Obsessive-compulsive disorder comes with a set of unique challenges, including racing thoughts, a shifting sense of sameness, and rituals. The combination of these symptoms spiral into unhealthy habits. And it’s these habits that cause OCD to get worse.

What is OCD?

Obsessive-compulsive disorder (OCD) causes anxious and intrusive thoughts followed by ritualistic behaviors to relieve anxiety. ¹ According to the International OCD Foundation, an estimated 2-3 million American adults struggle with the condition. 

Ritualistic actions are meant to bring you a sense of calm. ² However, this relief is often short-lived and followed by more intrusive thoughts. As such, this can lead to several OCD symptoms, including perfectionism and over-cleanliness.

OCD is commonly treated with a mixture of: ³

• Behavioral therapy
• Medication (such as antidepressants)
• Talk therapy

This combination is meant to help relieve intrusive thoughts and thereby reduce compulsive behaviors.

What Causes OCD Symptoms to Get Worse?

While researchers aren’t sure what causes OCD, they have determined triggers that make OCD worse. Symptoms are often compounded by triggers. Therefore, it’s in your interest to identify triggers to relieve yourself of symptoms.

These are some of the most common triggers that cause OCD to get worse:

1.) Stress

Stress is one of the reasons OCD symptoms exist. When you’re stressed about an intrusive thought (i.e. contamination), you compulsively act to get rid of that thought (i.e. ritual cleanings).

When stress goes unchecked, it can cause negative physical and emotional responses. In the case of those with OCD, it can send intrusive thoughts out of control. ⁴

One of the methods of OCD treatment is to find stress control measures. Coping mechanisms will look different for everyone. For example, you may find breathing exercises to help calm you down. Whereas, someone else may practice meditation daily to ease thought processes.

2.) Contamination

Wanting to be clean isn’t necessarily a bad thing. However, when contamination becomes a phobia, it can lead to unhealthy behaviors. ⁵

When we consider OCD, we often associate it with a person compulsively cleaning. That’s because contamination phobia is common for those with the condition. In fact, this is a prime example of how OCD is a type of anxiety disorder – your intrusive thoughts have made you fear contamination.

If you frequently wash your hands or excessively clean, you’re only worsening your OCD. What you’re doing is allowing triggers to get the best of you. Likely under the assumption that the cleaner you are, the more your anxiety will be relieved. However, such behaviors will only continue to spiral.

3.) Self Worth/Perfectionism

We all are aware of our self-image and a desire to perfect it. However, if you have OCD, you may struggle with major issues with your self-image. More specifically, you may be so much of a perfectionist that your lack of perfection determines your self-worth. ⁶

This destructive pattern is marked by negative thoughts concerning oneself. Naturally, such thoughts can get in the way of daily life and may lead to other mental health issues, such as depression. ⁷

You need to develop realistic expectations of yourself. To take a step back and ground yourself from what may be an inflated ego. ⁸ Nobody is perfect and the idea of attaining perfection is impossible.

4.) Losing Control Over Situations

OCD makes you want to take control of every situation. ⁹ However, as you already know, you don’t have control over many things.

The need for control can be even more taxing if that situation is directly tied to a compulsion or obsession. For example, let’s say you’re a perfectionist and believe your career advancement indicates your self-worth. If you don’t get this career advancement (as it’s out of your control), it can trigger other ritualistic behaviors to “perfect” yourself.

Final Word

The natural cycle of OCD’s obsessions and compulsions makes it difficult to break triggers. However, if you can identify your triggers, you can take the steps to diminish them.

We recommend consulting your healthcare provider. They will provide you with medication that can help ease anxiety and psychotherapies to help address obsessions. From there, you can develop healthier lifestyle changes to prevent the OCD cycle from spiraling out of control.

References

¹ Brock H, Rizvi A, Hany M. Obsessive-Compulsive Disorder. 2024 Feb 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 31985955.

² Bond RW Jr, Guastello SJ, Guastello AD. Temporal Dynamics of Rituals in Obsessive Compulsive Disorder. Nonlinear Dynamics Psychol Life Sci. 2017 Apr;21(2):159-188. PMID: 28302189.

³ Goodman WK, Storch EA, Sheth SA. Harmonizing the Neurobiology and Treatment of Obsessive-Compulsive Disorder. Am J Psychiatry. 2021 Jan 1;178(1):17-29. doi: 10.1176/appi.ajp.2020.20111601. PMID: 33384007; PMCID: PMC8091795.

⁴ Raposo-Lima C, Morgado P. The Role of Stress in Obsessive-Compulsive Disorder: A Narrative Review. Harv Rev Psychiatry. 2020 Nov/Dec;28(6):356-370. doi: 10.1097/HRP.0000000000000274. PMID: 33027102.

⁵ Rachman S. Fear of contamination. Behav Res Ther. 2004 Nov;42(11):1227-55. doi: 10.1016/j.brat.2003.10.009. PMID: 15381436.

⁶ Coles ME, Frost RO, Heimberg RG, Rhéaume J. “Not just right experiences”: perfectionism, obsessive-compulsive features and general psychopathology. Behav Res Ther. 2003 Jun;41(6):681-700. doi: 10.1016/s0005-7967(02)00044-x. PMID: 12732376.

⁷ Tibi L, van Oppen P, van Balkom AJLM, Eikelenboom M, Rickelt J, Schruers KRJ, Anholt GE. The long-term association of OCD and depression and its moderators: A four-year follow up study in a large clinical sample. Eur Psychiatry. 2017 Jul;44:76-82. doi: 10.1016/j.eurpsy.2017.03.009. Epub 2017 Apr 7. PMID: 28545012.

⁸ Chamberlain SR, Solly JE, Hook RW, Vaghi MM, Robbins TW. Cognitive Inflexibility in OCD and Related Disorders. Curr Top Behav Neurosci. 2021;49:125-145. doi: 10.1007/7854_2020_198. PMID: 33547598.

⁹ Sandstrom A, Krause S, Ouellet-Courtois C, Kelly-Turner K, Radomsky AS. What’s control got to do with it? A systematic review of control beliefs in obsessive-compulsive disorder. Clin Psychol Rev. 2024 Feb;107:102372. doi: 10.1016/j.cpr.2023.102372. Epub 2023 Dec 5. PMID: 38091769.