Living With Someone With OCD: How You Can Help

OCD is an extremely challenging disorder, and opinions on how partners, friends, and relatives can help may vary. Some suggest setting limits on how much time is spent discussing the disorder or establishing OCD-free times, such as agreeing not to discuss OCD during dinner.

This may be helpful for some families, but it shouldn’t become a demand for the person with OCD to simply “act normal.” OCD can be extremely consuming, and even when someone manages to hide their symptoms for a while, the thoughts and anxiety may still be there. A better goal is to keep OCD from taking over the entire household while still acknowledging what the person is going through.

Another important point is not to get distracted by everything you find on the Internet. With a little research, you may come across “natural” OCD fixes involving diet changes, supplements, meditation, or other approaches. There are still many aspects of OCD that aren’t completely understood, but giving up well-established treatments in favor of a questionable diet or alternative treatment could be a big mistake.

This doesn’t mean your loved one can’t experiment with healthy lifestyle changes if they want to. However, these approaches shouldn’t replace appropriate treatment, and you shouldn’t encourage someone to stop prescribed medication without discussing it with the healthcare professional who prescribed it.

OCD is also associated with an increased risk of suicidal behavior. A large Swedish study found that people diagnosed with OCD had a substantially higher risk of both suicide attempts and death by suicide compared with matched people in the general population. This is another reason why severe or worsening OCD should be taken seriously.

Make sure the person with OCD is getting help from someone who is properly qualified to treat the disorder. Although primary care physicians can play an important role, OCD treatment may require someone specifically trained and experienced in treating it, such as:

• a psychiatrist,
• a psychologist,
• or another mental health professional trained in OCD treatment.

“You really want to make sure that this person has an adequate experience because treatment and evaluation requires a lot of training,” says Dr. Wayne K. Goodman.

A lot of times, people simply assume that a certain behavior, such as becoming angry or anxious when the house is messy, is OCD, but in reality that may not be the case. Getting a proper diagnosis is the first step toward getting the right kind of help.

One of the most effective psychological treatments for OCD is cognitive behavioral therapy that includes exposure and response prevention, usually called ERP. During ERP, a person gradually faces situations that trigger obsessive fears while learning not to perform the compulsions they would normally use to reduce their anxiety.

Family members can sometimes be involved in this process, but ideally this should be done according to a treatment plan rather than by trying to convince the person that their fears are irrational.

For example, if your loved one is afraid of germs, repeatedly explaining that something is clean or proving that other people touch the same object without getting sick may provide temporary relief, but it can also become another form of reassurance. If they keep returning for certainty, answering the same question again and again may unintentionally become part of the OCD cycle.

Instead, you can support them in tolerating uncertainty and resisting the compulsion, particularly if this is part of the approach they are working on with their therapist.

If your loved one keeps replaying an unpleasant memory or trying to remember long-forgotten details with complete certainty, it may be useful to learn about the phenomenon of false memories and the work of Dr. Elizabeth Loftus.

However, be careful not to turn this information into another form of reassurance. With OCD, repeatedly trying to prove exactly what happened can sometimes become part of the problem. The goal is not always to obtain perfect certainty, but to become better able to tolerate not knowing every detail.

Learning about exposure and response prevention and reading about other people’s experiences with treatment may also make the process feel less mysterious and give your loved one some hope before they begin therapy themselves.

One of the most important things you can do is avoid becoming involved in the person’s compulsions. This is known as family accommodation. It might mean cleaning something repeatedly for them, checking doors or appliances, helping them count, changing your own routine to avoid their triggers, or providing the same reassurance over and over again.

This can be one of the hardest things to change because helping with a compulsion often makes the person feel better in the moment. Unfortunately, that temporary relief can reinforce the OCD cycle.

That doesn’t mean suddenly refusing every request without warning. It is often better to agree in advance on what you will and won’t participate in and, when possible, follow the plan recommended by the person’s OCD therapist.

Finally, don’t forget about yourself. Living with someone with severe OCD can be exhausting and can affect your own mental health and well-being. It can be particularly difficult when the person with OCD is your life partner or someone you would normally lean on during hard times.

When OCD is severe, so much of the person’s attention and energy may be taken up by obsessions and compulsions that they have less emotional energy available for the people around them. Meanwhile, you may find yourself carrying responsibilities you never expected to carry.

Look for ways to support yourself as well. Perhaps you need to spend more time with friends and family, exercise, maintain your own hobbies, or talk to a counselor who can listen to you and help you deal with the situation. Looking after yourself isn’t separate from helping your loved one. It makes it easier for you to remain supportive without allowing OCD to take over your life too.

Strategy Review

• Make sure the person with OCD is getting help from someone who understands the disorder and has experience treating it.
• Help them get appropriate treatment as soon as possible. Earlier treatment can prevent OCD from becoming even more disruptive.
• Healthy lifestyle changes can be used alongside treatment, but they shouldn’t replace evidence-based treatment or prescribed medication without professional guidance.
• Learn about OCD so you can understand what is happening without becoming another source of reassurance.
• Learn about ERP and encourage your loved one to work with someone who is trained in this type of treatment.
• Avoid participating in compulsions, excessive reassurance, and other forms of family accommodation. When possible, reduce these behaviors according to an agreed treatment plan.
• Take care of your own mental and physical well-being too.