OCD, also known as obsessive-compulsive disorder, is a mental health disorder that can affect men and women of all ages, but can it lead to dementia or psychosis? Is there a connection? Well, first, it’s important to explain that dementia is not a mental illness. It is a brain condition. In contrast, psychosis is considered a psychotic disorder, which is regarded as a severe mental disorder that leads to abnormal thinking and perceptions. Individuals with psychosis will lose touch with reality, but is it something that stems from OCD?
It’s common to have a specific routine each morning, something that you do each day. It’s also common to want a clean home or workspace. However, what separates these normal feelings from OCD is when you experience anxiety when something isn’t done, causing you to fight irrational urges to repeat these tasks. If you experience this, it’s possible you’re dealing with OCD, but you’re not alone. OCD affects one in 40 adults in the United States and is considered one of the top 10 most disabling illnesses by a decreased quality of life and income. The lifetime prevalence of OCD for U.S. adults is 2.3 percent.
Although OCD doesn’t affect a significant portion of the population, dementia, which isn’t a mental illness, impacts the United States greatly. According to Alzheimer’s Disease International (ADI), a person develops dementia every 3 seconds globally, and over 55 million people were living with the condition worldwide in 2020. ADI also states this figure is expected to double every 20 years, reaching 78 million in 2030 and 139 million in 2050. The increase will take place mostly in developing countries, with 60 percent of people with the condition living in low and middle-income countries. By 2050, this will increase dramatically by 71 percent.
Another condition affecting the population and could stem from OCD is psychosis. Psychosis describes brain conditions in which there is a loss of contact with reality. Psychosis typically occurs in someone’s late teens to mid-20s and can be a symptom of mental illness or a physical condition. Medication, drug, or alcohol abuse can also cause it. The National Institute of Mental Health (NIMH) says that three out of 100 people will battle psychosis at some point in their lives. They also mention that 100,000 adolescents and young adults will experience their first episode each year.
Below, we’ll go in-depth and explain how the conditions affect each person and answer the lingering question, “can OCD lead to dementia or psychosis?” We’ll discuss the connection and more surrounding this topic.
What Is OCD?
The Mayo Clinic defines obsessive-compulsive disorder as a pattern of unwanted thoughts and fears that lead to engaging in repetitive behaviors. These obsessions and compulsions can significantly disrupt daily activities, leading to distress and discomfort in your life.
Even if you try to ignore these obsessions or flat out stop them, you risk increasing the anxiety and stress you experience. Unfortunately, it could push you to perform these compulsive acts so you can try to relieve your stress. Despite your best efforts to ignore or eliminate bothersome urges or thoughts, they’ll return, leading to more ritualistic behavior, known as the vicious cycle of OCD.
Obsessive-compulsive disorder is often centered around specific themes. One such example of this is the fear of being contaminated by germs. The only way to ease your fear is to compulsively wash your hands until they’re sore, chapped, and in extreme pain. If you have OCD, it’s common to feel embarrassed or ashamed of the condition. However, treatment can be extremely effective. Below, we’ll discuss the most common OCD symptoms.
What Are the Most Common Symptoms of OCD?
Obsessive-compulsive disorder obsessions are repeated, persistent, and unwanted thoughts, urges, or images that are intrusive and cause significant anxiety and stress. Your best efforts to ignore these and get rid of them by performing compulsive rituals won’t be enough. The obsessions are severe enough to leak into your thoughts or things you’re trying to accomplish.
Obsessions typically follow a theme, including the following:
- Fear of getting contaminated or dirt
- An inability to tolerate uncertainty and having extreme doubt
- An urge to keep things symmetrical and in a specific order
- Horrific and sometimes aggressive thoughts that you’ll lose control and harm yourself or someone else
- Undesirable thoughts, such as sexual or religious subjects or aggression
- Fear of being contaminated by touching objects someone else touches
- Always doubting if the door is locked when you leave or the stove is still running
- You avoid situations that trigger obsessions, such as shaking someone’s hands.
Obsessive-compulsive disorder compulsions are repetitive behaviors that make you feel like you have to perform. These mental acts or repetitive behaviors are supported to reduce the anxiety stemming from your obsessions and prevent something bad from happening. However, engaging in these leads to no pleasure and perhaps only temporary relief from your urges. Many people make up rules or rituals they must follow that help control anxiety when they encounter obsessive thoughts. The compulsions are not realistic and often excessive. The individual typically knows this but has no control over it.
Similar to obsessions, compulsions follow a specific theme, including the following:
- Washing and cleaning
- Demanding reassurance
- Following a strict routine
The most common signs and symptoms of compulsions include:
- Always checking to make sure doors are locked
- Washing your hands until they become raw
- Counting in patterns
- Checking the stove to ensure it’s off
- Arranging canned goods so that they face one way
- Silently repeating prayers, words, or phrases
The severity of OCD varies from one person to the next. The condition typically manifests itself in the teen or young adult years. However, it can also show up in childhood. Symptoms will gradually worsen but will vary in severity throughout the person’s life. The types of obsessions and compulsions might change over time. Symptoms typically worsen during periods of extreme stress. OCD is a lifelong disorder.
Unfortunately, there is evidence that shows a person with OCD could be at an increased risk of dementia. However, these studies have been small, but the results show evidence that someone with the disorder is at a higher risk of developing dementia, such as vascular dementia and Alzheimer’s disease.
What Is Dementia?
According to the U.S. Centers for Disease Control and Prevention (CDC), dementia is not considered a specific disease. Rather, it is a general term for someone’s inability to think, remember, or make decisions. The condition severely impacts their daily activities. Alzheimer’s disease is the most common form of dementia. Although it typically affects older adults, it’s not a common part of aging. The condition affects an estimated 5 million adults in the United States, which is expected to rise to 14 million by 2060.
Most adults will live their entire lives without developing dementia or any related symptoms. Weakening muscles and bones is par for the course when it comes to aging, including some age-related memory changes, including the following:
- Forgetting recent events
- Struggling to find words only to remember them at a later time
- Misplacing car keys on occasion
- Forgetting an acquaintance’s name
In most cases, experiences and knowledge that you’ve built over the course of your life, including language and old memories, will stay intact.
What Are the Most Common Signs and Symptoms of Dementia?
Since dementia is a general term, the symptoms will vary from one person to another, especially if that person has OCD or has recently gone through psychosis. A person with dementia will exhibit problems the following:
- Judgment, reasoning, and solving problems
- Visual perceptions that are worse than normal age-related vision changes
Signs that point someone might have dementia include the following:
- Forgetting old memories they talked about a lot
- Forgetting the name(s) of close family members or friends
- Getting lost in their neighborhood or one they are familiar with
- Using strange words to describe familiar objects
What Increases the Risk for Dementia?
The most common factors that increase your odds of developing the condition include:
- Age: The most prevalent risk factor for the condition is your age; most cases affect people aged 65 and older.
- Family history: Those with siblings or parents with the condition are more likely to develop it at some point in their lives.
- Traumatic brain injury (TBI): Head injuries at any point in your life put you at an increased risk of developing dementia, especially if they’re severe or occur often. For example, professional football players have a 3.5 times higher risk of death from neurodegenerative diseases like Alzheimer’s, a form of dementia. However, age and family history play the most significant role in its development, while excessive alcohol consumption, high blood pressure, smoking, and other lifestyle factors also play a role.
- Poor heart health: As mentioned above, high cholesterol, high blood pressure, and smoking increase your odds of developing the condition.
- Race/ethnicity: The CDC report referenced earlier states that older African Americans are twice as likely to have dementia than white men and women in the same age group. Hispanics are 1.5 times more likely than white men and women of the same age group to have dementia.
- Obsessive-compulsive disorder (OCD): In most cases, OCD will manifest before a person is diagnosed with dementia. The individual will show OCD symptoms, including repeating rituals or obsessive thoughts. Memory loss is one reason you might increase the times you perform rituals.
Will OCD Lead to Dementia?
Many causes and factors play a role in the development of dementia. However, late-onset OCD could also point toward the risk of dementia. Obsessive-compulsive disorder symptoms occur before the individual is diagnosed with dementia. An estimated 65 percent of patients with frontotemporal dementia will exhibit compulsive or ritualistic behaviors. Unfortunately, the relationship between OCD and dementia has not been well-studied, but there is a correlation between the two.
In a survey from Healio, 78.3 percent of participants surveyed developed OCD or other related symptoms zero to 27 years before their frontotemporal dementia diagnosis. The survey found that 17.4 percent of participants said their OCD and associated symptoms occurred simultaneously with the dementia diagnosis.
Unfortunately, there isn’t a definitive answer to this question. More research is needed to help this argument carry weight. But for now, the small sample size gives us a small glance into OCD and dementia.
Although dementia is one condition that could stem from OCD, another possible mental health condition caused by OCD is psychosis. OCD has the potential to make even the strongest-minded individual feel like they’re losing their mind. It’s often so intrusive and debilitating that you can label it psychosis. However, the truth is that some people could have a form of OCD and psychosis, which is referred to as OCD with psychotic features. We’ll explain it more in-depth below.
OCD and Psychosis: Can OCD Cause Psychosis?
Obsessive-compulsive disorder is a lot of things; in some cases, it can even resemble psychosis. However, the truth of the matter is far more complex, and even though you exhibit behaviors that look like psychosis, it might not be psychosis. So, what does this mean?
It means you can have psychotic behaviors with OCD. It also means that while you display these behaviors, your actual mental health condition is severe OCD. For example, if your ritual is to check the front door several times before going to work, it’s not considered psychosis because you realize the difference between your thoughts and reality.
However, if you believe someone is breaking into your home because the door is unlocked, this feeling is so relentless that you’ll feel compelled to keep checking the door until you believe the house is secure. Checking the door over and over again is frustrating, but it’s not psychotic, even if the urge is overwhelming. Even then, you’re aware the behavior is useless and won’t prevent someone from breaking into your home. Still, you’ll continue performing the action for the temporary peace of mind you receive. You are aware, which isn’t typical in someone with psychosis.
If that’s not psychosis, then what is psychosis?
What Is Psychosis?
The term “psychosis” is used to describe conditions that affect an individual’s mind. It indicates the person has lost contact with reality. When a person becomes ill like this, it’s referred to as a “psychotic episode.” The condition is defined as an illogical, fanciful, and magical way of thinking, causing individuals to lose touch with reality.
Psychosis affects how your brain processes information. It can cause you to see, hear, and believe something that isn’t real, no matter how much someone tells you it’s not true. Psychosis is a symptom, not an illness. It’s triggered by a physical injury or illness, mental illness, substance abuse, or extreme trauma or stress.
The most common psychotic disorders are:
- Schizoaffective disorder
- Bipolar disorder (mania)
- Delusional disorder
All of these can cause the following:
- Magical or unrealistic thinking, known as delusions
- Mental confusion
- Confused thinking
- Visual and auditory visions, known as hallucinations
Psychosis typically affects you in your late teen years or during early adulthood. Young people are at the highest risk of developing psychosis, but doctors aren’t sure why that happens. Even before what doctors consider your first episode of psychosis, you’ll have slight changes in how you act and think, referred to as the “prodromal period.” It can last days, weeks, months, and in some cases, years.
It’s possible to lose touch with reality even if you don’t have an underlying mental health condition. This is called secondary psychosis. These episodes are the result of something else, such as a medical condition or drug abuse. No matter the reason, they disappear rapidly and won’t come back as long as you stay away from what caused them.
The most common psychosis symptoms include the following:
- Feeling uneasy or even suspicious around friends and family for no reason
- A decline in your school or work performance
- Inability to think clearly or concentrate
- Isolating and spending more time away from others than usual
- Lack of hygiene or self-care
- Strong emotions
- No emotions
- Hearing, seeing, or tasting things others don’t
- Pulling away from family and friends
- Hanging on to unusual thoughts and beliefs, despite what others say about it
- Auditory hallucinations: hearing voices when no one is around
- Visual hallucinations: seeing or hearing things that aren’t there
- Tactile hallucinations: strange feelings you can’t explain
- Outside forces control your actions and feelings
- Seemingly meaningless comments mean something huge
- Feeling like you have special powers, that you’re a god or that you’re on a special mission
Psychosis can be severe, and in some cases, it can be extremely dangerous. If you’ve been diagnosed with OCD but aren’t sure if you might have something else like psychosis, it’s important to look at both sides of the equation to determine what you could be experiencing.
OCD vs. Psychosis: Can OCD Cause Psychosis?
People with OCD sometimes compare their thoughts to “mental tics,” which refers to the intrusive, unwanted thoughts, fears, and images that take over their minds. While they understand these fears, ideas, or pictures aren’t true or realistic, it’s impossible to get them out of their brains. They become obsessed with these thoughts and cannot stop the disturbing cycle and ritualistic behaviors.
The primary difference between OCD and psychosis is that OCD is a mental health condition, whereas psychosis is not. Psychosis describes a state of mind, but can OCD cause psychosis? The answer is yes. Someone with OCD can experience psychosis, but it doesn’t mean OCD is a psychotic disorder. It’s crucial to make this distinction when seeking medical treatment to avoid a misdiagnosis.
Unfortunately, OCD can be mistakenly diagnosed as a psychotic disorder. Recognizing patterns in compulsive thoughts and obsessive behaviors will help physicians find the right diagnosis.
Are There Treatment Options Available?
Various treatment options exist for OCD and psychosis. Individuals with OCD will work with a therapist and try different approaches to find the right treatment plan. Medications will work for some, while therapy will work for others. In some cases, a combination of drugs and treatment will be successful. The International OCD Foundation found that 70 percent of people with OCD will benefit from cognitive behavioral therapy (CBT).
Unfortunately, there is no known cure for dementia. However, medication can be used in some cases to temporarily improve symptoms of dementia. These medications include Aricept, Exelon, and Razadyne. They work by boosting levels of the chemical messengers involved in judgment and memory.
Only a doctor can determine which course of treatment works best for you for any of these conditions.