care. They can help you develop the tools you need to manage your OCD and suicidal ideation to move you along your mental health journey.

It’s important to remember that if your suicidal ideation leads to a mental health crisis, then inpatient care is essential. Call emergency services or the 988 Suicide & Crisis Lifeline. After you’re released, our levels of care such as Residential Treatment and Partial Hospitalization can be effective treatment options.

Change is possible. When you’re ready to take the first step, reach out to our Admissions Concierge Team. We’ll take the next steps together, toward the fullest, brightest version of you.

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