Coping And Getting Over Harm OCD

Obsessive-compulsive disorder (OCD) affects around 1%¹ of the U.S. population. There are many possible obsessions (uncontrollable, reoccurring thoughts) and/or compulsions (behaviors) that can affect people with OCD. The most common of them are contamination, symmetry, checking, and harm.

Harm OCD causes the person to worry about inflicting harm on others, either accidentally or when acting on an involuntary impulse. Living with this type of OCD is frustrating and debilitating. Thankfully, its symptoms can be managed.

Let’s take a closer look at living and coping with harm OCD.

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We make it easy for you to participate in a clinical trial for Obsessive compulsive disorder (OCD), and get access to the latest treatments not yet widely available - and be a part of finding a cure.

What is harm OCD? 

Harm OCD² is a common form of traditional obsessive-compulsive disorder. People who live with harm OCD have thoughts about various ways they could hurt other people. They feel upset and guilty about having these thoughts and worry about the possibility of acting upon them.

Many people have thoughts about inflicting damage on themselves or others. For example, when you are mad at someone for cutting you off in traffic or being rude to your child, you could think about hurting them. Sometimes, you may also look out of the window and wonder, “What will happen if I jump?”

In people who don’t have OCD, these thoughts are fleeting. They pass quickly, allowing you to continue with other tasks. In an hour or two, you may not even remember having these thoughts. You are also highly unlikely to feel guilty about having them.

When people with harm OCD have the same thoughts, however, it becomes nearly impossible to let them go. They start worrying about these thoughts, the reasons behind them, and the possibility of acting on them. Eventually, these intrusive thoughts become unbearable.

To deal with such thoughts, the person may try to engage in compulsions and rituals to decrease the anxiety and get some assurance that they won’t act on the thought. When they complete the ritual, people with OCD may feel some relief until the thought comes back.

If not addressed properly, harm OCD causes a person to constantly live in doubt and fear. This prevents them from leading a normal life.

What triggers harm OCD?

Scientists are yet to find out what causes harm OCD. The main theories include:

  • Biological — it may happen due to some changes to your body’s chemistry and brain functions

  • Genetic — if a family member has it, you’re more likely to get it, too

  • Acquired — you may learn obsessive fears and compulsive behaviors from watching people around you who live with the condition

  • Environment — environmental factors could also play a role in developing OCD

OCD usually starts before you reach 25 years of age.³ However, the first symptoms may occur in your childhood or adolescence. While it affects men and women equally, OCD often manifests itself earlier in men. Harm OCD can also occur in women⁴ during the postpartum period.

What are the symptoms of harm OCD?

The symptoms of harm OCD usually are:

  • Fearing thoughts that you may cause harm to yourself or other people (accidentally or purposely)

  • Excessive worrying about such thoughts and trying to analyze them extensively

  • Feeling guilty about having thoughts of harming someone

  • Compulsive actions aimed at avoiding the risk of causing harm to yourself or others

Harmful thoughts can vary from person to person. They could be related to almost anything. For example, a person may worry about stabbing someone with a knife or running them over with their car. Other people worry about sexual actions, such as inappropriately touching a child.

Other common harm OCD obsessions include:

  • Fear of hurting a loved one because you aren’t being careful enough (e.g., dropping something heavy)

  • Anxiety about possibly committing a violent act

  • Fear of accidentally giving in to a violent urge

  • Fear of committing suicide to avoid hurting someone

  • Worry that someday you could lose control and harm someone without even knowing about it

When people with harm OCD worry about their violent thoughts becoming a reality, they come up with compulsive actions that help relieve the anxiety. 

These compulsions include:

  • Checking yourself and others to make sure you didn’t cause any harm

  • Trying to avoid people and situations that could trigger violent thoughts

  • Asking others to control you to make sure you don’t cause any harm

  • Constantly trying to remember what happened earlier in the day to make sure you didn’t harm anyone

  • Avoiding objects that you could use to hurt someone (e.g., knives, guns, sharp objects)

  • Avoiding activities that may be harmful (e.g., driving a car)

People who live with harm OCD have an impaired quality of life. Their social functioning and ability to perform at work can worsen significantly.

The onset of OCD is often gradual. However, for some people, it can start suddenly. Symptoms of OCD generally worsen with age, reducing the quality of life even further.


People who live with OCD are at a high risk of developing a variety of coexisting conditions, including:

  • Major depression

  • Social phobia

  • Eating disorder

  • Simple phobia

  • Panic disorder

  • Tourette’s syndrome

According to research,⁵ some of the most common comorbid conditions that affect people with OCD are major depressive disorder and generalized anxiety disorder. 

Treatment for harm OCD 

Treatment for harm OCD is usually comprehensive. It can include therapy, medication, and family support.

Cognitive-behavioral therapy (CBT) 

CBT consists of several therapy strategies. One of them is called exposure and response prevention (ERP). ERP is a highly effective treatment for people who live with OCD.

ERP involves confronting harmful thoughts and situations that make you worry in a safe environment. The therapist teaches you to deal with the thought without giving in to compulsive behavior.

With time, you learn how to avoid anxiety related to harm OCD triggers. Eventually, you get used to the problem and figure out how to accept the obsession instead of trying to deal with it. This reduces stress, prevents compulsive behavior, and allows you to lead a normal life.

According to studies, around 50%⁶ of people with OCD achieve excellent results with ERP alone or when combined with medication. Others may achieve moderate results or might not benefit at all.  


Research shows that the most effective drugs for OCD are Serotonin Reuptake Inhibitors (SRIs).⁷ They are usually used as antidepressants but are effective in the treatment of OCD. 

The common SRIs that your doctor may prescribe for harm OCD are:

  • Citalopram (Celexa)

  • Clomipramine (Anafranil)

  • Escitalopram (Lexapro)

  • Fluvoxamine (Luvox)

  • Fluoxetine (Prozac)

  • Paroxetine (Paxil)

  • Sertraline (Zoloft)

  • Venlafaxine (Effexor)

All of these drugs have side effects. That’s why it’s imperative to discuss the treatment with your doctor and follow their advice carefully. Around 50%⁸ of people with OCD stop taking SRIs due to their side effects or for other reasons.

Patients report good to moderate improvement after taking SRIs for about 8 to 12 weeks.⁹ The maximum benefit may take up to 6 months to achieve. Around 60% of people experience at least some improvements on their first try taking an SRI.

It’s worth noting that not all antidepressants can help with OCD. However, if major depression is comorbidity, other types of antidepressants may be prescribed.

Family support 

Research shows that the way family members respond to a loved one’s OCD symptoms may fuel compulsive behavior. For example, they could help a person with harm OCD hide knives and other sharp objects. Or they may offer to drive the person somewhere so as not to trigger worrisome thoughts about driving.

To help a family member with OCD, it’s important not to encourage their behavior but:

  • Help them find the right therapist

  • Offer encouragement through the treatment process

  • Attend a support group

By creating a supportive environment, you can help a family member achieve better results with ERP and drug therapy.

Studies show that it takes people with OCD between 14 to 17 years from the time symptoms begin to get professional treatment. The lack of awareness coupled with the difficulty of finding experienced therapists and the inability to afford proper treatment causes patients to avoid help.

Admitting that you have a problem is the first step toward improving your quality of life and learning how to deal with obsessive harmful thoughts. Contact your primary care physician as soon as you experience any of the symptoms.

Frequently asked questions (FAQ)

Are people with harm OCD good people?

People who live with harm OCD don’t want to harm anyone. The opposite is true; they do everything possible to avoid causing harm. This worry about hurting others turns into an obsession.

Can you live with harm OCD?

With the right treatment, you can live with harm OCD without hindering your quality of life. Unfortunately, it takes people years to admit the problem and get professional treatment. If you or your loved ones have harm OCD symptoms, get help as soon as possible.  

Does harm OCD ever go away?

Many people who get professional medical treatment learn to live with harm OCD. While the condition may not go away entirely, its symptoms can decrease significantly.

What does harm OCD look like?

People who have harm OCD may engage in rituals that help them ease the worrisome thoughts about causing harm. For example, they could hide sharp objects or avoid driving a car. Some of these rituals may not be obvious to others.

What is the best diet for OCD?

Diet could play a role in managing OCD.¹⁰ While more research needs to be done, a diet that stimulates serotonin (chemical messenger that can stabilize your mood) production could help. This includes protein-rich foods, such as turkey, chicken, milk, and eggs.

Can OCD make you violent?

Some forms of OCD could cause aggressive and violent behavior. However, people who live with harm OCD usually just worry about being violent instead of actually acting on their thoughts.

Does OCD get better with age?

With age, symptoms of OCD usually worsen. However, they can be controlled with the right treatment. The earlier you start treating OCD, the faster you can improve your quality of life.

Is harm OCD a mental illness?

Harm OCD is a mental health disorder.

Are violent intrusive thoughts normal?

Fleeting violent thoughts are normal. However, when they become intrusive and interfere with your life, it could be a symptom of harm OCD.

The lowdown 

Harm OCD is a subset of obsessive-compulsive disorder characterized by excessive worries about harming other people. It’s possible to control harm OCD with CBT, medication, and proper family support.

If you or your loved ones live with harm OCD, don’t delay treatment. Seeking help can significantly improve your quality of life.

Have you considered clinical trials for Obsessive compulsive disorder (OCD)?

We make it easy for you to participate in a clinical trial for Obsessive compulsive disorder (OCD), and get access to the latest treatments not yet widely available - and be a part of finding a cure.

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