What Is Suicidal OCD?

Obsessive-compulsive disorder¹ (OCD) is one of the most disabling² mental health conditions. It causes obsessive thoughts and compulsive behaviors. If you or someone you love has OCD, you know the daily struggles the disorder brings with work, school, and maintaining relationships. 

OCD also has numerous subtypes, including suicidal OCD, which causes unwanted thoughts or impulses related to ending your life. Surprisingly, this comes from a desire to protect yourself rather than end your life. Nonetheless, it can produce alarming thoughts and symptoms.

This article explains what suicidal OCD is and how doctors diagnose and treat it.

What is suicidal OCD?

OCD causes obsessive thoughts, usually related to fear. Some people with OCD fear dirt and germs, while others fear harming their loved ones. Those obsessions lead to compulsive behaviors in an attempt to escape the fixations or resolve the feelings they cause.

Compulsions may include excessive hand washing, placing objects in a specific fashion, or physical gestures, like tapping or blinking. 

Suicidal OCD is a subtype of OCD that creates obsessions about killing yourself. These obsessions don’t mean you necessarily want to end your life. Most people with this condition are terrified of killing themselves and don't want to do it. This fear prompts obsessive thoughts about suicide.

Someone with suicidal OCD may struggle with unwanted impulses or thoughts about jumping out of a window several stories above the ground. They may feel increased anxiety whenever they are near a window at a certain height, fearing they will impulsively jump out. They may back away immediately and avoid going near windows at great heights. 

If you have obsessive thoughts about harming yourself with a knife, you may remove all sharp objects from your home to feel safe. 

How is suicidal OCD different from suicidal ideation?

Suicidal obsessions are unwanted, intrusive thoughts or fears about suicide. People with suicidal OCD don't want to die, so these thoughts can be distressing.

If you have suicidal OCD, you may use compulsions to eliminate your obsessive thoughts about suicide and reduce self-harm impulses.

Suicidal ideation is the intent to end your life deliberately. If you have suicidal ideation, you may not have a suicide plan but think about ending your life. Unlike suicidal OCD, these thoughts may provide you with a sense of relief rather than fear or dread. 

How is suicidal OCD diagnosed?

A doctor or therapist can diagnose suicidal OCD after a physical exam and evaluation to learn more about your symptoms and their impact on your daily life.

Diagnosing suicidal OCD can be challenging for healthcare practitioners as they must notice the difference between someone who wants to end their life and someone battling unwanted, obsessive thoughts about it. It is especially hard for children who end up on suicide watch when they don't want to kill themselves but need treatment for suicidal OCD instead. 

OCD often occurs with other mental health conditions or psychiatric disorders. Your doctor may refer you to a specialist for further evaluation and treatment options to get you feeling better. 

Is recovery from suicidal OCD possible?

Yes, recovery from suicidal OCD is possible. A few treatment options can help you overcome obsessive thoughts and redirect when you feel your mind going down a negative spiral. Such treatment options include:

Cognitive behavior therapy (CBT)

CBT is an evidence-based and effective treatment for OCD. CBT is a type of psychotherapy that involves discussing your thoughts and feelings with a trained therapist.

You and your therapist can figure out strategies to shift your mind when you feel obsessions coming on, and they may ask you questions to help you understand where your fears stem from. 

Your therapist may recommend integrating exposure and response prevention (ERP) therapy, which allows you to gradually face your fears to overcome the anxiety they produce.

For example, your therapist could encourage you to step closer and closer to a high window while using coping strategies to ease the anxiety that may arise. It can take some time to feel the effects of CBT, but many people begin to respond after just a few sessions. 

Medication

Some medications can control OCD symptoms, and most doctors recommend starting with antidepressants like sertraline or fluoxetine. It usually takes a few weeks to feel them working, and finding the right drug and dosage can take time. 

If you don't feel a difference or feel worse after six weeks on the medication, your doctor may recommend increasing your dosage or trying something different. If you decide you don't want to stay on an antidepressant, talk to your doctor. Suddenly stopping antidepressants can be dangerous, produce negative side effects, and make you feel worse. 

Support groups

Because OCD can disturb everyday life, many people with the condition feel isolated from friends and family members who haven't had the same experiences. Support groups³ bring together people with OCD to discuss how it impacts their lives and to share helpful strategies.

Your doctor or therapist may be able to refer you to a support group for OCD in your area, or you can search for support groups that focus specifically on suicidal OCD. 

When to see a doctor

If you believe you are suffering from suicidal OCD, it may be helpful to speak with a doctor about your symptoms. Your doctor can help you rule out other possible conditions, provide the correct diagnosis, and set you on a path toward recovery.

If you believe you have suicidal ideation, speaking to your doctor may be beneficial. You can also call the Suicide Prevention Lifeline⁴ 24/7 for free if you are struggling with suicidal thoughts. 

The lowdown

If you or a loved one are struggling with suicidal OCD, speak with a doctor about your symptoms. Learning more about the condition can help you cope and improve your quality of life. Suicidal OCD can feel overwhelming, but it is treatable. Don’t be afraid to ask for help.