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The ultimate guide to relationship anxiety–and how to overcome it

Jun 28, 202414 minute read

We all know that relationships are supposed to bring joy into our lives but let’s be real—they’re also a very real source of stress. Even within a great partnership — one where there’s compatibility, respect, and shared values — you might notice yourself feeling uneasy, anxious, or low-key panicked at times. Your relationship worries can be about, quite literally, anything:

Am I going to wake up one morning to a break-up text?
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?

Are you struggling with relationship anxiety? Our specialized therapists can help.

What is relationship anxiety?

Relationship anxiety is the persistent worry, overthinking, rumination, or nervousness in a 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. That’s relationship anxiety.

Understanding when your worries have crossed the threshold into something that deserves your attention — and when they may even be a symptom of a bigger issue — is crucial. For instance, 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 be experiencing something called relationship obsessive-compulsive disorder (ROCD).

When a mental health issue is causing your angst, the impact on your life is hard to ignore. Living in a constant state of anxiety in your relationship 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. Luckily, once you know what’s really going on, your anxiety can be reduced with evidence-based therapy and support.

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

8 common signs of relationship anxiety

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


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. When you sense they are creating any distance at all, your mind goes into overdrive, questioning everything.


You’re not convinced you really matter to your partner

One common False Memory OCD compulsion involves mentally reviewing past experiences to try to prove or disprove one’s doubts about what happened. So, if one’s obsessive worry is that they walked out of a restaurant without paying, they might try to replay every single moment of that experience in their head to isolate when the server came over, what they paid with, or if anyone was looking at them when they walked out of the restaurant. 


You have a constant need for reassurance

Without regular verbal affirmations, you tend to spiral into anxious thoughts.


You are preoccupied with the fear of being left

Worries about splitting up take center stage in your mind and completely prevent you from enjoying a healthy and loving relationship.


You’re people-pleasing in the relationship

Maybe you’re not expressing yourself, or communicating things that are important to you, because you fear that doing so will push them away. Trying to keep everything “perfect” between you takes a lot of energy.


You need to know what the future will look like

No one knows what the future holds, and occasionally wondering how relationship situations will turn out is perfectly normal. But it can be a sign of “anticipatory anxiety” (anxiety about something that hasn’t happened) if it impacts your day-to-day life and sends you future-tripping.


Your emotional reactions are disproportionate to the situation

When you hit small snags in the relationship, you react intensely. To others, your emotions and reactions seem out of proportion compared to what’s going on.


You’re sabotaging the relationship

This can look like pushing your partner away, picking fights, or holding back because of a fear of becoming too happy in the relationship.

Struggling with relationship anxiety?

Our specialized therapists can help.

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:

  • You have an anxious attachment style. Deep subconscious programming known as your attachment style informs how you relate to others. If you have an anxious attachment style, you may be highly sensitive to any emotional distance from your partner, need regular assurance, and constantly fear abandonment. 
  • You struggle with low self-esteem. Low self-worth can lead to constantly second-guessing yourself or feeling like you’re not enough.
  • You have general anxiety. If you struggle with anxiety overall, it may manifest as worry within your relationships.
  • You have ROCD. “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,” says Kimberley Quinlan, LMFT, a therapist who provides treatment for OCD and related disorders.

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

Wait — what if there are real relationship issues causing my anxiety?

To state the obvious: Sometimes anxiety is a result of problems that are real — and not the consequence of your brain doing a number on you. Signs of an unhealthy partnership vary for every couple, but it may help to note some common relationship red flags:

  • 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. 

Bottom line: If your life together doesn’t fit your needs, or is toxic or troublesome, it could be time to move on.

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

It’s worth reiterating: It’s perfectly normal to evaluate your relationship, express your insecurities from time to time, and have the passing doubt or worry about your relationship. That’s very different from having a mental health issue like relationship anxiety or ROCD, where the worries are near-constant. You may find that you’re on frequent high-alert with the sense that something is or could go wrong at any moment. 

The “recurring” and “frequent” part is a key distinction here. According to the American Psychological Association (APA), people with anxiety usually have recurring intrusive thoughts or concerns. Likewise, ROCD involves lasting and unwanted thoughts that keep coming back. 

It’s no wonder that people with anxiety often report physical symptoms such as sweating, dizziness, upset stomach, or a rapid heartbeat, and that those with ROCD say the distress is so significant that it impairs their relationships, work, and other areas of their life.

We can help you get your life back from the grip of relationship anxiety

Relationship anxiety vs. Relationship OCD 

While relationship anxiety and ROCD both revolve around uncertainty and distress within the context of a relationship, they’re different. Also worth noting: Relationship anxiety or distress is a key part of ROCD, but it’s absolutely possible to have relationship anxiety without having ROCD.

So, what, exactly, is ROCD? It’s a subtype of obsessive-compulsive disorder. People with all forms of OCD experience repeated unwanted and intrusive thoughts (that’s the obsessive part) that compel them to perform repetitive behaviors (aka compulsions). In the case of ROCD, these repetitive thoughts center around a romantic partner or relationship — and the compulsions follow suit. For example, maybe someone with ROCD can’t shake the thought that their partner will leave them, and this obsession leads to a particular compulsion, like repeatedly asking for reassurance, says Dr. Patrick McGrath, psychologist and Chief Clinical Officer at NOCD.

The “cycle of OCD,”  as it’s called, is like a flywheel kept in motion by compulsions. For a moment, you may actually get a hit of relief from your intrusive thoughts when you ask for reassurance or engage in some ritualistic behavior. The problem is that relief from the distress the thoughts cause is always temporary, which puts you right back at the beginning, obsessing yet again.

Although this pattern can be debilitating, people often fail to recognize that there’s a disorder that’s leading to their distress, says McGrath. “People with ROCD frequently brush off their symptoms and tell themselves things like ‘all relationships are hard’ or ‘if I could just change myself or my partner, I wouldn’t feel this way.” But dismissing the symptoms of ROCD is a mistake — since the condition usually gets worse, not better, without proper OCD treatment.

People frequently brush off their symptoms and tell themselves things like ‘all relationships are hard’ or ‘if I could just change myself or my partner, I wouldn’t feel this way. But dismissing your symptoms usually ends up in things getting worse, not better.

— Dr. Patrick McGrath, psychologist and Chief Clinical Officer at NOCD

The ROCD Cycle

The OCD cycle of obsession, distress, compulsion, and temporary relief.

Common Obsessions

  • Ruminating over your compatibility as a couple
  • Questioning whether you are in the “right” relationship or if someone better is out there
  • Excessively thinking about your partner’s physical “imperfections” or questioning your attraction to them
  • Comparing the chemistry in your relationship to what you see in TV or movies
  • Worrying that your partner will reject or abandon you, or worrying that you’ll cheat
  • Obsessing over whether you’re aroused around your partner or having other intrusive thoughts during sex

Common Compulsions

  • Continuously seeking reassurance from your partner 
  • Regularly looking for validation from friends and family that you’re in the right relationship
  • Spending excessive time researching relationship problems online
  • Self-checking and monitoring for feelings of passion and attraction
  • Avoiding intimacy or even being in a relationship
  • Avoiding romantic movies or books that trigger doubts about your relationship.

How to know if it’s ROCD (and not just relationship anxiety) 

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.

That said, if your obsessions and compulsions take up to an hour or more per day, that’s a good clue that ROCD could be at play. Another possible indicator: You’ve experienced other OCD subtypes, whether it’s Harm OCD, “Just Right” OCD, or something else. “The likelihood is that somebody with OCD is going to have some other types of obsessions outside of relationship concerns,” notes Dr. McGrath.

Why ROCD is often misdiagnosed by mental health providers

OCD is a very common but very misunderstood condition — and this misunderstanding also exists within the medical community. Mental healthcare professionals who have limited awareness of ROCD and don’t have the detailed education and training they need about the mental illness may mistake your symptoms for something else. This only delays recovery, which is unfortunate since ROCD is highly treatable with a specific type of therapy called Exposure and Response Prevention. But don’t let this discourage you. OCD specialists exist — and an adequately trained professional can help you get the clarity you need. 

Stop guessing. We can help you get to the bottom of your relationship anxiety.

9 essential resources for anyone struggling with relationship anxiety or ROCD

You can conquer your relationship anxiety 

Sometimes when people hear that their distress is a sign of relationship anxiety or ROCD, they feel scared and hopeless. But people can and do recover from these mental health issues every day. Allison F., a NOCD member, is proof.

“When I entered my first relationship, I started to deal with what I now know as ROCD. I was overanalyzing every situation and grieving the loss of the relationship even before it had really started. One of my obsessions centered around whether I wanted to have children someday or not. (My partner at that time was certain they did not.)

It was difficult to live in the unknown; I felt like I needed to know right then. I obsessively scrolled the internet looking for a doctor willing to remove my fallopian tubes — to show my commitment to being child-free. 

I didn’t follow through, but I was under so much stress that I was throwing up every morning. I felt like my brain was going through a cheese grater. It was constantly churning out more things to be afraid of. I finally talked to a therapist who mentioned seeing an OCD specialist at NOCD. I took a risk, opened up, and let the specialist help me. ERP pushed me. I was asked to sit with uncertainty. It was the best decision that I could have made. I met MaryBeth, who is a fantastic therapist.”

OCD Journeys

“The more I do the ERP, the easier it gets. It takes the power away from intrusive thoughts. It has been worth it in every way.”

Read more of Allison’s story

How to overcome relationship anxiety 

As we mentioned earlier, ROCD is a type of mental health disorder that requires a specific treatment with the help of a professional (we’ll explain exactly what it is and how to access it). 
However, if relationship anxiety is the true culprit, certain strategies can help you cope:


Name the anxiety to detach from it

In a moment when you feel really wound up with worries, pause and say to yourself, “Oh yeah, this is just the mental state of anxiety, and I can choose to detach from it, even if it’s just for a second.” Simply looking at your anxiety from a different perspective can help you to not get consumed by it.


Tend to your own well-being outside of your relationship

When you have relationship anxiety, it’s easy to veer away from other people and activities that bring you joy. Remember to make time for friendship, family, hobbies, and even the things you love to do alone.


Try meditation

Mindfulness meditation, when done regularly, can eventually help train your brain to manage anxious thoughts about your relationship when they arise. You can try a free guided meditation app, or simply sit quietly for a few moments each day and focus on your breathing.


Open up to your partner

It’s normal to have a fear of being vulnerable, but sharing what you’re going through and explaining that the anxiety is not a reflection of your partner’s actions (or how you feel about them) can go a long way. Opening up can also create the space to shift your attachment style — giving you new experiences that heal what you learned as a child.


Seek professional support

You can seek therapy on your own, or — if you’re in a relationship with a willing partner — pursue couples therapy. This may help you both understand your triggers for anxiety, work through conflicts together, and develop healthier coping strategies.

What’s the best treatment for ROCD?

Exposure and Response Prevention (ERP) therapy is considered the gold-standard treatment for ROCD (and all other forms of OCD). It’s an evidence-based therapy, which in simple terms means that extensive research has been done to prove that it’s successful. This specialized treatment is unlike traditional talk therapy or general cognitive behavioral therapy (CBT). And without practicing ERP specifically, it’s very likely that your ROCD will get worse, not better.

ERP works by gradually exposing you to your triggers, and teaching you response prevention strategies to cope with your distress—things that don’t involve compulsions. You will never be forced into anything before you’re ready, but you will be encouraged to do exposures that move you toward recovery.

“OCD lies to you and tells you that you have to feel 100 percent secure and certain in all matters related to your relationship, but ERP helps you see that’s not possible or even the goal,” says Dr. McGrath.

NOCD member Victoria A. says that before ERP “I wanted to know with 100% accuracy whether I was with the right person. Questions bombarded my head: Is it too soon to settle down? Being a queer adult, should I develop this aspect more — develop my characteristics more and see what that meant for me? Even if I was happy in my relationship, could I be happier? I could not feel sure.”

For Victoria, medication paired with ERP was the key to freedom: “I have learned how important it is to let thoughts be there. I don’t need to respond, I don’t need to do anything with them. Within my first couple of months of treatment, I started to feel some relief. It’s been over 2 years now and I continue to make huge strides.”

ERP therapy for ROCD: How it works

Now you’re probably wondering: What, exactly, are ROCD exposures or response prevention techniques? They’re different for everyone and customized for you — but here’s a glimpse into what you might expect:

Does my partner really love me and want to be with me forever?
Asking for constant reassurance that your partner loves you
Response Prevention Technique
Writing “I don't know if we'll be together forever” in your journal
What if I make the wrong romantic choice?
Testing your feelings by flirting with others
Response Prevention Technique
Watching a romance movie, and acknowledging the anxiety you feel
Am I good enough for my partner?
Ending the relationship over fears that you're not worthy
Response Prevention Technique
Saying to yourself, “I can never know exactly how others see me”
Am I really attracted to my partner?
Avoiding looking at your partner
Response Prevention Technique
Intentionally looking at an unflattering photo of your partner throughout the day

Frequently asked questions about ROCD

Can my partner be involved in treatment?

Do I have to work with a couples counselor?

Can medication help my ROCD?

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