What Causes OCD To Get Worse?

Obsessive-compulsive disorder (OCD) is a mental health condition that causes compulsive behavior and uncontrollable obsessions. According to the American Psychiatric Association (APA), 2–3% of Americans have OCD.

If not addressed, unwanted obsessions and thoughts become more challenging to manage due to their repetitive nature. As a result, you may be unable to maintain close relationships or perform duties, reducing your overall quality of life.

The first step to preventing OCD from progressing further is to understand how it works. This article examines what causes OCD to worsen over time, common symptoms, and preventive measures.

Common symptoms of OCD

OCD manifests itself in two ways — as obsessions and compulsions. For some people, it starts with addictions and progresses to compulsion symptoms, while others experience only obsession or compulsion symptoms:

Obsession symptoms

Obsessions are repetitive, persistent unwanted thoughts, images, and urges that cause distress and anxiety. When you have obsessive tendencies, you recognize your obsessions and try to escape them through compulsive behavior.

Obsessive symptoms include:

• Fear of contamination by people or dirt

• Fear of losing control (hurling insults), especially in public

• Aggressive images or sexual thoughts

• Wanting things in a certain symmetry, order, or precision

• Repetitive thoughts of obscene images, sounds, words, or numbers

• Fear of discarding essential items

Compulsion symptoms

Compulsions come from the repetitive actions you feel obliged to perform whenever an obsession takes over your thought process. These actions or mental acts offer temporary relief from any anxiety or distress caused by the unwanted thoughts. However, in some cases, compulsive actions can be unrelated to an obsession.

Common signs of compulsion include:

• Excess hand washing, brushing teeth, or showering

• Cleaning household objects repeatedly

• Arranging and rearranging things in a specific manner

• Checking locks, appliances, and switches repeatedly

• Counting up to a particular number or repeating a phrase

Factors that cause OCD to get worse over time

OCD symptoms have been known to intensify over time, begging the question: What causes OCD to get worse? The short answer is comorbidities. These are mental health conditions that trigger and aggravate OCD symptoms.

Research¹ shows that most people with OCD struggle with some other type of mental health condition. When these conditions remain untreated, they increase anxiety and distress, causing OCD behaviors to increase. Such conditions include:

• Anxiety disorders

• Mood disorders

• Impulse control disorders

• Social anxiety disorder

• Attention deficit hyperactivity disorder (ADHD)

• Substance abuse disorders

• Major depressive disorder

Even though comorbidities impact OCD symptoms, it's hard to predict when, how, or if they will worsen. Everyone's OCD symptoms are different, and there are many subtypes that you can't track in their specific categories. Even so, as OCD symptoms worsen, you may begin to experience:

• Problems focusing

• Increased panic attacks

• Isolation 

• Failure at work or school

• Depression

• Harmful thoughts of committing suicide

• Emotional, physical, and mental exhaustion

How to prevent OCD from worsening

Managing OCD is much easier once you understand what causes it to worsen. Preventive measures can vary depending on the stage of the OCD cycle you're in. These include:

Therapy or medication

OCD medication and therapy, or a combination of the two, helps contain OCD symptoms to a manageable level. During the cognitive behavioral therapy session, a mental health professional uses a strategy known as exposure and response prevention (ERP). 

ERP is effective in managing mild to severe cases of OCD. This therapy exposes you to the root cause of your OCD, often something you fear or wish to avoid, to help improve your resistance to the trigger/s.

Manage triggers

Stress, anxiety, and worry are the common aggravators that consume you with obsessive and unwanted thoughts. Once you know what triggers your OCD, you can take the appropriate steps to avoid them before they happen. 

Some of the recommended OCD coping strategies include:

Control stress levels

Try to engage in activities that elevate your mood or help manage stress. These include yoga, working out, meditating, and eating healthy food. The less stress you have, the easier it is to manage your OCD symptoms.

Don't focus on blocking out thoughts

Constantly thinking of ways to prevent your OCD only intensifies your symptoms. Instead, channel your energy and focus on other activities.

Avoid seeking reassurance

Seeking validation from others or yourself is an OCD symptom. So, avoid reassurance-seeking and focus on embracing what's to come, regardless of the outcome. 

Develop a "the worst has already happened” mental attitude.

Let go of perfectionism

Everyone strives to be the best in life, which can sometimes become an obsession. Perfection doesn't exist and seeking it only increases your OCD. It is good to remember that no one is perfect, and perfection doesn't always mean progress.

Get medical treatment

If your OCD symptoms become severe, even after therapy and trigger management, the next reasonable step is to see a doctor. While surgical OCD treatments are rarely recommended due to the significant risks involved in the procedure, deep brain stimulation² is the last line of options for severe cases.

The doctor implants lead into the brain during the surgery, stimulating specific parts to regulate abnormal activities. This process also works for Parkinson's disease and people with epilepsy.

The lowdown

There you have it. You have your answer if you've been wondering what causes OCD to get worse. OCD symptoms usually start as habits and continuously grow to become erratic behavior. Aggravators of OCD can vary from stress to anxiety and other mental health conditions. As such, it is essential to seek therapy, manage triggers and see a doctor if symptoms worsen.

Frequently Asked Questions (FAQs)

Can OCD be diagnosed?

Yes. A physical exam can diagnose OCD to rule out medical conditions that might explain symptoms and a psychological assessment as early as 19.

What foods can help with OCD?

Nuts, seeds, protein, like eggs or meat, and any type of vitamin D-rich food can help with OCD.

Where can I get help for OCD?

If you're feeling too overwhelmed by your OCD symptoms, contact the International OCD Foundation³ or The Anxiety and Depression Association of America⁴ for help.

Does OCD worsen with age?

OCD symptoms worsen with age. When this happens, people have a hard time remembering when the symptoms started manifesting.