Understanding the differences and the overlap between Autism and Obessive-Compulsive Disorder from the point of view of someone with both ASD and OCD - a thread. /1

Disclaimer: this is from the point of view of someone with lived experience. These are my opinions only. I am not a medical professional. /2

Obsessive behaviour and rituals are both components of OCD and autism. An autistic person may have a particular routine they carry out before they go to sleep. Equally, someone with OCD may also have this routine. This can cause confusion at distinguishing between the two. /3

Everyone’s experiences are individual and I can not speak for everybody. However, based upon some articles, research and speaking to others with lived experience, it seems the difference between the two is found in the anxiety. /4

People with OCD experience repetitive intrusive thoughts which cause distress and affect their daily life, and in order to reduce anxiety over the thoughts they feel overwhelming urges to carry out compulsions or behaviours. /5

Autistic people who exhibit ritualistic behaviours often carry out their routines quite contently. Their routines may be a source of comfort, they may enjoy them, and they may help them organise their thoughts and understand and process what is going on around them. /6

However, an autistic person may still become distressed if they are unable to carry out their routine. This distress can be mistaken to be a result of OCD. But, the routines itself are not usually a result of distress such as with OCD. /7

Autistic people can have a need for things to be done a certain way, or in a certain order. This is not as a result of reducing anxiety over particular intrusive thoughts as with OCD, but because the routine provides comfort and reduces anxiety. /8

Repetitive behaviours which autistic people carry out are different to OCD ritualistic behaviour even if they present the same way, such as by tapping, ordering things, or repeating the same words over and over. The key difference is in why they are doing this. /9

Another overlap is the obsessions. Autistic people can become obsessed or fixated on certain topics, people or objects. A key part of OCD is the obsessions sparking distress, leading onto the compulsions. /10

The overlaps between the two mean that misdiagnosis is common, as well as autistic people being more likely to suffer from OCD. People with OCD are four times more likely to later be diagnosed with autism (Meier et al, 2015). 17% of autistic people also have an OCD diagnosis. /11