Can OCD Cause Psychosis? Exploring the Connection and Risks

The purpose of this article is to answer questions like can OCD cause psychosis and what is the relationship between OCD and psychosis. You will learn the connection and overlap between the two and the different symptoms of OCD vs psychosis. If you believe you are experiencing symptoms of either, it’s important to contact a professional for mental health treatment.

OCD And Psychosis


Obsessive-compulsive disorder, or OCD, is a mental health disorder characterized by unreasonable thoughts, the obsessive part, or compulsive behaviors, the compulsion part. Symptoms can vary throughout life and, if left untreated, can manifest in the form of fear of germs or the need to keep a specific order for physical things.

Psychosis is another mental health disorder characterized by a distinct disconnection from reality. Psychosis might include hallucinations, agitation, delusions, or incoherent speaking and can be the result of schizophrenia, medications, or OCD.

There exists a significant overlap between psychosis, namely paranoia and hallucinations, and OCD. This article will cover when OCD becomes psychosis, strategies for OCD and psychosis, and the risks for psychosis and OCD.

Exploring the connection and overlap between OCD and psychosis

Can OCD cause psychosis? Recent studies indicate that there is a significant overlap between OCD and psychotic disorders. As OCD can lead to changes in thinking, control, beliefs, and mental processes, it can also leave individuals susceptible to other psychological disturbances, including hallucinations. 

Research has found that psychotic symptoms, including thought disorders, delusions, and hallucinations, are more likely to occur in people with OCD compared to the rest of the population.

When OCD becomes psychosis?

But can OCD cause psychosis? OCD causing psychosis is much more likely in individuals with high anxiety and OCD symptoms. 

For example, individuals with OCD struggling with chronic stress, an upcoming move, or job loss might notice increased obsessions and compulsions. The worse anxiety gets, the more likely the symptoms will worsen concurrently. 

In the DSM-5, individuals with OCD can be subdivided based on specific cognitive functions.

  • The lowest level is when an individual has good insight, so they might struggle with intrusive thoughts, but they recognize that these are very likely or not likely to be true.
  • The next highest level is when that same individual has a poor inside, and they start to believe that their intrusive thoughts are likely true.
  • The highest level is when an individual has completely delusional beliefs and thinks their hallucinations or intrusive thoughts are true.

Psychosis happens when individuals no longer remain in reality. These symptoms mean you struggle to understand what’s real and what’s not. If you reach the highest level for OCD insight, you are likely to struggle with co-occurring symptoms of psychosis. 

OCD Vs Psychosis

Understanding the nature of psychotic symptoms experienced in individuals with OCD

OCD is characterized by intrusive thoughts or obsessions and repetitive behaviors, and compulsions. Some people experience one over the other or both. Compulsions can interfere with daily activities and daily functions.

Obsessions can be unwanted mental impulses or intrusive images, which can lead to delusions and hallucinations, both of which are psychotic symptoms. 

Psychosis is when your brain processes information in such a way that you are no longer grounded in reality. Psychosis is not often a mental health disorder on its own and can more often be a symptom of other mental health conditions like ocd. 

Examples of OCD-related psychotic symptoms include:

  • Difficulty concentrating
  • Delusions
  • Hallucinations
  • Paranoia
  • Anxiety
  • Depression
  • Disorganized speech, such as someone who rapidly changes subjects

Examining the risks associated with OCD and psychosis co-occurrence

If left untreated, OCD symptoms can increase, especially during periods of high stress. This can lead to increased functional impairment and treatment complexity. Unfortunately, there remain many misconceptions and stigmas surrounding OCD and psychosis. 

What matters most is understanding when OCD becomes psychosis, it is much more complex to treat because treatment must involve therapy for both sets of symptoms. However, there are steps that you can take to control OCD and psychosis and prevent stress from interfering with your insight.

Strategies for managing OCD symptoms and reducing the risk of psychosis

There are strategies you can employ at home in addition to seeking professional mental health treatment.


Mindfulness and meditation are particularly effective for managing OCD symptoms. Mindfulness can help you recognize your thought patterns and try to change them. This gives you increased control over your obsessions and can reduce compulsions. 

As it relates to psychosis and OCD symptoms, practicing mindfulness and increasing control over your thought patterns will keep your insight at the lowest level, which reduces your risk of psychosis.


Studies have found that poor sleep habits and sleep hygiene contribute to a higher risk of increased symptoms of OCD, schizophrenia, and psychosis. You can reduce your risk of OCD and psychosis co-occurrence by:

  • Keeping your room clean, cool, and dark
  • Going to bed and waking up at the same time, no matter what day it is
  • Turning off all devices at least one hour before bed
  • Doing light stretching or meditation before bed
  • Avoiding alcohol, sugar, or heavy meals before bed


Research indicates that exercise is an effective way to reduce symptoms of OCD, but it can also help treat psychosis. Exercise does not have to be extreme to be effective. Even simple walks on a daily basis, light yoga, or weight lifting can work. Moreover, increased exercise helps improve sleep. 


Therapy can be an effective strategy for managing OCD symptoms long term. In therapy, you’ll be able to build on mindfulness techniques and access more comprehensive ways to integrate exercise and thought recognition through treatment, such as cognitive behavioral therapy or dialectical behavioral therapy. 

Can OCD Cause Psychosis

Summing up

There is a complex relationship between OCD and psychosis. Can OCD cause psychosis? Studies indicate that it can lead to certain psychotic symptoms. It’s essential that you consult with mental health professionals in order to achieve accurate diagnoses and treatments for OCD vs psychosis or any other mental health disorders like schizophrenia. If you are experiencing psychosis and OCD symptoms, reach out for support today.