Living with OCD

Jun 25, 2024 | Cognitive Behavioral Therapy, Mindfulness, Obsessive Compulsive Disorder

Illustrated cover showing the title of the blog with letter blocks spelling out OCD

What is OCD?

Living with mental health disorders can be challenging, especially when feeling out of control of thoughts, feelings and actions. This is often what it feels like when having obsessive-compulsive disorder (OCD). Obsessive-compulsive disorder, or OCD, affects around 2-3% of the population in the United States and begins often in childhood/adolescence or early adult years (American Psychiatric Association, 2022). Its source can come from various factors such as genetics, environment, trauma, and much more (National Institute of Mental Health, 2022).

OCD occurs when there are uncontrollable or unwanted thoughts that may or may not cause repetitive behaviors that can significantly affect daily living (National Institute of Mental Health, 2022). For example, an individual may believe they are going to harm their family, and in order to prevent that thought from occurring, they will send a text to their loved ones to provide temporary relief towards their distress. This only furthers the cycle to repeat itself, causing discomfort when the person can’t act on their compulsion.

Some other obsessive thoughts are fears related to germs or contamination, losing control, thoughts related to religion, harm, or keeping things organized (National Institute of Mental Health, 2022). Some compulsions may include excessive cleaning, checking things, counting, or repeating steps (National Institute of Mental Health, 2022). With that being said, OCD may have differing symptoms at differing levels of severity depending on the person. It is important to understand that OCD and other mental health disorders are not a one-size-fits-all perspective.

Symptoms of OCD can vary for each individual but may get worse when stress occurs in their life and can be debilitating to some. To be classified as OCD, these symptoms must last at least an hour a day and affect someone’s daily functions of living (American Psychiatric Association, 2022). A mental health professional such as a therapist, psychiatrist, or psychologist can provide a diagnosis to begin the next steps towards finding the resources to help with these symptoms and being able to manage a healthy life.

Therapy Types to Improve OCD:

A person living with OCD would benefit from cognitive-behavioral therapy with exposure and response prevention. Cognitive behavioral therapy, or CBT, has been used to help those suffering from numerous mental health conditions such as anxiety, depression, OCD, eating disorders, substance abuse, etc (APA, 2017).

CBT is focused on thought patterns, feelings, and beliefs that are made in our minds and how that impacts our behavior and decision-making. With someone who has OCD, this would help them to identify their thought patterns and how it leads them to their responses or behavioral patterns. A part of CBT that has been beneficial to OCD treatment known as exposure and response prevention, or ERP, to help ease the obsessions and compulsions. ERP has two parts, exposures and response prevention.

In the first step, exposures are used to confront the thoughts or feelings that are causing anxiety and disturbances in one’s life (International OCD Foundation, n.d.). In therapy, this may take time for the client to build confidence and comfortability to talk about thoughts and feelings they are fearful of. Building rapport with the client while creating a safe and comfortable environment is an important part of the process with any step of ERP. The counselor’s role is to help the client engage in their fearful thoughts without engaging in their compulsions. This can be done with mindfulness practices by reminding the client they are safe which allows space for these thoughts.

The response prevention comes next. This is when the therapist encourages the client to not allow the compulsion to occur while having the exposure (International OCD Foundation, n.d.). Over time your brain starts to understand that these thoughts and feelings are safe and don’t define who the individual is. This can lead towards healthy ways of coping with their OCD thoughts and feelings.

CBT and/or ERP can be short-term or long-term depending on the needs and severity of each person which may involve multiple sessions each week as well as homework or exercises to do while in between therapy sessions. Mental health professionals should openly discuss treatment plans and goals with the client before beginning therapy and as the process continues. Counselors and clients should talk about ERP and ways to help incorporate it into the client’s daily life so that they can utilize the tools on their own.

Being Aware and Ways to Cope:

When being diagnosed with OCD, it is important to be aware of triggers that may cause someone to lead into their obsession thoughts and compulsions. OCD symptoms may worsen when stressed, uncomfortable, or anxious, sometimes with or without physical or environmental reactions (Kobrin, 2023). Being aware of these situations is important to prepare yourself to have coping skills ready when working through the OCD.

Living with OCD can be challenging, having the right tools to help outside of therapy is needed as well. Basic needs are essential when taking care of OCD symptoms. Making sure that the person is getting quality sleep, exercise, a healthy diet, and having a support system helps to create balance in their body (American Psychiatric Association, 2022). On top of that, many people use mindfulness meditation and breathing exercises to help keep their nervous system in balance (American Psychiatric Association, 2022). Techniques such as the 4-4-6-2 breathing by inhaling for 4 seconds, holding for another 4 seconds, breathing out for 6 seconds, and holding for another 2 seconds helps to bring balance back to the body.

Breathing techniques can also be grounding techniques that help the body to feel grounded and regain a sense of control for itself. When the body can do this, it can help it to make more rational and cognitive decisions (Higginbotham, n.d.). When the mind wanders into thoughts, especially, with OCD, it takes away the ability to stay present with the world. Staying grounded can help to regain that perspective. Tapping your body, using the 5 senses (hear, taste, smell, feel, see), holding onto an ice cube, eating sour candy, going outside, and many more are ways to focus your body on the present moment.

Self-talk is also a helpful aspect of coping with OCD thoughts since often our thoughts lead to our emotions and behaviors. Reframing our thoughts helps us to better cope with them to feel safe and trust ourselves. For example reframing, “I need to check to see if the door is closed again or someone will harm me” into, “It is ok if I don’t check the door again, no one is going to harm me”, will help to build trust in your own thoughts. This is easier said than done, but practice over time helps to rebuild a habit in our brains.

Supporting Those with OCD:

Living with or supporting someone who has OCD can be challenging, and it is important to understand the tools for those who are struggling. Being aware of the person’s symptoms and how it is impacting their day-to-day life is important. Communication is a large part of OCD treatment, or any mental illness, and allows the person to feel less shameful about themselves for their struggles (Van Noppen & Pato, 2009). Creating a safe space for the person to come and express their feelings is important for improvements in their lifestyle. While living or knowing someone with OCD, lifestyle choices may change. Making those changes to adjust to each person’s needs involved with the OCD is important.

One of the more challenging aspects of OCD in relationships with others is asking for reassurance. “When you ask for reassurance, you’re basically asking someone else to neutralize the distress of confronting uncertainty, by presenting a different way of viewing the situation. It feels like a big relief to have this distress taken away, but in the long term it guarantees that you won’t learn how to tolerate uncertainty (or even learn that you can tolerate it)” (McGrath, 2022). When someone is looking towards another person for reassurance, they are in fear of trusting themselves, their thoughts, and actions.

Finding a balance between showing compassion and individuality while having a relationship with someone with OCD can be difficult at times. Remembering that someone with OCD will need time and space for themselves to grow and care for themselves is a large part of the process (Van Noppen & Pato, 2009). Those who are struggling to work together as a family, couple, or partnership may consider using couple or family therapy to work through this change together and find ways to support everyone in this situation.

Conclusion:

Overall, Obsessive-compulsive disorder, or OCD has its challenging aspects, but also has a great amount of resources and education to help better understand the symptoms, diagnosis, treatment, and ways to support others through it. Remembering that mental illness is nothing to be ashamed of but something to embrace and learn to cope with. OCD and other mental health disorders show up differently for everyone. If you or a loved one is suffering from OCD or any mental health disorders, please reach out to mental health professionals, educate yourself, and be kind throughout the journey.