Living with OCD (Obsessive-Complusive Disorder)

Living with OCD — or obsessive-compulsive disorder — is more common than you might think. Approximately 1.3% of the world's population will live with OCD at some point in their lifetime. That’s around 101 million people.

OCD often occurs with other mental health conditions, sometimes including additional obsessive-compulsive and related disorders like anxiety disorders (specifically social phobia),  tic disorders, and depressive disorders. 

Whether you or a loved one are living with OCD, this article details the symptoms and triggers of OCD, the emotional experience of living with OCD, and specific skills you can use to manage symptoms effectively.  

What is obsessive-compulsive disorder (OCD)?

OCD is a mental health condition. With OCD, someone has repetitive, unwanted thoughts. These unwanted thoughts are called obsessions or intrusive thoughts. The thoughts might be images or urges. And because they're unwanted, they cause a lot of stress. 

People living with OCD try to ignore the thoughts, but find it really hard to. Sometimes the only way to make the thoughts go away is to do mental acts or behaviors. These are called compulsive behaviors. Someone diagnosed with OCD feels driven to perform these behaviors to lower feelings of anxiety or prevent something bad from happening. Typically, the likelihood of this bad outcome happening is very low, but a symptom of OCD is that people truly believe it will happen unless they perform certain behaviors. 

For example, someone who thinks a loved one will die of a horrible disease may feel driven to clean. Or they will repeatedly check on loved ones to make sure they are safe. The distress is usually so high that they engage in their compulsive behaviors over and over again.

There are a few common categories of OCD symptoms:

• Forbidden thoughts: These relate to taboo categories like violence, sex, and religion. This can include fears of hurting loved ones or awful things happening. 
• Symmetry obsessions: These center around making sure objects, procedures, and rituals are "right," which leads to behaviors like counting, ordering, or repeating things a number of times.
• Cleaning and contamination obsessions: These are about preventing dirt, illness, or disease by excessively cleaning or even avoiding cleaning altogether.
• Hoarding: This involves forming strong attachments with items or feeling unable to let go of nonessential things. 
• Doubt/checking: This involves feeling unsure and subsequently checking, like inspecting locks over and over, or following up on loved ones. 

People can have obsessive thoughts outside of these categories. For example, people can also have obsessions around perfectionism (evenness or exactness) or fears of losing control, according to the International OCD Foundation.

Some people may only experience obsessions without associated repetitive behaviors. 

It's important to understand which type(s) of OCD best capture your symptoms to better recognize your personal triggers. 

OCD triggers 

Sometimes unwanted thoughts are more likely to happen around certain people, places, or things. We call these triggers. Triggers can be anything that increases emotions and makes you more vulnerable to experiencing OCD symptoms. 

If you're living with OCD, it's important to know what your triggers are — not to avoid them, but to deal with them effectively.

According to the National Institute of Mental Health and Dr. Marina Harris, a psychologist specializing in anxiety disorders, common OCD triggers can include:

• Changes in routine
• Anniversaries or important dates
• Leaving the house (in general or for extended trips)
• Moving homes or downsizing the home
• Big life events or life transitions 
• Certain challenging emotions like grief, disgust, shame, hopelessness, or sadness
• Disorganization
• Perceived failure
• Interactions with people (in general or in certain situations)
• Interpersonal conflict
• New, additional responsibilities
• Topics that are taboo or dangerous 
• Using the bathroom
• Trauma-related stimuli (people, places, or things that remind someone of the traumatic experience)

Although this is not an exhaustive list, by identifying some of your personal triggers for obsessive thoughts and compulsive behaviors, it can sometimes help restore a feeling of control so that when you experience a trigger down the road, you are prepared to identify it more quickly. 

Emotions of living with OCD

People living with OCD experience a lot of different emotions. OCD is considered an anxiety disorder, so many people with OCD feel anxiety, fear, or worry. People with OCD may also feel disgust or horror, especially if they have unwanted mental images about taboo or stressful things. They can feel intense shame, blame themselves, or feel hopeless at the prospect of feeling better. All of these emotions make living with OCD harder.

If you have a friend or family member who is living with OCD, make sure you keep in mind that they experience these emotions at any given time. It's important to acknowledge how they feel. You might provide emotional support or validation by saying, “That seems really challenging,” or “I can’t imagine how frustrating that must be.” Let them know you are there for them by using validation or encouragement. 

Living with OCD can also be isolating, but it doesn’t have to be. By understanding how a loved one might feel, you can help them feel less alone. Even though you don’t know what it’s like to live with OCD, you can acknowledge how they might feel. Emotional support is an incredible resource that should not be undervalued. 

Coping strategies for OCD symptoms

Living with OCD can be challenging, but there are strategies you can use to help you cope and even thrive. Licensed psychologist Dr. Marina Harris provides several recommendations below to effectively cope with OCD symptoms, including deep breathing, thinking techniques, and finding support.

Take a deep breath

When you experience intrusive thoughts, your nervous system goes into hyperdrive. When the nervous system gets wound up, shallow breathing increases anxiety. Although it sounds simple, taking deep breaths with long exhales can soothe your nervous system. Breathing skills can help you deal with difficult situations. The University of Michigan recommends several different breathing techniques for maximizing calm. 

Remember that thoughts aren't facts

It's easy to believe your scary OCD thoughts as truth. For example, you may believe that because you have an intrusive thought a loved one will die, that it will come true unless you engage in compulsions. Or because you experience an image of accidentally hurting someone, it might happen until you check that it hasn't. 

In moments when you're stuck in obsessive thinking, remember that thoughts are just thoughts. Even though your brain links them with outcomes in real life, fears are just fears. It can be scary to believe. And yet, the more you can learn to challenge your thoughts, the less stuck you will feel. Using thinking techniques for OCD is another way to help you get unstuck.

Don’t get stuck on repeat

When your brain gets stuck on repeat, try to ground yourself. Ask yourself, "Can I have this thought and not act on it?" If the answer is no, ask, "Can I delay acting on this thought for 10 seconds? 20 seconds? 5 minutes? 20 minutes or longer?" Try to increase the amount of time you can wait between the thought and the compulsion. 

Find meaningful support

Support groups are an enormous source of comfort for many people living with OCD. People with OCD can spend a lot of time isolating, feeling ashamed or alone, or blaming themselves. Linking with a supportive network of people can help you increase insight, manage symptoms, feel connected to others, and get back into your daily life. 

The International OCD Foundation has a directory of over 200 support groups, making it easy for someone living with OCD to find a support group in their area. 

You're not alone. Others can help — especially those who are also affected by OCD. 

Get individual support

Individual psychotherapy by a trained mental health professional is also an option. One type of therapy, Exposure and Response Prevention (ERP), which is a type of Cognitive Behavioral Therapy (CBT), is widely accepted as a very effective treatment for OCD symptoms. 

CBT and ERP are based on the idea that you can change how you feel by changing your thoughts and behaviors. In this way, treatment changes the core symptoms of OCD. Recent research found that CBT and ERP were significantly more effective than medication and receiving no treatment at all.

Living and thriving with OCD

Living with OCD can be a complex experience. Even when it feels challenging, there are ways to not only live with OCD but thrive with OCD.

First, there are a lot of different types of OCD and differences in symptoms across the types. Know the type(s) of obsessions and compulsive behaviors you experience and identify common triggers. Identifying the triggers is helpful — not to avoid them, but to know when to use your coping skills.

You have the ability to manage your symptoms. A great place to start is working on breathing skills to soothe your nervous system. Remember your thoughts are just thoughts, not facts. And take steps to connect with people who understand what you're going through, either via a support group, supportive network, or a licensed therapist. With these techniques, you can experience hope for the future. OCD is a condition that is treatable, that many people find help for. With these steps you can go from living with OCD to thriving with OCD.