What Causes OCD To Get Worse? Everything You Should Know

Obsessive-compulsive disorder (OCD) is a mental health condition that causes repetitive, unwelcome thoughts, images, fears, doubts, urges, sensations, and/or emotions (obsessions) and/or ritualistic behaviors (compulsions). While some people only suffer from obsessions, others struggle with obsessions and compulsions.

OCD does not just involve compulsive behaviors like picking your skin, biting your nails, or having intrusive thoughts, it can also involve mental compulsions like counting or repeating mantras or phrases in your mind, or viewing certain numbers or colors as “lucky” or “unlucky,” obsessively organizing things, avoiding certain places or people because they are “bad” or “dangerous,” being afraid to leave your home due to germs and the possibility of getting sick, etc.

If you have OCD and suffer from obsessions and compulsions, you may excessively bathe or wash your hands, recheck your door, windows, stove, etc., multiple times, clean your home over and over again, etc. And, even if you do not want to have those thoughts or perform those rituals or routines, you are unable to stop. The truth is most people have experienced unpleasant or even disturbing or upsetting thoughts at one time or another, and most people have done things to reassure themselves that everything is going to be okay. That is normal.

A problem only arises when these thoughts and behaviors begin to take over your life, dictating what you do and do not do daily. When this occurs, it is time to seek OCD help. But what happens when you have OCD and notice that your symptoms have worsened? Does that even happen and if so, how should you handle this new development?

You probably have a ton of questions – and fears, however, the good news is this article should be able to answer many of them, so you no longer have to worry about what comes next if your OCD symptoms intensify. In other words, there is help available and even on your worst day, there is still a way to recover from OCD.

If you are in the midst of a severe OCD flare or simply want to know what to look out for should your OCD symptoms worsen – look no more because this article can help prepare you for the ups and downs of OCD.

So, is it possible for your OCD symptoms to ramp up? Yes, it is definitely possible.

How Common is OCD?

Approximately 65% of people live with chronic OCD. So, it is a fairly common anxiety condition.

How Is OCD Diagnosed?

OCD is typically diagnosed through a physical exam, observation, psychological assessments, and labs or blood tests. The goal of the labs or blood tests is to make sure you are not suffering from another health condition that mimics OCD. Your doctor will also talk with you about your experiences, thoughts, symptoms, feelings, behaviors, urges, and habits to determine if you are indeed suffering from OCD.

What Are Some Risk Factors for OCD?

The truth is researchers, doctors, and other mental health providers are unsure why some people develop OCD and others do not. However, one thing that most experts agree on is that stress can aggravate OCD, triggering more severe and frequent obsessions and/or compulsions. According to researchers, women are more likely to experience OCD than men, as are teens and young adults.

OCD risk factors include:

• A parent, sibling, or child with OCD
• A brain chemical imbalance
• Depression
• Bipolar disorder
• Anxiety
• Tics
• Trauma
• Childhood physical, emotional, and/or sexual abuse
• Streptococcal infection (PANDAS is a pediatric autoimmune neuropsychiatric disorder linked to a streptococcal infection)

Can OCD Worsen Over Time?

Yes, OCD symptoms can worsen over time.

Keep in mind that OCD symptoms can range in severity, frequency, and intensity. You are likely to notice them more during periods of high stress, emotional distress, and/or boredom. It is common to see an escalation in obsessions and compulsions as time goes on – even if they began in adolescence. Once these symptoms worsen, they can be challenging to wrangle back under control.

Obsessions and/or compulsions may resemble the following:

• Extreme orderliness
• An intense need for symmetry
• Unrelenting fear of contamination, germs, and/or dirt
• Upsetting, violent, or disturbing thoughts, fears, images, emotions, urges to self-harm or harm others
• Unwanted thoughts of being aggressive towards others
• Disturbing thoughts, fears, images, urges to be sexually aggressive towards others – i.e., sexual assaults, rapes, sexual harassment, child sex abuse, etc.

What Can Make OCD Symptoms Worse?

Several things can make OCD worse, such as comorbidities (i.e., anxiety and OCD, substance abuse or alcoholism and OCD, or depression and OCD). Researchers suggest that comorbidities are one of the primary causes of severe OCD. According to studies, approximately 90% of OCD sufferers have another mental health condition, which can lead to an escalation in OCD.

A History of Mental Health Conditions

• Anxiety Disorders (i.e., Panic Disorder, Panic Attacks, Phobias, Social Anxiety, Post-Traumatic Stress Disorder or PTSD, Generalized Anxiety Disorder or GAD, Obsessive-Compulsive Disorder or OCD, etc.)
• Impulse Control Conditions
• Attention-Deficit Hyperactivity Disorder (ADHD)
• Mood Disorders (i.e., Depression, Bipolar Disorder, Major Depression Disorder or MDD, etc.)
• Eating Disorders (i.e., Bulimia, Anorexia, Binging and Purging, etc.)
• Tic Disorder
• Substance Abuse and Alcoholism
• Hypochondriasis

Note: Untreated OCD can naturally lead to a progression in severity and frequency in people suffering from this condition.

Stressful Life Events

Stress can be caused by various factors, such as:

• Unemployment
• Relationship Issues
• Death of a Loved One, Pet, or Close Friend
• Debt or Financial Problems
• Relocation to a New City, State, Country, School, Neighborhood, and/or Job
• Marriage or a Wedding
• Birth of Child
• Work Conflicts
• Low Self-Confidence or Self-Esteem

Note: Any event that is unexpected or overwhelming can worsen OCD symptoms. Thus, OCD sufferers must learn healthy coping skills and strategies that can help them better manage their symptoms should a stressful event occur in the future.

Hormones

A fluctuation in hormones (i.e., puberty, menstruation, pregnancy, menopause, etc.) can also cause OCD to worsen. Any change in hormones can aggravate your OCD.

Junk Foods

Junk foods, processed foods, sugary, fatty, greasy, salty foods, or sodas can exacerbate your OCD symptoms. A poor diet can put stress on the body and high levels of oxidative stress can worsen your OCD symptoms. Thus, it is important to maintain a healthy diet full of fresh fruits and veggies, lean meat, fish, whole grains, low-fat dairy products, and water to keep your OCD symptoms manageable.

Inadequate or Poor Sleep

Are you getting enough quality sleep at night? If not, it could be worsening your OCD symptoms. It is common to have a hard time falling and staying asleep, due to racing, nightmares, intrusive thoughts, urges, fears, etc. Many people with OCD struggle with chronic insomnia. When you do not get enough sleep, it can wreak havoc on your health and well-being, and as such, it can worsen your OCD symptoms.

Compulsions

Ironically, compulsions can make your obsessions worse. Although you may think that engaging in rituals and routines will reduce or alleviate the intrusive thoughts, urges, doubts, emotions, fears, mental images, etc., that may not be the case – in the long run. Keep in mind that OCD is cyclic which means that it will return over and over again until it is properly managed.

OCD can also be progressive, which means it can and will likely intensify over time, especially if it is left untreated. By focusing on performing compulsions, you may be putting more attention on your obsessions. In other words, because the compulsions bring you relief, it could cause your obsessions to become more pronounced – but this time the compulsion may involve thinking about whatever you are “fixated” on so you can get the relief you had before.

Trauma

Traumatic experiences can worsen OCD symptoms. This not only applies to “fresh trauma” but also past trauma. Past trauma can creep up on you triggering obsessions and compulsions. “Fresh trauma” can worsen OCD symptoms if you already struggle with them. Even things that you do not think are affecting you may, indeed, be affecting you. Therefore, it is important to seek OCD help if you have experienced trauma.

Boredom

Boredom can provide you with more opportunities to stress and obsess over things, which could worsen your OCD. When we are bored, our minds are more apt to wander and “fixate” on certain things. When we obsess over something, we are likely to find ways to alleviate our angst. Conversely, when our minds are busy, we are less likely to “fixate” on things, which means the risk of severe OCD symptoms is lower.

Unsubstantiated Advice

Friends, family members, co-workers, romantic partners or spouses, freelance blog writers, and strangers may not be the best people to take advice from when it comes to your condition, especially if they do not have OCD or have never been trained on it. Even doctors may not be up-to-date when it comes to new and effective OCD treatments.

Therefore, it is important to take unsubstantiated advice with a grain of salt. In other words, do your research and then make an informed decision about whether or not to use the “advice” you have been given. This is important because the wrong advice could worsen your OCD symptoms and leave you sitting in a big fat mess.

Excessively Talking About Your OCD Symptoms

It is okay to talk about OCD with your loved ones and close friends. In fact, in many cases doing so is therapeutic and healing. However, talking about your OCD symptoms too much can make them worse. In other words, it can cause you to be hypervigilant about your symptoms – until it becomes a full-blown obsession. Yes, your obsession can become an “obsession.”

This is especially true if you find yourself continuously talking about your OCD on social media sites. OCD sufferers are increasingly turning to online forums, like Reddit, to share their OCD experiences. Some join forums for support, advice, and tips, while others use it as a way to get reassurance that they are okay and that they would never act on their obsessive thoughts.

Although using OCD forums for reassurance may work in the short run, in the long run, it could exacerbate your OCD. Support from other people, who are struggling with the same condition can be beneficial, however, it is important to avoid “advice” or information that could worsen your OCD symptoms.

The Wrong Type of OCD Therapy

Some therapy approaches do not work for some people, and OCD therapies are no exception. Cognitive-behavioral therapy (CBT), especially exposure and response prevention (ERP) therapy, a subtype of CBT, is the to-go treatment for OCD.

However, there are many more therapies that may be used to treat OCD, and some of these therapies may worsen your OCD symptoms. Although these therapies may be beneficial for various mental health conditions, they may not be beneficial, and could, in certain instances, be determinantal for OCD.

Note: Finding the right OCD therapy may be challenging, because many, if not most, psychotherapists do not specialize in OCD. The consensus is that ERP therapy is the gold standard treatment for OCD, a type of CBT, geared to expose you to your OCD triggers in hope that it will cause you to become desensitized to them. Thus, ERP therapy aims to “quiet” the intrusive thoughts, urges, fears, etc., so you do not feel compelled to perform compulsions.

Thinking That You Are an Anomaly

If you struggle with OCD, you may feel as if you are the only person in the world who is experiencing intrusive thoughts, urges, doubts, fears, emotions, and/or mental images. But the truth is you are not alone. Intrusive thoughts can pop into anyone’s mind, and in most cases, this is an everyday occurrence. However, when these thoughts take a turn for the worse and begin to affect your life in various ways, it becomes a real problem that requires OCD help.

The good news is most psychotherapists have seen and heard it all – so you are not an anomaly. You are someone with a condition, just like any other condition, who needs help figuring it all out and getting back on track. If you go about life thinking you are “odd,” “strange,” or “defective,” then you run the risk of making your OCD symptoms worse (by obsessing about being an anomaly) instead of better.

What Symptoms Should I Expect If My OCD Worsens?

As your OCD symptoms worsen, you may experience the following:

• Work and/or School Failures
• Inattention or Difficulty Focusing
• Depression
• Self-Isolation
• Frequent Panic Attacks
• Mood Swings
• Headaches
• Aches and Pains
• Gastrointestinal Distress – i.e., nausea, vomiting, upset stomach, abdominal pain, diarrhea, and/or constipation
• Physical, Emotional, and Mental Exhaustion
• Self-Harm or Suicidal Ideation (Suicidal Thoughts and/or Attempts)

How is OCD Treated?

First, there is no cure for OCD. However, there are ways you can manage your OCD symptoms so they do not worsen. OCD treatments typically involve a combination of medicine, therapy, lifestyle changes, natural remedies, and self-help tools, like Impulse Therapy, an online OCD treatment program.

Psychotherapy

As mentioned above, CBT can help change your thinking patterns, which, in turn, may help reduce or stop your compulsions. ERP therapy can help you become desensitized to your OCD thoughts, urges, mental images, fears, etc., so they no longer have power over you. The goal of this treatment approach is to put you in situations that trigger your anxiety so that you are “forced” to face them. The theory is that if you are exposed to something long enough, you will no longer feel the need to engage in rituals or routines to ease your stress and stop your obsessions.

Relaxation

Mindfulness meditation, yoga, hypnosis, CBD, and massages can help keep your OCD symptoms at bay so they do not worsen over time.

Medication

Psychotropic drugs, like selective serotonin reuptake inhibitors (SSRIs), can help OCD sufferers control their obsessions and compulsions. Understand, however, that it could take up to 4 months before these medications start working. Common SSRIs used to treat OCD symptoms so they do not get out of control are citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine, paroxetine (Paxil), and sertraline (Zoloft). If you experience treatment-resistant OCD, your doctor may prescribe antipsychotic drugs, like aripiprazole (Abilify) or risperidone (Risperdal) to help you manage your OCD symptoms.

Neuromodulation

In rare cases, when your OCD is resistant to conventional OCD treatments (i.e., medication and therapy), your doctor may prescribe neuromodulation to prevent your OCD symptoms from getting worse. Neuromodulation involves emitting electrical pulses to certain areas of your brain. One kind of neuromodulation is transcranial magnetic stimulation (TMS).

The good news is TMS is an FDA-approved treatment for OCD. TMS uses electricity to “activate” your nerve cells. Another more complex neuromodulation medical procedure used to treat OCD is deep brain stimulation (DBS). DBS implants electrodes on specific parts of your head to transmit electrical pulses to various areas of your brain.

Lifestyle Changes, Natural Remedies, and Self-Help Tools

Lifestyle changes, natural remedies, and self-help tools can lower your risk of severe OCD symptoms. Lifestyle changes like a healthy diet, proper rest and sleep, regular exercise, and spending quality time with friends and family; natural remedies like vitamins and minerals, CBD, and home remedies; and self-help tools like Impulse Therapy, an online OCD treatment program, designed to help you better manage your OCD symptoms, so they do not get out of control, hypnosis, finding hobbies, and journaling can help you keep your OCD symptoms at bay, so you can have a healthy and happy life.

References

• Fenske, J. N., & Petersen, K. (2015). Obsessive-compulsive disorder: Diagnosis and management. American Family Physician, 92(10), 896–903. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26554283/
• National Institute of Mental Health. (n.d.). Obsessive-compulsive disorder (OCD). Retrieved from https://www.nimh.nih.gov/health/statistics/obsessive-compulsive-disorder-ocd
• Adams, T. G., Kelmendi, B., Brake, C. A., Gruner, P., Badour, C. L., & Pittenger, C. (2018). The role of stress in the pathogenesis and maintenance of obsessive-compulsive disorder. Chronic Stress, 2. Retrieved from https://doi.org/10.1177/2470547018758043
• Sansone, R. A., & Sansone, L. A. (2010). Obsessive-compulsive disorder: Over and over. Relias Media. Retrieved https://www.reliasmedia.com/articles/20719-obsessive-compulsive-disorder-over-and-over