Work and OCD: The Ultimate Survival Guide
Kyle Lucas had been juggling work at a retail clothing store and evening graphic design classes when his OCD became unmanageable.
For the 27-year-old Ohioan, a peer advocate at NOCD, it felt like everyone on the retail floor knew something was wrong. Simply getting through a conversation became difficult. “I didn’t want to be around people because I didn’t want them to see that I was struggling or think, ‘Oh, he seemed off today. Are you OK?’” Lucas says. The more intrusive thoughts he experienced, the more overwhelming it became to get through the workday.
Mollie Albanese, 28, from Virginia (also a peer advocate at NOCD), has a similar story of feeling overwhelmed by her OCD in a people-facing profession. “It feels sometimes like if you have OCD, the whole world knows, and you are kind of up against other people’s stigmas,” Albanese tells me. She’s not alone: OCD affects millions of adults, yet it can make them feel like they’re the only ones going through it.Lucas ended up taking a leave of absence from his job and getting treatment for OCD. Today, Lucas considers himself recovered, in large part due to the treatment he received while taking time off. He’s lucky, he says: “I had a good boss at the time, and we were able to talk about mental health stuff. She was very accepting and knew that I was having a hard time.”
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Lucas’ and Albanese’s experiences tell a larger story about the many ways OCD can interfere with a person’s work life. For many people, managing OCD at work can bring on a new set of challenges they may not experience at home.
How OCD can affect work
One study shows that people with OCD lose 46 working days per year to the condition, on average. This could be because a person’s intrusive thoughts make it difficult to concentrate or because their compulsions interfere with their ability to be productive. Someone with harm OCD may be convinced he needs to avoid a specific coworker for fear of harming them, for example.
For some people, the condition can cause minor disturbances that may not require a leave of absence but still add up over time. Often, work complications are what lead people to seek treatment for their OCD.Albanese had been working as a special education teacher when her OCD caused her to become fixated on continually checking her paperwork and making sure every last detail was correct. Before long, it was difficult to focus on anything else.
The turning point came when she missed an important meeting.
“My compulsions were to keep checking things, and because I was so hyper-focused on the little things on the paperwork, I ended up missing the date, which is not a little thing,” she explains. “That’s actually when I reached out for help: I noticed that my work performance was not where I would like it to be. And I was spending a lot of time in my head and not actually present with my students.”
When OCD poses challenges at work, people face common — but no less difficult — questions: “Should I tell my employer at all?” “What should I say in the conversation?” “What accommodations can I request?”Not everyone can be open about mental health challenges with their employer, like Lucas or Albanese were. For many workers, going public with their OCD may not be the right choice, given that mental health stigma persists in many workplaces. No matter how supportive a boss may seem, navigating these decisions is complicated. You might need to weigh whether your OCD impacts your work, the severity of your condition and whether accommodation will help your work performance.
Should you tell your employer you have OCD?
For some people, sharing an OCD diagnosis can be helpful, especially when their employer has openly promoted mental health awareness. Others choose to keep this information private. There are many factors that can contribute to this decision, like the type of work environment a person is in, how comfortable they feel and how severe their symptoms are.
So if you’re in this position, and you want to talk to your employer, how do you know you’ll be safe?
Licensed OCD therapist Teda Kokoneshi says it’s helpful to consider whether or not the condition is an obstacle to job performance. “If their OCD is interfering with their ability to work, and they believe they would get more support if they disclosed that they’re suffering from a mental health condition, they might want to present their employer with documentation of their diagnosis,” she says.
What accommodations to request at workAccording to Davida Vaughn, a licensed professional counselor in Nashville, “Flexible working hours, more time to complete certain tasks or more frequent breaks can be helpful in managing mental health needs.”
She adds, “Other accommodations might include adjustments to workspace (for example, working further away from others, working in a well-lit environment, etc.) and time off for counseling appointments.”
However, make sure those accommodations don’t simply feed into OCD compulsions, she advises. It’s possible that some requests (for example, extra time to send emails) may perpetuate OCD symptoms like “just right” checking behaviors. “Be cognizant of the ‘why’ behind your request,” she says. “I recommend that a person speak to their therapist and develop a plan for which accommodations would be assistive, and which would be detrimental.”
Work and OCD: Know your rights
According to the Americans With Disabilities Act, employers with over 15 employees cannot discriminate on the basis of disability and are also obligated to provide reasonable accommodations to their employees. Some of the reasonable accommodations a person might request are modified work hours, time off for treatment or modifications to supervision methods.In order to request reasonable accommodation, a person needs to have a condition that would “substantially limit” their ability to perform, and the condition doesn’t need to be severe. That phrasing simply means that a condition makes “activities more difficult, uncomfortable or time-consuming to perform compared to the way that most people perform them,” the U.S. Equal Employment Opportunity Commission states.
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To request reasonable accommodation, then, you need to provide a letter from a mental health professional with your diagnosis.
When is the right time to tell your employer about OCD?
If you have decided that sharing your condition at work will be beneficial, you’ll also want to consider the right time to do so. “I think something I’ve learned for the future is to be open before you really start to struggle, because it’s a little bit harder when you’re in the depths of it,” Albanese says. “I did not tell my employer until I was really struggling. At that point, it felt like it was more of an excuse, like I was trying to say, ‘I’m not doing well because of my mental illness,’ as opposed to, ‘I have a mental illness, and I’m also not doing well.’”
According to the EEOC, requesting reasonable accommodation when your OCD is under control — as opposed to waiting until it gets worse — will also limit chances of discipline or termination due to underperformance. Though many people might hold off on sharing their condition while it’s manageable, the EEOC also states that waiting until your OCD starts to interfere with work isn’t always the way to go. Instead, requesting an accommodation before any problems at work occur or become worse could be the best approach.
Disclosing your OCD isn’t always necessaryRemember that there is no obligation to disclose your condition — especially if your employer may not be understanding or accommodating.
It’s also important to keep in mind that OCD affects everyone differently, so just because a person has OCD, it doesn’t mean they necessarily experience symptoms at work. “Certain people have no impairment in their work life. Quite to the contrary, at work they’re able to set their OCD concerns and struggles aside, to return to them with dread only once they get back in the car to head home,” Kokoneshi says. “But then there are others, [for example] with just right OCD, who obsess over work emails. They might even have magical thinking, where so much depends on completing work tasks just so.”
What if you have gaps in your resume?
Resume gaps can make any job applicant nervous, but there are many positive ways to handle this. Recruiters recommend highlighting your relevant experience as a functional resume rather than a chronological one. If the gap is only a few months, Sylvia Giltner, an HR manager, writes, “You can use years, rather than months and years, for employment history,” which minimizes any periods between jobs.
Not every employer will ask you to speak about those gaps, and you don’t have to go into detail about why you took time off. Hiring managers recommend being prepared to discuss gaps if they do come up in interviews. If they do, keeping it simple is the best policy. “Say, ‘I had a medical issue and took care of it, and now I’m ready to get back to work,’” Shawn Desgrosellier, CEO of recruiting firm Vitality Group, suggests for Monster.com.
How to manage your OCD at workWhile managing OCD will look different for each person, here are some techniques that could be helpful to try. A growing body of research studies suggest that mindfulness can play a valuable role in managing OCD, especially during stressful situations. There are many different ways to practice mindfulness. One option is to take purposeful breaks throughout the day to focus on your breath. You can practice mindfulness techniques while sitting, walking or moving, and it can also be a part of physical activity, like exercise or yoga.
It’s important to watch your stress, too. Workplace stressors “can influence the experience of OCD symptoms over time,” Vaughn explains. “Stress tends to cause everyone, even those without OCD, to get stuck on a particular thought or in a particular thought pattern.” For people with OCD, “stress may make OCD symptoms worse.” So it’s important, she advises, to “stay present and attuned to how you’re feeling, thinking and behaving in the moment — and use response prevention strategies.”
Experts also recommend practicing good sleep hygiene. Research shows that on average, people with OCD experience higher levels of insomnia, often a result of engaging in obsessions and compulsions. Unfortunately, lack of sleep can exacerbate OCD symptoms. There are many different techniques that can help you improve your sleep, like going to bed and waking up at the same time each day and shutting down devices an hour before bed.
How to talk about your OCD at work
There are certain things to keep in mind about the best way to talk to your employer about OCD. Employers will want to see a letter from a mental health professional in order to be able to provide reasonable accommodation. Beyond that, the way you choose to share — and how much you share — will depend on the situation.“The way they approach their supervisors depends a lot on the type of relationship they have with them and on the particular company culture. Hopefully they work in a supportive environment, open-minded and aware of mental health issues,” Kokoneshi says.
Given that mental health can be stigmatized, Albanese says, she’s found it’s best to have this conversation in person (or via video call) if possible.
Sometimes simply knowing other people are aware you’re going through something can be a relief. “Being open with my employer and my coworkers, and even my students — they’re little, but they understand when somebody is struggling — was helpful,” Albanese says.
If you or someone you know is struggling with OCD, you can schedule a free call today with the NOCD clinical team to learn more about how a licensed therapist can help. At NOCD, all therapists specialize in OCD and receive ERP-specific training. ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP.
Leeron Hoory is a writer based in New York City focusing on health, culture and politics. Her work has appeared in Quartz, the Village Voice, Gothamist, and Salon, among others.
Keara E. Valentine, Psy.D., is a postdoctoral fellow at Stanford University School of Medicine in the OCD and Related Disorders Track, where she specializes in the assessment and treatment of OCD and related disorders. Dr. Valentine utilizes behavioral-based therapies including Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) with children, adolescents, and adults experiencing anxiety-related disorders.
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Licensed Therapist, MA
I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.
Licensed Therapist, LCMHC
When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.
Licensed Therapist, MA
I have personally struggled with OCD and know what it's like to feel controlled by intrusive thoughts and compulsions, and to also overcome it using the proper therapy. I’ve been a licensed therapist since 2017. I have an M.A. in Clinical Mental Health Counseling, and practice Exposure and Response Prevention (ERP) therapy. I know by experience how effective ERP is in treating OCD symptoms.