⚠️ Trigger Warning: This post discusses suicide, intrusive thoughts, and self-harm.

The Hard Truth: OCD and Suicide

Research has shown that people with Obsessive-Compulsive Disorder (OCD) are at a greater risk of suicide than the general population.

This can be difficult to hear—especially if you live with Harm OCD, where intrusive thoughts already involve fears of harming yourself or others. Learning that OCD increases suicide risk might feel frightening or confusing. But knowing this truth also helps us take the right steps toward understanding, support, and treatment.

Why is Risk Higher for People with OCD?

OCD is more than just unwanted thoughts—it can bring intense suffering. Risk factors for suicide among people with OCD include:

Greater OCD severity.
Depression and hopelessness.
Certain OCD symptoms, such as intrusive thoughts about aggression, sexual themes, religion, or symmetry/ordering.
Severe distress from intrusive thoughts and feelings of being “out of control.”
Excessive guilt and shame tied to taboo content.
Impaired functioning and social isolation.
Treatment-resistant OCD or inadequate access to specialized care.

It’s also possible to have both OCD and true suicidal thoughts at the same time, which can feel confusing for the person living with it and for the professionals who are trying to help.

What the Numbers Show

Suicide is the 11th leading cause of death overall in the U.S.
It is the 2nd leading cause of death among individuals ages 10–14 and 25–34.
Suicide rates are highest among American Indian/Alaskan Native populations, for both men and women.
The suicide rate among men is about four times higher than among women.
Men aged 75 and older have the highest rates; women ages 45–64 have the highest among females.
Among veterans, an average of 16.8 suicides per day occurred in 2020.

These statistics can feel heavy—but they highlight the importance of awareness, prevention, and access to proper care.

The Role of Substance Use

Substance use adds another layer of risk:

People with alcohol dependence are 10 times more likely to die by suicide.
People with drug dependence are 14 times more likely.
Over 50% of suicides are associated with dependence on drugs or alcohol.
At least 25% of people with drug or alcohol addiction die by suicide.
Around 70% of adolescent suicides are associated with drug or alcohol dependence.

OCD and substance use frequently overlap, with about 25% lifetime prevalence of co-occurrence. Substances most often involved in suicide deaths include alcohol, opiates, marijuana, cocaine, and amphetamines.

Why Awareness Matters

For someone with Harm OCD, hearing that OCD increases suicide risk may trigger fear:

“Does this mean I’m more likely to hurt myself?”
“What if my scary thoughts turn into real ones?”

These worries are real and valid. The truth is, not everyone with OCD is at risk—but awareness helps providers assess risk accurately and helps individuals get the right support.

Misdiagnosis is also common. Many clinicians mistake OCD symptoms for something else, especially when intrusive thoughts involve taboo themes like sexual orientation, pedophilia, aggression, or religion. This is why more training, research, and awareness are essential—so that people living with OCD get the right care.

Hope Through Treatment

Even though the statistics sound heavy, there is hope. OCD is treatable—and when treated effectively, suicide risk can be reduced.

One of the most effective approaches is Exposure and Response Prevention (ERP). ERP teaches people to face intrusive thoughts and triggers without doing compulsions, breaking the OCD cycle and reducing fear. Over time, ERP helps intrusive thoughts lose their power, creating space for healing and peace.

With proper treatment, support, and awareness, people with OCD can and do reclaim their lives.

✦ Next week’s post: How to tell the difference between Harm OCD and true suicidal or violent thoughts—and why that distinction is so important.

Sources:

International OCD Foundation (IOCDF.org)
Glazier, Calixte, Rothschild, & Pinto (2013)
Glazier, Swing, & McGinn (2015)
National Institute of Mental Health (NIMH, 2021)
U.S. Department of Veterans Affairs, National Veteran Suicide Prevention Report (2022)
National Center for Biotechnology Information (NCBI, 2013)

OCD and Suicide Risk: What the Research Tells Us