The ultimate guide to relationship anxiety

We all know that relationships are supposed to bring joy into our lives, but let’s be real: they’re also a source of stress. Even within a great partnership — one with compatibility, respect, and shared values — you might notice yourself feeling uneasy, anxious, or even panicked at times.

Relationship anxiety can show up in all sorts of ways:

“Will this person cheat on me and how will I know?”
“Why can’t I get over that past infidelity?”
“Can I trust myself to be faithful over the long haul?”
“Am I attracted to my partner or just lying to myself?”

What is relationship anxiety?

Relationship anxiety involves persistent worry, overthinking, rumination, or nervousness about your relationship. “Worrying about, say, your partner’s loyalty, or doubting the quality of your own devotion to them, is fairly common. However, for some people these insecurities and fears can get out of control,” says Teda Kokoneshi, LMHC, CCTP, a therapist at NOCD.

Worrying about your partner’s loyalty, or doubting the quality of your own devotion to them, is fairly common. However, for some people these insecurities and fears can get out of control and take over their lives.

– Teda Kokoneshi, LMHC, a therapist at NOCD

Understanding when your relationship anxiety has crossed the threshold into something that deserves your attention (and when it may even be a symptom of a bigger issue) is crucial. Living in a constant state of relationship anxiety can interfere with your well-being, make it difficult to eat, sleep, or focus on anything other than what you’re worried about. It can also — shocker — impact your relationship as a whole.

When you keep returning to the same relationship concerns over and over again, and the thoughts become so intrusive that they cause significant distress, you could even be experiencing something called relationship obsessive-compulsive disorder (ROCD), a subtype of obsessive-compulsive disorder (OCD), where intrusive thoughts about a romantic relationship lead to compulsive behaviors. For example, someone with ROCD might obsess over the fear that their partner will leave them, leading them to repeatedly seeking reassurance.

Dismissing the symptoms of ROCD can make things worse over time, as it typically doesn’t improve without proper treatment.If you’re scratching your head and not sure what you’re dealing with: you’re not alone. The best way to know if it’s relationship anxiety, ROCD, or both is to see a mental health professional who is trained to spot the differences.

What Causes Relationship Anxiety?

Why do some people feel secure and confident in their partnerships while others develop relationship anxiety? There’s no one cause across the board, but here are some possible factors:

Anxious attachment style: Your attachment style, which is shaped by past experiences, informs how you relate to others. If you have an anxious attachment style, you may be highly sensitive to any emotional distance, need constant assurance, and fear abandonment.
Low self-esteem: Struggling with self-worth can lead to persistent self-doubt and feelings of inadequacy, making it hard to feel secure in your relationship.
General anxiety: If you experience anxiety, it may manifest as worry in your relationship.
ROCD: According to Kimberley Quinlan, LMFT: “Those with ROCD are often more sensitive to what a ‘good’ relationship looks like. They may have heightened expectations and struggle with the idea that no relationship comes without struggle or hardship.”

Those with ROCD are often more sensitive to what a  ‘good’ relationship looks like. They may have heightened expectations and struggle with the idea that no relationship comes without struggle or hardship.

– KImberley Quinlan, LMFT

What if there are real relationship issues causing my anxiety?

Sometimes anxiety is a result of problems that are real — not the consequence of your brain doing a number on you. While every relationship is different, here are some common red flags that may indicate deeper issues:

You don’t spend much time together, without a clear reason.
Criticism runs rampant.
Boundaries aren’t respected.
You don’t see eye-to-eye on important things.
The relationship feels lopsided, with one person showing up a lot more than the other.
There’s actual violence, neglect, or abuse.

How do I know if my relationship anxiety is a mental health concern?

It’s important to remember that it’s perfectly normal to evaluate your relationship, express occasional insecurities, or experience passing doubts. This is different from relationship anxiety or ROCD, where worries are constant and overwhelming. People with relationship anxiety often experience physical symptoms like sweating, dizziness, or a rapid heartbeat, while those with ROCD may find that the distress significantly interferes with their relationships, work, and other areas of life.

8 Common Signs of Relationship Anxiety

Relationship anxiety can manifest in different ways for everyone. That said, there are some signs that often appear:

1. You doubt your partner’s true feelings

Even if your partner is expressive, affectionate, and loving, you can’t escape the sense that they don’t really care about you or feel a romantic love for you.

2. You’re not convinced you really matter to your partner

You constantly wonder whether your partner truly cares about you.

3. You have a constant need for reassurance

Without regular verbal affirmations, you may spiral into anxious thoughts and doubt your connection.

4. You are preoccupied with the fear of being left

Concerns about splitting up dominate your thinking, making it hard to fully enjoy a healthy and loving relationship.

5. You’re people pleasing in the relationship

You avoid expressing your true needs or desires out of fear that being honest might push your partner away.

6. You need to know what the future will look like

It’s normal to wonder about the future, but when these worries become all-consuming and impact your daily life, they may be a sign of anticipatory anxiety—fearing something that hasn’t even happened yet.

7. Your emotional reactions are disproportionate to the situation

When minor issues arise, your emotional response can be intense and may seem excessive to your partner or others around you.

8. You’re sabotaging the relationship

You might unknowingly push your partner away, pick fights, or hold back because of a fear of becoming too happy in the relationship.

How to Overcome Relationship Anxiety

If you’re suffering from relationship anxiety, some strategies may help you cope:

1. Naming the anxiety to detach from it

When you feel overwhelmed by relationship anxiety, pause and say to yourself, “This is just anxiety, and I can choose to detach from it.” Simply looking at your anxiety from a different perspective can help you to not get consumed by it.

2. Tending to your own well-being outside of your relationship

When you’re caught in relationship anxiety, it’s easy to neglect other aspects of your life. Make time for friends, family, hobbies, and activities you enjoy to regain balance and perspective.

3. Meditating

Mindfulness meditation, practiced regularly, can help train your brain to manage anxious thoughts when they arise. You can start with free guided meditation apps or simply take a few moments each day and focus on your breathing.

4. Opening up to your partner

It’s normal to have a fear of being vulnerable, but sharing your relationship anxiety with your partner helps them understand it’s not a reflection of their actions or how you feel about them. Honesty can foster a shift in your attachment style, giving you new experiences that heal what you learned as a child.

5. Seeking professional support

Individual therapy can be incredibly beneficial, but couples therapy may also help. By working together, you and your partner can identify triggers, work through conflicts, and develop healthier coping strategies.

If your anxiety is driven by OCD, Exposure and Response Prevention (ERP) therapy is the gold-standard treatment.

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All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.

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Frequently Asked Questions

Can my partner be involved in treatment?

Having your partner join a session or two of therapy with you can help them understand your experience and how to best support you. “If your partner is not aware of the challenges you are facing, it can lead to misunderstandings and false assumptions, which could prevent you both from building intimacy, as well as trust,” says Keara Valentine, PsyD, an OCD specialist and psychology professor at Stanford.

Do I have to work with a couples counselor if I have ROCD?

No. In fact, the key is to find a therapist who has specialty training in OCD and exposure and response prevention (ERP).

Can medication help my ROCD?

Sometimes. In most cases ROCD can be successfully treated with ERP—no medication required. That said, medication can help people with more severe cases. For example, Selective Serotonin Reuptake Inhibitors (SSRIs)—which work by increasing the levels of serotonin in the brain and can help take the edge off anxiety—may make it easier for some to participate in ERP so they can regain control of their lives.