Obsessive-compulsive disorder (OCD) is a disorder that causes a person to have obsessive thoughts and compulsions. Someone with suicidal OCD may have intrusive thoughts about suicide.

Intrusive thoughts that occur due to OCD can cause a person extreme distress and discomfort. These thoughts may relate to specific things, such as:

  • contamination
  • sex
  • religion
  • harming themselves or others

According to the International OCD Foundation (IOCDF), around 1 in 100 adults in the United States has OCD. Suicidal OCD is a way that OCD behaviors can present.

Read on to learn more about suicidal OCD, such as its symptoms, causes, and treatments.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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Suicidal OCD can cause a person to experience thoughts, obsessions, and compulsions that involve suicide. However, this does not mean that they are suicidal.

People with suicidal OCD may find the idea of suicide distressing rather than a relief.

Thoughts and obsessions

A person who has suicidal OCD has intrusive thoughts and compulsions relating to suicide. These thoughts can cause extreme anxiety or distress.

According to Intrusive Thoughts, an OCD community organization, possible thoughts, and obsessions relating to suicidal OCD include:

  • a fear of dying by suicide
  • constantly thinking of ways to die by suicide
  • a fear of becoming depressed, which may lead to dying by suicide

People may also think about how they could die by suicide in everyday situations, such as walking into traffic. They may also experience fear of violent or horrific images relating to suicide that flash inside their minds.

Learn more about intrusive thoughts.

Behaviors and compulsions

A person with suicidal OCD may feel compelled to engage in compulsive behaviors in an attempt to suppress these thoughts.

Suicidal OCD behaviors and compulsions may include:

  • excessive reflection to determine if they will act on their thoughts
  • checking that they did not or will not harm themselves
  • avoiding situations that may trigger obsessions
  • avoiding using potentially harmful items such as knives
  • seeking help for their thoughts
  • seeking reassurance from friends and family that they will not die by suicide
  • researching people who have died by suicide and thinking about what happened

While doctors do not know what causes OCD, researchers have various theories about how it may occur.

We discuss possible causes of OCD in further detail below.

Genetics

The differences in certain genes may increase a person’s risk of having OCD. These variations appear in genes that help produce specific proteins and those involved in communication within the brain.

Information from the National Institute of Mental Health (NIMH) notes that people with first-degree relatives, such as a parent or sibling, with OCD are more likely to also have the condition.

Brain structure and function

The NIMH states that there may be differences in the brain structure of people with OCD. Abnormalities in the frontal cortex and subcortical areas of the brain are observable in those with the condition.

However, researchers note that the link between these abnormalities and OCD is not yet clear.

Environment

Certain environmental factors may make a person more likely to have OCD. These factors include:

A therapist can help diagnose OCD. They will check for specific criteria when diagnosing the condition, which include:

  • obsessions
  • compulsive behaviors
  • obsessions and compulsions that take up at least 1 hour per day and interfere with other activities, such as work

A therapist may ask someone with suicidal OCD about the nature of their thoughts. It is important for a therapist to determine if a person has suicidal OCD or if they are suicidal in general. A correct diagnosis ensures the individual gets the treatment they need.

Learn more about overcoming OCD.

Several types of treatment can help someone with suicidal OCD. Healthcare professionals may recommend medication, therapy, or a combination of both.

We discuss these treatments in further detail below.

ERP therapy

Exposure response prevention (ERP) therapy is an effective treatment for people with suicidal OCD. This method is a type of cognitive behavioral therapy that involves a therapist exposing a person to their fear until they are no longer afraid of it.

In relation to suicidal OCD, ERP may involve a therapist asking an individual to focus on their intrusive thoughts. The person then repeatedly thinks about their obsessions until they do not cause them distress.

Learn more about types of therapy for OCD.

Medication

A healthcare professional may prescribe certain medications to treat someone with suicidal OCD.

These medications may include selective serotonin reuptake inhibitors. These are a type of antidepressant to stop a person’s body from reabsorbing serotonin, a chemical that plays a part in mood regulation.

Learn more about the best medications for OCD symptoms.

Other treatment

Transcranial magnetic stimulation (TMS) is another possible treatment for OCD. This technique uses magnetic fields to stimulate nerve cells in specific parts of a person’s brain. Doctors may recommend this approach alongside other treatments for OCD.

According to information from the IOCDF, TMS may help reduce OCD symptoms in around 45% of people 1 month after treatment. However, some individuals will need to return for additional TMS sessions over time.

A person with suicidal OCD may find it helpful to speak to their family and friends about their condition, as they may be able to provide emotional support. This may also reassure their loved ones that they are not actually suicidal.

There are also various support groups available to help someone with suicidal OCD. These groups include:

Anyone experiencing thoughts of suicide needs to speak with a healthcare professional.

Suicidal OCD is a manifestation of OCD. It causes a person to have intrusive thoughts and compulsions relating to suicide.

However, having suicidal OCD does not mean someone is suicidal. Instead, thoughts of suicide usually cause a person with suicidal OCD distress and anxiety.

Healthcare professionals do not know what causes OCD. Researchers believe it may be a result of genetic and environmental factors.

Treatments for suicidal OCD include ERP therapy and medication. If an individual experiences symptoms of suicidal OCD, they need to speak to a healthcare professional.