Summary of “Recovery from co-occurring OCD in autistics” (Embrace Autism)

Original Blog Post

By Dr. Natalie Engelbrecht published October 8 2025 Embrace Autism

Introduction

This blog post tackles the difficulty of recognizing and recovering from co-occurring Obsessive–Compulsive Disorder (OCD) in people on the autism spectrum. The author shares personal experience (being autistic and later diagnosed with OCD) alongside current research to highlight how OCD may be overlooked in autistic individuals, and offers practical strategies for recovery. Embrace Autism

The importance of knowing you have OCD

• Many autistic individuals may not realize they have OCD because their obsessive thoughts or compulsive behaviors feel reasonable or aligned with their values (for example: perfectionism, moral responsibility).

• The concept of ego-syntonicity is explained: when symptoms feel part of the self rather than something separate that needs treatment.

• Insight into one’s own OCD symptoms is variable—poor insight is associated with more severe symptoms and longer delays in treatment.

• In autistic individuals, repetitive behaviors or intense focus may be misattributed as just “part of autism” (a phenomenon known as diagnostic overshadowing) rather than recognized as OCD.

Recognizing co-occurring OCD in autism

• The article explains how the overlap between autism and OCD can be subtle, and mislabelling is common:

  • Some behaviors might look like autism (repetitive behaviors, intense interests) but are driven by OCD (obsessional distress, compulsive relief).

  • Others might look like OCD (checking, doubt, moral scrupulosity) but maybe serve autistic regulation or sensory function.

• The distinction matters because it affects what intervention is appropriate—treating autistic coping as pathology may fail to address distressing OCD, and treating “autistic behaviors” as strictly OCD may mis‐target support.

• The author emphasizes working with clinicians who understand both autism and OCD.

Key take-aways

• If you’re autistic (or know someone who is) and struggling with repetitive, distressing thoughts or urges, consider the possibility of co-occurring OCD—not every repetitive behavior is just “autism”.

• Recognizing OCD (especially when insight is limited) is a critical first step toward recovery.

• Recovery from OCD in autistic individuals often needs a combination of approaches: noticing and reframing thoughts, calming the nervous system (e.g., via breathing), cultivating self-compassion, practising mindfulness, and possibly using medication to stabilize the brain’s circuitry.

• The practitioner or support team should ideally have experience with both autism and OCD, to navigate the overlap effectively.