Are OCD and Tics Related — What the Studies Really Say

When someone experiences both intrusive thoughts and repetitive movements, it’s easy to notice how the two seem to feed off each other.

In fact, many clinicians and researchers have spent decades exploring exactly how OCD and tics are related.

The connection runs deeper than most people realize, sharing patterns in symptoms, genetics, and even brain circuitry.

Understanding how these two conditions overlap can lead to more precise diagnoses and more effective, personalized treatment.

Understanding OCD and Tics

Obsessive-compulsive disorder (OCD) involves unwanted, intrusive thoughts (obsessions) and repetitive behaviors or mental rituals (compulsions) meant to reduce distress.

A person might repeatedly check a door, wash their hands, or mentally replay an event to feel safe or “right.”

Tics, meanwhile, are sudden, involuntary movements or sounds, such as blinking, throat clearing, or shoulder shrugging. When both motor and vocal tics persist for over a year, Tourette syndrome may be diagnosed.

While OCD is rooted in anxiety and doubt, tics often come from a physical urge or tension that feels irresistible. Both involve repetitive patterns that can feel beyond control, which is part of why they so often intersect.

How Common Is The Overlap?

Research suggests that 20–30% of people with OCD also have a tic disorder, while up to 60% of those with Tourette syndrome experience OCD symptoms.

The overlap appears more often in males and in early-onset OCD cases that begin in childhood or adolescence.

This shared occurrence hints at common biological pathways and genetic factors. 

Families with a history of either OCD or tics tend to have higher rates of both, suggesting an inherited component that affects how the brain manages impulses and anxiety.

What The DSM-5 Says

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) now includes a “tic-related OCD” specifier to help clinicians recognize when OCD occurs alongside current or past tics.

This matters because tic-related OCD often looks different from non-tic OCD.

For example, people with tic-related OCD are more likely to experience “just-right” compulsions, repeating behaviors until things feel perfect or symmetrical. These individuals may also have stronger urges around ordering or touching rituals. 

Recognizing these differences allows therapists to tailor treatment approaches more precisely.

What Science Reveals About The Connection

So, are tics and OCD related biologically? Evidence suggests they are. Both involve overactivity in the cortico-striato-thalamo-cortical (CSTC) circuit, a network in the brain that helps regulate movement, habits, and error detection.

When this circuit misfires, it can lead to repetitive thoughts in OCD and repetitive movements in tic disorders.

Genetic studies also reveal overlap. Relatives of people with Tourette syndrome are more likely to have OCD, and vice versa.

These shared traits point to common genetic influences on neurotransmitters such as serotonin and dopamine, which regulate mood, anxiety, and movement.

When Symptoms Blend

People who experience both tics and OCD often show a unique mix of symptoms. 

For example, a person might have a motor tic like blinking, while also feeling compelled to touch objects until they feel “right.” Another may repeat phrases or sounds both as a tic and as part of a compulsion.

Distinguishing between the two can be challenging. The key difference lies in motivation: compulsions are performed to relieve anxiety or prevent perceived harm, while tics are driven by a physical urge or internal tension.

A skilled clinician can help identify which behaviors belong to which category, crucial for choosing the right therapy.

Evidence-Based Treatments

When OCD and tics coexist, treatment should address both simultaneously. The gold standard for OCD is Exposure and Response Prevention (ERP), which helps individuals confront feared thoughts or situations without engaging in compulsions. 

Over time, the brain learns that anxiety decreases naturally, even without rituals.

For tics, the most effective behavioral therapy is Comprehensive Behavioral Intervention for Tics (CBIT). It teaches awareness of pre-tic urges and introduces competing responses, alternative behaviors that make the tic harder to perform.

When both conditions are present, therapists often integrate ERP and CBIT. This approach helps individuals manage anxiety-driven and movement-driven symptoms together, avoiding conflicting strategies.

The Role Of Medication

Medication can support therapy when symptoms are severe or persistent.

Selective Serotonin Reuptake Inhibitors (SSRIs) are commonly prescribed for OCD, while antipsychotic medications such as risperidone or aripiprazole may be added for individuals with tics or treatment-resistant OCD.

Studies show that people with both OCD and tics sometimes respond better to combination therapy than to SSRIs alone.

However, medication works best alongside behavioral treatment, not as a substitute. A collaborative approach between therapist and prescriber yields the strongest outcomes.

Sudden-Onset Cases: What About PANDAS?

Some children develop a sudden onset of OCD and tics after an infection, a condition known as PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) or the broader PANS.

While these cases can be dramatic, they are relatively rare. Research is ongoing, and most children with OCD or tics do not fall into this category. Accurate diagnosis by a medical professional is essential before considering immune-related treatments.

Living With Both OCD And Tics

Managing both conditions can be challenging, but recovery is absolutely possible. 

Many individuals improve significantly with the right combination of therapy for tics and OCD treatments, lifestyle balance, and family education. Mindfulness practices, structured routines, and adequate rest also help reduce symptom severity.

Families can play a big role by learning the difference between compulsions and tics, responding calmly, and avoiding reassurance cycles that can unintentionally reinforce OCD patterns.

Moving Forward With Expert Care

So, are tics and OCD related in a meaningful way? Absolutely.

They share overlapping brain pathways, genetic vulnerabilities, and behavioral characteristics. Recognizing this relationship allows for more precise treatment and better long-term outcomes.

If these symptoms sound familiar, The OCD Treatment Center offers specialized programs designed for OCD.

Our team combines ERP and mindfulness-based therapies to help clients regain confidence and reduce symptoms. With the right support, it’s entirely possible to quiet both the mind and body, and live a life defined by values, not fear.Contact us today to take the first step toward calmer days and a clearer mind!