How to Manage Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder (OCD) is marked by irrational fears or intrusive thoughts that compel individuals to perform repetitive behaviors in an attempt to ease or eliminate their anxiety. OCD exists on a spectrum from mild to severe, and may be accompanied by other mental health challenges. Treating OCD can be complex, particularly if the individual does not seek professional help. Psychiatrists employ various medications and treatment methods for OCD. Patients may also engage in therapies such as journaling, joining support groups, and practicing relaxation techniques to cope with OCD. If you believe you may have OCD, it is important to seek guidance from a mental health professional. Continue reading to learn more about managing OCD.

Get a Professional Diagnosis. If you suspect you may have OCD, never attempt to diagnose yourself. Mental health diagnoses can be quite complex and must be conducted by a qualified mental health professional.

• If you are struggling to address the issues related to obsessions or compulsions, consider seeing a psychologist or psychiatrist for evaluation and treatment.
• Ask your primary doctor for a referral if you're unsure where to begin.

Consider Psychotherapy. Psychotherapy for OCD involves discussing your obsessions, anxiety, and compulsive behaviors with a therapist during regular sessions. While therapy may not cure OCD, it can be an effective way to manage symptoms and reduce their intensity. This method helps around 50-80% of patients, although it only provides complete relief in about 10% of cases. Therapists use various approaches when working with OCD patients.

• Some therapists use exposure therapy, where patients gradually confront anxiety-inducing situations, such as deliberately not washing their hands after touching a door handle. The therapist works with the patient until their anxiety decreases.
• Other therapists employ imaginal exposure, where they describe scenarios that cause the most anxiety for the patient. The goal is to help the patient manage anxiety and become less sensitive to those triggers.

Consider Medication Prescribed by Your Doctor. Several prescription medications have been proven effective in reducing obsessive thoughts or compulsive behaviors associated with OCD. Keep in mind that medications address symptoms but do not cure the disorder, so it is best to combine medication with therapy. Some medications include:

• Clomipramine (Anafranil)
• Fluvoxamine (Luvox CR)
• Fluoxetine (Prozac)
• Paroxetine (Paxil, Pexeva)
• Sertraline (Zoloft)

Build a Strong Support System to Cope with OCD. While OCD is often believed to stem from brain dysfunction, it is important to recognize that it can also be triggered by traumatic events or a series of stressors in life. Experiences such as the loss of a loved one, losing a significant job, or being diagnosed with a serious illness can cause stress and anxiety. For some, these stresses may lead to an overwhelming urge to control aspects of life that might seem trivial to others.

• Strive to build a social support network that respects and values your past experiences.
• Surround yourself with empathetic people. Studies show that feeling supported by others is crucial to maintaining good mental health.
• Make time for the people you care about. If you feel that your current social circle isn't offering enough support, consider joining an OCD support group in your area. These meetings are often free and provide a great way to share your struggles with others who understand what you're going through.

Work with Triggers. Make a conscious effort to pay more attention to situations that tend to trigger your obsessions. There are small tricks you can use to feel more in control in these moments, enough to prevent stress from leading to compulsive thoughts and behaviors.

• For example, if you're constantly worried about whether you turned off the oven, try to vividly imagine yourself turning it off each time. Creating this mental image will help you remember that you actually turned the oven off.
• If imagining the situation doesn't help, try leaving a notebook next to the oven and make a note every time you turn it off.

Record your thoughts and feelings in a journal. Journaling is a powerful tool for reflecting on your emotions and gaining a deeper understanding of yourself. Set aside time each day to sit down and write about the experiences that cause you anxiety or distress. Expressing and analyzing your obsessive thoughts on paper is a great way to gain a sense of control over them. Journaling can also help you connect your anxiety with other thoughts or behaviors you’ve had. Developing this level of self-awareness can be incredibly helpful in understanding what situations may contribute to obsessive-compulsive disorder.

• Try writing your obsessive thoughts in one column, then categorize and rate your emotional reactions in another. In the third column, you can explore how your obsessive thoughts align with those emotions.
  • For example, imagine you have an obsessive thought like, "This pen is covered in germs from strangers and could lead to me contracting a terrible disease that I might spread to my children, making them sick."
  • Next, you might respond to that thought with, "If I know I could infect my children by not washing my hands, then I’m being a negligent and terrible parent. If I don’t do everything I can to protect my children, it’s just as bad as intentionally harming them." Write these thoughts down and reflect on both in your journal.

Regularly remind yourself of your positive qualities. Self-affirmation has proven to be effective in combating negative feelings. Don’t constantly blame yourself or let OCD define who you are. Although overcoming OCD may be difficult at times, always remember that you are stronger than your circumstances.

• Make a list of all the wonderful qualities you possess and read it whenever you feel down. Even just focusing on one of these qualities while looking at yourself in the mirror can elevate your positive feelings about yourself.

Celebrate when you reach a goal. A key aspect of treating OCD is setting goals. Even small goals provide you with something to aim for and a reason to celebrate. Every time you accomplish something that you couldn’t have done before starting OCD treatment, take pride in your achievement and acknowledge yourself for it.

Take good care of yourself. During OCD treatment, it is crucial to care for your body, mind, and soul. Go to the gym, nourish your body with healthy food, get plenty of rest, and nurture your spirit by attending religious services or participating in other activities that help soothe your soul.

Incorporate relaxation techniques. OCD can cause significant stress and anxiety. Medication and treatments may help alleviate some of these negative feelings, but it’s equally important to set aside time each day to relax. Combining activities like meditation, yoga, deep breathing, aromatherapy, and other soothing methods will help you manage stress and anxiety.

• Experiment with various relaxation techniques until you find what works best for you, and then make them a part of your daily routine.

Maintain a daily routine. Coping with OCD might tempt you to neglect your usual schedule, but this approach won't help. Stick to your routine and keep moving forward in life. Don’t let OCD stop you from going to school, work, or spending time with family.

• If you feel anxious or fearful about certain activities, consult your therapist, but try not to avoid them.

Recognize the signs of OCD. Individuals with obsessive-compulsive disorder (OCD) are disturbed by the intrusive and repetitive thoughts, urges, and uncontrollable behaviors they experience. These actions can interfere with their daily functioning. Common behaviors associated with OCD include excessive hand washing in a particular manner, an uncontrollable urge to count objects, or repetitive negative thoughts that may send shivers down your spine. People with OCD often feel a pervasive and constant sense of uncertainty and lack of control. Some behaviors related to OCD include:

• Rechecking everything multiple times. This might involve checking if the car door is locked, turning lights on and off repeatedly to ensure they are off, or any other repetitive action. OCD sufferers typically recognize that these obsessions are irrational.
• Obsessive fear of dirt or contamination. Individuals with this obsession will wash their hands immediately after touching anything they perceive as dirty.
• Intrusive thoughts. Some OCD sufferers endure distressing, intrusive thoughts – inappropriate and disturbing thoughts that cause them distress. These are usually categorized into three groups: inappropriate violent thoughts, inappropriate sexual thoughts, and blasphemous religious thoughts.

Understand the pattern of obsession/stress/compulsion. OCD individuals experience stress and anxiety when triggered, which compels them to perform certain behaviors. These actions provide temporary relief or reduction in anxiety, but the cycle repeats once the relief fades. An OCD sufferer may go through cycles of obsession, stress, and compulsion multiple times a day.

• Trigger. Triggers can be internal or external, such as a thought or an experience. It could be the fear of contamination or a past traumatic event like a robbery.
• Interpretation. The OCD sufferer interprets the trigger as a significant and threatening event. When a trigger becomes an obsession, it is perceived as an imminent danger.
• Obsessions/anxiety. If the OCD sufferer sees the trigger as a real threat, it leads to intense anxiety, which can evolve into a full-blown obsession with that thought or possibility. For example, if the thought of being robbed causes intense fear and anxiety, that thought may turn into an obsession.
• Compulsions. Compulsions are habits or actions performed to cope with the stress caused by obsessions. The obsession stems from the need to control some aspect of the situation to feel in control of the anxiety or obsession. This could involve checking whether the lights are turned off five times, reciting a self-made prayer, or washing hands repeatedly. The person may justify that the pressure from checking the door lock multiple times is less intense than the anxiety of the robbery they fear.

Understand the difference between OCD and OCPD. When discussing OCD, many people think of an excessive concern with order and rules. While this tendency can be a symptom of OCD, it’s not necessarily classified as OCD unless these thoughts and behaviors are tied to unwanted concerns. On the other hand, this tendency may reflect OCPD, a personality disorder characterized by high personal standards and an excessive focus on order and discipline.

• It’s important to remember that not everyone with OCD has a personality disorder, but it is possible for OCD and OCPD to occur simultaneously.
• Many behaviors and thoughts related to OCD are unwanted, which often leads to a higher degree of dysfunction compared to OCPD.
• For example, behaviors associated with OCD may interfere with time management, and in rare cases, the individual may even be unable to leave the house. Intrusive and sometimes vague thoughts, like “What if I forgot something important at home this morning?” can cause debilitating anxiety. If someone experiences such behaviors and thoughts from a young age, they are more likely to have OCD rather than OCPD.

Understand that OCD manifests in various forms and severities. In all instances of OCD, the disorder develops through intrusive thoughts or behaviors, which significantly interfere with daily activities. Given the diverse nature of OCD, it may be better to consider it a type of disorder rather than a single condition. The symptoms may lead you to seek treatment or not, depending on how they affect your day-to-day life.

• Ask yourself if the recurring thoughts and behaviors are negatively impacting your life. If so, seeking help could be beneficial.
• Even if your OCD symptoms are mild and don't disrupt your routine, you might still need support to prevent them from becoming overwhelming. For example, a mild form of OCD could involve the urge to check if the door is locked repeatedly, even though you've already done so. Although you may not act on these urges, they can still distract you and make it hard to focus on other important aspects of life.
• The distinction between OCD and occasional irrational urges is not always clear. You'll need to determine whether these urges are severe enough to warrant professional assistance.

• Be sure to follow your psychiatrist's instructions for taking your prescribed medication. Do not skip, stop, or adjust the dosage without consulting your doctor first.

• If your OCD symptoms worsen or reoccur, contact your psychiatrist immediately.