Supporting Someone With Obsessive-Compulsive Disorder
Obsessive-compulsive disorder (OCD) is a mental health condition that involves unwanted, distressing thoughts or urges (obsessions), and repetitive mental or physical acts that a person feels the need to do (compulsions). When a person has OCD, the condition can affect others, such as friends and family members. Friends and family can help by offering support and understanding.
How does this condition affect the person I am supporting?
A person with OCD may experience obsessions, compulsions, or both. The person may try to ignore obsessions, or may try to stop or undo the obsessions with a compulsion such as a ritual. The compulsive acts may seem senseless or excessive to you. The person with OCD may think that acting on compulsions will reduce or prevent discomfort, but compulsions do not have this effect.
Examples of common obsessions include:
Fear of contamination with germs, waste, or poisonous substances.
Fear of making the wrong decision.
Violent or sexual thoughts or urges toward others.
Need for symmetry or exactness.
Examples of common compulsions include:
Excessive handwashing or bathing due to fear of contamination.
Checking things again and again to make sure tasks are finished, such as making sure a door is locked or a toaster is unplugged.
Repeating an act or phrase again and again, sometimes a specific number of times, until it feels right.
Arranging and rearranging objects to keep them in a certain order.
Having a very hard time making a decision and sticking to it.
Obsessions and compulsions can be time-consuming and can interfere with personal relationships and usual activities at home, school, or work. OCD usually starts in young adulthood and continues throughout life. Many people with OCD also have depression or another mental health condition.
What do I need to know about the treatment options?
OCD may be treated with:
Behavioral therapy. Exposure and response prevention therapy is used to target and reduce compulsive behaviors. It involves exposing the person with OCD to things or situations that cause obsessions to start (triggers), then preventing the person from carrying out the compulsions. This is considered to be the most effective treatment for OCD.
Cognitive behavioral therapy (CBT). This type of therapy teaches a person how to identify irrational thoughts that are associated with obsessions, and how to replace those thoughts.
Electrical stimulation of specific areas of the brain. Examples include deep brain stimulation (DBS) or transcranial direct current stimulation (tDCS).
Antidepressant medicine. Medicine is most effective when it is used along with therapy.
Self-soothing methods, such as meditation, yoga, or muscle relaxation exercises.
What actions can I take to help someone with OCD?
Talk about the condition
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Ask what the person with OCD goes through when experiencing obsessions, and what the person intends for the compulsions to achieve. Try to understand the person's experience.
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Remember that OCD is a mental health condition, not a personal flaw. The person with OCD cannot change quickly or change just because you tell the person to do so.
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Be supportive when discussing symptoms. Do not direct anger or frustration toward the person.
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Communicate clearly, in simple terms. For example, if the person with OCD asks about locking the door, respond simply with "yes" or "no." Explaining too much can cause greater stress, and too much reassurance can make the person's rituals worse.
General support
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When the person with OCD is experiencing doubt and asks for reassurance, remind the person that the uncertainty or anxiety is caused by the OCD. Do not give the reassurance when asked for it. Doing that can make the anxiety worse next time, and needing your reassurance may become part of the ritual. Be supportive but firm.
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Make an effort to learn all you can about OCD.
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Help the person with OCD follow the treatment plan as directed by health care providers. This could mean driving the person to therapy sessions or suggesting ways to manage stress.
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Encourage the person with OCD and avoid pushing the person too much. Stress can make symptoms worse.
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Make sure that you and the person with OCD have opportunities for alone time.
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Do not join the person with OCD in rituals. You can provide support and encouragement while still being clear that the person's rituals are not productive.
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Consider making an agreement with the person who has OCD that gives specific directions about where or when OCD symptoms are allowed, and when they are not allowed. This can help to make it clear to the person that symptoms can be contained.
Taking care of yourself
It is important to find ways to care for your body, mind, and well-being while supporting someone with OCD.
Make time for activities that help you relax.
Consider joining a support group or going to therapy for yourself.
Consider trying meditation and deep breathing exercises to lower your stress.
Get plenty of sleep, eat a healthy diet, and exercise regularly.
Where to find support
A health care provider may be able to recommend mental health resources that are available online or over the phone. You could start with:
Substance Abuse and Mental Health Services Administration (SAMHSA):
www.samhsa.gov
Consider joining self-help and support groups, not only for the person with OCD, but also for yourself. People in these peer and family support groups understand what you and the person with OCD are going through. They can help you feel a sense of hope and connect you with local resources to help you learn more.
Get help right away if you feel like the person with OCD may hurt himself or herself or others, or if he or she has thoughts about taking his or her own life. Go to your nearest emergency room or:
Summary
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A person with OCD may experience obsessions, compulsions, or both.
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Therapy, medicine, and self-soothing methods may be used to treat OCD.
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Be supportive and encouraging when discussing symptoms with the person who has OCD. However, do not encourage the rituals.
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Make time to relax and care for yourself.
This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.
