With appropriate treatment, obsessive-compulsive disorder (OCD) can improve gradually. However, there are instances where symptoms may intensify or new compulsions emerge, even when you believe you have it managed. Suddenly, it can feel like a maze with no way out. Although confusing, there are some lesser-known things and scenarios that can contribute to this. Know what causes OCD to get worse so you’ll know how to manage it better.

What is OCD?

This mental health condition happens when a person gets trapped in a cycle of obsessions and compulsions. An individual can have either of the two or both. 

Obsessions are intrusive urges, thoughts and images that can cause stress and disrupt routines. On the other hand, compulsions refer to repetitive behaviors and thoughts someone may feel compelled to do to generate relief from the anxiety brought by their obsessions.

OCD starts with unwanted thoughts, often fear-driven, that can balloon into distress. For instance, if contamination is your obsession, possible compulsions would be washing hands excessively and avoiding public restrooms.

There are four main branches of OCD, including:

• Order OCD: An individual with this type of OCD wants everything in order, such as their items, thoughts and actions.
• Checking OCD: People with this condition constantly check certain things. Someone with Checking OCD might go outside the house, forget if they locked the door and relock it repeatedly until they feel satisfied with the task. 
• Rumination OCD: This type happens in the place where obsessions originate —the mind. Persistent “what ifs” and fear of hurting oneself are some manifestations.
• Contamination OCD: This subtype is characterized by obsessions about fear of spreading germs or becoming infected with contaminants.

What Causes OCD to Get Worse?

Before we take a deep dive into its potential triggers, it’s essential to know that OCD is a diagnosed condition. To say someone has this mental health condition because they are obsessively organized is inaccurate. For example, a friend may enjoy organizing your closet, but someone with OCD will do it for hours because of their obsessive urges. It’s not a quirk but a medical condition that requires medical intervention.

1. Coexisting Mental Health Conditions

Sometimes, individuals with OCD get diagnosed with other mental health problems called comorbid conditions. This may include anxiety disorders, depression, Post-Traumatic Stress Disorder (PTSD), eating disorders and Attention Deficit Hyperactivity Disorder (ADHD). When you or a loved one struggles with two mental health conditions, it might exacerbate obsessions and compulsions even more.

2. Life Transitions

If you have OCD, you are likely to notice that symptoms worsen when you’re experiencing a significant transition. Maybe you moved into a new house and are obsessively checking the stove and doors. Suddenly, your intrusive thoughts are louder and more challenging to deal with. Feelings of anxiety and regret may appear during these moments. Therefore, you rely on your compulsions to feel in control.

3. Recent Traumatizing Event 

The adverse effects of traumatic events that happened recently can cause distress to an individual with OCD. For instance, an individual may resort to hoarding after losing something significant. This disorder is characterized by difficulty throwing physical items that no longer bring value. Trauma can also exacerbate the need to feel in control after a destabilizing situation.

4. Past Traumas

Experiencing a traumatic situation in the past can trigger the development of OCD. Trauma can cause the brain to create recurring thoughts and behaviors. Individuals with diagnosed PTSD can experience worsening symptoms when they remember this painful event. Obsessions and compulsions can serve as avenues to reestablish safety and control.

5. Stress

One of the causes of OCD getting worse is stress. For instance, acute stress can trigger obsessive thoughts. Toxic stress, such as chronic job stress, can leave you feeling overwhelmed, so you resort to your compulsions in an attempt to gain control over your life. Stressors such as relationship problems, breakups, bullying, job loss or marriage can trigger worse symptoms of OCD.

6. Menstruation

Females who have OCD might experience worsening symptoms during their period. One study found that anxiety-related signs can fluctuate along with the menstrual cycle, albeit noting that this isn’t the case for everyone. Women may also experience aggravated symptoms during their luteal phase, which happens after ovulation and before menstruation. 

7. Substance Abuse 

Those with OCD and battling substance abuse may experience changes in some brain areas, which can lead to aggravated symptoms. Regular use can increase the risk of depression, anxiety and schizophrenia. If left untreated, it can lead to chronic illnesses and other mental health conditions.

8. Poor Lifestyle 

Another cause that can make OCD get worse is your lifestyle choices. If you have this mental health condition and you’re not getting enough sleep, it might alter your natural hormone production, which regulates stress and appetite. Alternatively, if you eat unhealthy foods, you may consume excessive calories, which can exacerbate symptoms of depression, anxiety and OCD.

9. Inefficient Treatment Strategies

Sometimes, the reason why your OCD symptoms are getting worse is because of a lack of treatment or ineffective interventions. Without appropriate medical interventions, controlling your urges may feel more uncontrollable. On the other hand, if you’re following your physician’s orders but nothing seems to be working, it may leave you feeling stressed and isolated, further increasing your obsessions and compulsions.

When Is OCD at Its Worst?

You’re most vulnerable to symptoms at night because there’s time for rumination, which can lead to compulsions like relieving past situations and excessive seeking of validation.

To help manage your symptoms, try practicing mindfulness. When you are catastrophizing about the worst things that can happen, consider meditating for a moment—focus on your breathing and slowly let go of your worries.

Speaking with your physician about medical support options can help improve your symptoms. Therapy is a safe and effective way that can help you identify and slowly free yourself from unhealthy thoughts and compulsive behaviors. Your licensed mental health professional may also advise you to take medications to reduce stress levels.

Manage Your OCD

Living with this mental health condition is challenging. However, it shouldn’t be the be-all and end-all of your existence. Learning what causes your OCD to get worse and seeking professional treatment are your initial steps toward feeling better.