Living With Obsessive-Compulsive Disorder

Living with obsessive-compulsive disorder (OCD) presents many challenges for individuals and the people who care about them. This mental health condition causes obsessive thoughts that are negative and distressing. A person can’t simply get rid of these thoughts; they persist. It also causes a person to engage in repetitive, ritual behaviors that may provide temporary relief from the obsessions, but which also cause other problems and more distress.

OCD can bleed into all areas of life, taking up a lot of time, energy, and focus. It can make relationships, working, going to school, socializing, and engaging in hobbies or activities difficult. With good treatment, though, a person can learn to live well with OCD, to manage symptoms, to control and challenge obsessive thoughts, and to resist the compulsion to engage in repetitive behaviors.

Someone with OCD struggles with distressing, obsessive thoughts, compulsive behaviors or, in many cases, both. In order to actually be diagnosed with OCD, these factors must be present and take up a significant amount of time, cause distress, and cause impairment in one or more areas of a person’s life.

• Obsessive thoughts. The thoughts that characterize OCD are called obsessive because they occupy a large portion of a person’s focus and are difficult or impossible to control or stop. These thoughts are negative and distressing. Each person’s obsessions are unique, but some common themes include worrying that someone will get hurt, violent images or impulses, and fear of contamination by germs or chemicals.
• Compulsive behaviors. The obsessive thoughts of OCD cause a great deal of anxiety, and many people use ritualized and repetitive behaviors as a way to soothe that anxiety. The behaviors are also used to try to stop the thoughts or prevent them from becoming reality. They take up a lot of time and may or may not be connected to the actual thoughts. Examples of OCD behaviors include excessive hand washing or mentally reciting prayers over and over again, although as with the obsessions, there are endless variations of compulsive behaviors.

While patients with a diagnosis may wonder how to cure OCD, the fact is that there is no cure. This doesn’t mean that the condition can’t be managed, however. A comprehensive, professional, and individualized treatment plan can help someone with OCD overcome and learn to manage their symptoms and be able to live a normal, functioning life again.

OCD is largely treated with a combination of therapy and medications, although the best treatment plans are designed uniquely for each individual. The type of therapy most often used for OCD treatment is called exposure and response prevention (ERP), a type of cognitive behavioral therapy (CBT). CBT is a type of therapy aimed at helping patients become more aware of their negative patterns in thoughts and behaviors and to take active steps to change them.

ERP uses CBT as a foundation but is specifically designed to help people manage obsessions and compulsions. It involves exposing a patient to whatever it is that causes them the most fear and anxiety, so they can learn how to prevent the ritual response, the compulsive behavior that typically follows the obsessive thoughts. Although ERP is frightening and initially increases stress, it is the most effective type of therapy in helping people manage OCD. It gives a patient the opportunity to face their fears, realize that the fears are irrational, and learn strategies for resisting the urge to engage in compulsions.

The medications that are most often used to supplement therapy for OCD are antidepressants. There are several different drugs that may work, but they take weeks to actually show results. It requires time, patience, and consistency to use antidepressants effectively and to find the right one that works for a particular individual.

A good therapy and treatment program should teach OCD patients the skills they need to challenge their obsessions and manage them outside of therapy sessions. When obsessing over anxiety-provoking thoughts, it is as if the brain is stuck, but there are strategies that people with OCD can use to unstick the brain and get past these obsessions. It requires taking active steps to challenge the thoughts:

• Write down and record obsessive thoughts, which causes them to lose their impact. Writing thoughts on paper takes more effort than simply thinking them, so the process can help the brain get over them more quickly.
• Change the wording of thoughts. Instead of saying, for example, “I am certain I am going to cause a car accident today,” say, “I am experiencing an obsession about causing an accident.”
• Actively recognize and state that the thoughts are caused by OCD, a real condition related to brain chemistry.
• Refocus attention on something else. Actively perform another task, unrelated to the obsession in order to refocus.
• Take value away from obsessive thoughts. They may not go away, but they can be recognized as unimportant.

A good therapist will also teach patients with OCD how to resist the compulsion to engage in their OCD behaviors. These behaviors may seem harmless and innocent, but they are unhealthy and unproductive ways of coping with obsessive thoughts and anxiety. They can also cause harm because they take up so much time and remove focus and energy from other areas of a person’s life.

Resisting behaviors is possible with active steps, but also requires exposure and distraction. Face what causes fear and anxiety. More exposure eventually reduces anxiety. As the urge to engage in a compulsive behavior arises, shift focus and do something else that is enjoyable, like watching a favorite show or calling a friend to talk. After refocusing, assess the compulsive urge; often it will be reduced.

Self-care is an important component for managing and living with OCD. Maintaining good health and reducing stress can help reduce the intensity of obsessions and compulsions. Managing stress is especially important because, for many people, high levels of stress trigger or worsen OCD symptoms. Learn and use relaxation techniques regularly to keep stress at bay. Yoga, meditation, deep breathing, guided imagery, and other strategies help manage and reduce stress.

Other important lifestyle habits to manage OCD help maintain good physical and mental health and promote overall well-being. Someone who is healthy is better able to manage and resist obsessions and compulsions. Healthy habits include eating well, getting adequate sleep, exercising regularly, and avoiding alcohol and drugs or using alcohol only in moderation.

Having good support from people who care is an important element of living with and managing any element. This means having family or friends who are supportive and will be there to listen or help during difficult times. It also means having a group of people who experience similar challenges. Joining a group therapy session or a support group that meets in person or online is a powerful way to cope with OCD and share experiences and strategies for managing it.

Living with OCD is difficult, but it can also be challenging to live with or care about someone with this condition. It is important for loved ones to be part of a strong support system for people with OCD, as social connection is so crucial to overall wellness. To support someone with OCD, first learn more about the condition to develop empathy. A greater understanding of what someone is going through helps a loved one be more compassionate and more patient.

It is also important for loved ones to encourage treatment. OCD won’t go away without professional help, but treatment can be frightening. Someone with OCD may resist treatment or want to give up but will be less likely to do so when a loved one is urging them on to continue. Loved ones can also support people with OCD at home by being available to listen without judgment, to model and support healthy habits, and to maintain a stable, stress-free environment.

Life with obsessions and compulsions presents many challenges. OCD triggers a great deal of stress, fear, and anxiety. It can shift focus away from other important areas of a person’s life and cause significant impairment and dysfunction. But overcoming OCD is possible with good treatment, practical strategies for managing symptoms, social support, healthy lifestyle habits, and the encouragement of family and friends.

OCD Treatment at Bridges