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What Causes OCD to Get Worse? Unpacking the Factors

This article will educate readers about the factors contributing to the worsening of OCD symptoms, offer guidance on managing and preventing such escalation, and explain why and when to seek appropriate help and support.


OCD, or obsessive-compulsive disorder, is a mental health condition that manifests in the form of obsessions and compulsions. These represent intrusive and uncontrollable thoughts or behaviors, things that have to be repeated regularly to give individuals a sense of control.

OCD is an ever-evolving mental health condition, and it has the potential for symptoms to intensify over time. Can OCD get worse? Yes.

ocd getting worse

What causes OCD to get worse?

What makes OCD worse?

Several things make OCD worse, and they can affect you at different times in your lifetime. Research is unsure about the pathophysiological relationship between OCD symptoms and things like external stress, but preclinical research has nonetheless demonstrated a relationship between the two, with a better understanding of the fact that stress or acute traumatic incidents can make OCD worse.

External stressors

Several external stressors qualify as things that make OCD worse.

  • Exposure to trauma or developing PTSD after a traumatic event can significantly exacerbate OCD symptoms.
  • Significant change can result in worsening OCD symptoms.
  • Experiencing significant loss like that of a loved one might lead to OCD getting worse.

In this context, things that make OCD worse can include starting a new job or moving to a new city. Something like picking up and moving to a new location where you don’t have any friends, family, or lay of the land can increase stress, anxiety levels, fear, depression, and OCD symptoms.

Similarly, external stress from exposure to trauma, either directly or indirectly, as well as the loss of a loved one, involvement in a car accident, or being in a natural disaster, can make OCD worse.

Note: Exposure to traumatic events can actually lead to the onset of OCD symptoms, especially compulsions, in an attempt to control an uncontrollable environment.

Biological factors

What causes OCD to get worse? Several biological factors can make symptoms of your condition suddenly feel overwhelming and out of control.

  • Genetics and hereditary factors can lead to worsening OCD symptoms.
  • Hormonal changes can influence symptoms as well.

For example, some people might notice OCD getting worse during menstruation, as a result of pregnancy, or during menopause.


The impact of avoidance behavior

Avoidance behavior can also exacerbate symptoms of OCD. Avoidance behavior refers to any situation or circumstance where an individual with OCD avoids acknowledging their condition or even the fact that they are struggling with obsessions or compulsions.

This can result in complete denial and repression and exacerbate symptoms. With OCD, there are three categories of severity, and the longer an individual struggles with avoidance behavior, the more likely it is that their severity will move from realizing that they have OCD and that sometimes their thoughts or actions are not founded in truth to believing that they are.

Substance abuse

Substance abuse impacts brain function and can significantly disrupt communication between neurons and function between the brain and the rest of the body. Substance abuse, if left untreated, can exacerbate OCD symptoms and even lead to secondary mental health conditions.

Coexisting mental health conditions

Tangentially, coexisting mental health conditions can make OCD symptoms worse. Some of the most common coexisting mental health disorders include:

  • Depression
  • Anxiety
  • ADHD

Environmental and lifestyle factors

Several environmental and lifestyle factors can alter OCD symptoms, particularly as it relates to things like hormonal changes. For example:

  • Poor sleep quality or lack of sleep can alter your natural hormone production, which regulates things like appetite or stress.
  • Poor appetite or stress regulation can lead to an unhealthy diet. People who struggle with insomnia are more likely to eat 300 calories per day by way of extra snacking when they can’t sleep.
  • An unhealthy diet and lack of sleep can also contribute to things like isolation. However, they are not mutually exclusive. Individuals can struggle with isolation, which can exacerbate symptoms of anxiety, depression, and OCD and lead to other mental health disorders development. Isolation might result from external stress like moving to a new city or losing a loved one.

Lack of treatment or ineffective treatment strategies

Lack of treatment or ineffective treatment strategies for your condition can make symptoms worse. No treatment means your symptoms are more likely to ebb and flow based on factors like environmental or lifestyle changes, external stress, or biological factors.

Ineffective treatment strategies can mean that the steps you are taking to manage your symptoms on a daily basis might not work, and that can leave you feeling even more stressed or isolated, further increasing the symptoms.

girl at a psychologist's appointment

Steps to take

If you notice OCD getting worse, it’s important that you:

Seek professional help

If you are not already seeking treatment to manage your OCD symptoms, and you notice OCD getting worse, it’s imperative that you reach out for an assessment and a treatment plan.

This is especially true if there are changes to your environment or lifestyle if you are struggling with biological factors, if you haven’t gotten treatment in the past, or if you are struggling with substance abuse.

Adjust any treatment plans you currently have

If you already use a treatment plan as advised, don’t be afraid to contact your mental health care team or primary care physician. Knowing what makes OCD worse might help you identify when you have signs or symptoms of another mental health condition like PTSD or an anxiety disorder.

A current treatment plan should consider biological factors, changes to your environment or external stress, and coexisting mental health disorders that might need to be integrated.

Implement lifestyle changes

Implementing lifestyle changes can be one of the best tools in addition to your professional treatment plan. For example:

  • If you notice OCD getting worse because of avoidance behavior, you can work with a therapist to stop that behavior and replace it with healthier coping mechanisms.
  • If you are struggling with external stress like the loss of a loved one or moving to a new city, you can build a network of support through friends and family, no matter how far apart they might be, while also working with a therapist to manage those stresses.
  • If there are environmental or lifestyle factors like isolation, an unhealthy diet, or lack of sleep, you can build a better routine to improve those factors within your control and monitor how effectively that helps reduce OCD symptoms.

Summing Up

What causes OCD to get worse? Several factors include environmental factors, biological factors, external stress, substance abuse, and more. Understanding things that may make OCD worse and getting the right help can make it possible to manage and reduce your symptoms.

Seeking professional help is important because you can work with your therapist to create a plan, adjust your treatment plan as necessary, and monitor the implementation of lifestyle changes.

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