What Causes OCD to get Worse?

Living with obsessive-compulsive disorder is already a struggle. For those struggling, it’s important to understand what causes OCD to get worse.

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Living with obsessive-compulsive disorder (OCD), like any other mental disorder, comes with its own set of unique challenges. The racing thoughts, the shifting sense of sameness, and the overwhelming desire to do things that are perhaps seen as unusual. However, to those that struggle with this condition, it’s the only sane action they can do. Yet, it’s this very behavior that may cause OCD to get worse.

Throughout this article, we’re going to take a look at what causes OCD to get worse. At the end, we invite you to ask further questions. 

What is OCD?

OCD is a disorder that causes an inability to control compulsions and thoughts and, according to the International OCD Foundation, an estimated 2-3 million American adults struggle with it. ¹ 

OCD is primarily made up of compulsive actions. You can exhibit in many different ways but most often they play out in a rhythm or a pattern. Through performing these actions, you most likely feel a sense of calmness. ² There are other signs and symptoms of OCD, such as making sure everything is in perfect order to re-thinking a situation in your head over and over again.

The most common treatment approach is a mixture of talk therapy, behavioral therapy, and medications such as antidepressants. The combination of this can help ease certain key symptoms like racing negative rumination and trying to control the compulsive thoughts and actions. ³

What Causes OCD Symptoms to get Worse?

When one is diagnosed with OCD, there are a lot of fears and misconceptions as to how the disorder has developed. However, there is a lack of focus placed on what can trigger OCD to get worse.

When we look at what causes OCD symptoms to compound, we first need to understand what triggers are and how they related to the disorder to begin with. Triggers are psychological stimuli that recalls a previous traumatic experience. There are several key triggers that can cause OCD symptoms to get worse and we’ve compiled a list of four key OCD triggers below:

1.) Stress

Stress can be a trigger for anyone, but for those that are dealing with OCD, stress can become an intimidating presence that exacerbates OCD symptoms to a point where – if not intervened – can become more concerning.

When stress goes unchecked, the pressure it puts on a normal person can cause abnormal physical and emotional responses. In the case of those with OCD, unchecked stress can send OCD symptoms spiraling out of control. For example, you may find yourself even more attentive to organization when stressed.

It is important for all of us, no matter where our mental health is at, to find adequate ways of coping with stress. And for those with OCD, coping with stress is going to look a bit different. You’ll want to find coping mechanisms that go along with your treatment plan. It can help to talk to a therapist about this as they’ll have a good sense of your personal situation.

2.) Contamination

Fixation on cleanliness isn’t necessarily a bad thing. However, for those that have OCD, the thought of being clean can become a compulsion. The concern of being contaminated is a common enough phobia that it’s irrevocably tired to those who suffer from OCD, whether or not the particular person actually has this phobia.

It is common for this phobia to manifest by making frequent bathing regimens that are, in contrast to others, usually excessive. A flare up of a contamination trigger could cause these extreme bathing behaviors to not only increase in frequency but also in severity. As controlling the compulsion becomes almost impossible as OCD symptoms worsen.

3.) Self Worth / Perfectionism

It is common for us to suddenly become aware of our own self image and try to, in some manner, perfect that image. However, for those struggling with OCD, self image can become a major issue. One symptom many with OCD fight is that of perfectionism. When this symptom dives into one’s self worth, it can trigger other OCD symptoms to worsen.

It is important for those that have OCD to have a realistic and relative self worth and self image to what is actually occurring in reality. Having someone to help ground the sufferer from an inflated ego, which can occur with those that suffer from questioning their self-worth, and help reassure the sufferer that there isn’t anything wrong with them as inherent people.

4.) Losing Control Over Situations

One of the most apparent and major triggers for those suffering from OCD is the inability to control a situation that they feel they should have control over. This trigger can become even more taxing on a person if that situation is directly tied to a compulsion or obsession that is sparked by their OCD.

For example, if you’re a compulsive hand-washer. You find yourself in a compromising position where you come in contact to an outside irritant and are not in reach of a bathroom. Therefore, you can’t carry out your compulsion to clean your hands. What can you do?

In situations like the one listed above, wherein the person struggling is having a compulsion flare up due to a triggering event and cannot – for whatever reason – exhibit their compulsive actions, the person may experience an anxiety rush and start to feel helpless.

Down The Spiral

Living with OCD has it’s own set of challenges that vary for each and every person who struggles from the disorder. However, when the ferocity and frequency of these OCD thoughts and compulsions become unbearable and seemingly unbreakable, the question of whether or not you are heading down a spiral of OCD symptoms has been answered for you.

Going down the spiral of having uncontrollable OCD compulsions is a frightening time not only for the sufferer but also for those in the sufferers support system. There is a tendency to try and mitigate or rationalize these worsening symptoms on the idea that perhaps medication or stress might be making these thoughts and actions worse in the moment.

A flare up of OCD symptoms, wherein the frequency and ferocity is becoming more and more unwieldy is a warning sign and not something to try and take lightly. It is recommended that you document the thoughts and behaviors so you have an account as to how your symptoms are improving or deteriorating. And, of course, we always recommend reaching out to a mental health professional or a trusted medical professional to ensure you or your loved ones are getting the best recommended therapies and treatment possible.

Pulling Out of the Spiral 

Pulling out of the spiral can begin as easily as calling out for help in a time of darkening thoughts or actions. There needs to be an option to speak up openly and honestly to a trusted supportive friend or family member.

It also helps to have someone in your support system who can observe your behavior routinely to be able to see if there are anything that might be concerning to them or others. The importance of this is, more often than not, concerning behavior looks normal to someone struggling with OCD.

Other options to intervene on worsening symptoms that are recommended by mental health professionals are changing up OCD behavioral therapy, adding an OCD behavioral coach and learning and implementing some personal thought retracing steps to try and intervene on worsening compulsive thoughts. ⁵

Taking charge of therapy is one the most dramatic changes someone who suffers from OCD can do to try and counter their worsening OCD symptoms. OCD sufferers have found a particular form of behavioral therapy called Exposure and Response Prevention (ERP) to be the most helpful in fighting back against OCD complications in thoughts and actions.

ERP revolves around immersing a patient in thinking through their actions by coaching the patient through situations that usually trigger the patient’s obsessions and compulsions. ERP therapy is done by a licensed therapist who knows how to talk and walk a patient proficiently through traumatic or stressful situations in order to try and implement healthy thought and behavior patterns in place of negative or unhealthy patterns of thought and actions. ⁶

When The Spiral Swallows 

Although many find ways to cope and getting out of the OCD’s downward spiral, there are those who do not. This is unfortunately is the case of Kassy Evans. After dealing with the “tornado of OCD symptoms,” as her mother puts it, Kassy Evans took her life at the age of nineteen. She had been struggling with OCD for over 8 years. ⁷

There are real consequences to the downward spiral of OCD thoughts and although it might a temporary flare up – as it is in many cases – it could also be a sign of going down a potentially dangerous path. It is imperative to try and establish strong communication about your condition, your symptoms and how they might be worsening.

Not being open and trying to stifle issues and complications can result in the condition not only worsening but swallowing you or your loved ones up in a cycle of negative thoughts, erratic behaviors and in some extreme cases suicidal thoughts and actions.

Final Word

OCD is already a difficult disorder to try and manage and to try and do that on your own is not recommended and it’s frankly detrimental for your or your loved ones’ health and wellbeing. And although we hate to harp on something so much, it’s so important to be able to communicate effectively and honestly about your health, whether it be your physical health, emotional health or your mental health. Having a support system could potentially save your life and being there for someone else who is suffering could save their lives.

All it takes is having an opportunity to reach out or have someone reach out to you and be comfortable in discussing things that are particularly uncomfortable to talk about. Life is already difficult as it is so having OCD on top of everything else can make the challenging things seem impossible but if you have a support system of doctors, mental health professionals and loved ones that you can be open to and depend on in times of strife and trouble, you have one piece of the puzzle already in place.

Remember that you can have the life you want but you have to be open and willing to reach out if you need help, if you feel you are spiraling and with your support team find ways in which to better manage and handle your OCD symptoms.

Your Questions

Still have questions concerning what causes OCD to get worse?

We invite you to ask them in the comments section below. If you have any further knowledge on this topic to offer – whether personal or professional – we’d also love to hear from you.

Reference Sources

¹ International OCD Foundation: “Who Gets OCD?”

² OCDUK: “What Are OCD Compulsions?”

³ International OCD Foundation: “How Is OCD Treated?”

⁴ EveryDayHealth: “What Are Common Obsessions and Compulsions?”

⁵ Anxiety & Depression Association of America: “How to Take the Power Back from Intrusive Thought OCD”

⁶ BeyondOCD: “Cognitive Behavior Therapy: ERP and CT Therapies”

⁷ HereToHelpCanada: “How My Daughter’s OCD Tore Our Lives and Our Family Apart”

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