What does it actually mean for OCD to be “triggered”?

People often throw around the word “triggered.” But if you’re living with obsessive-compulsive disorder (OCD), to be triggered is to experience a situation or environment that causes you to have an intrusive thought, image, or urge, or one that reminds you of a previous one. Essentially, a trigger is anything that leads to an OCD obsession. Once triggered, you may start to feel anxious and uncomfortable. The members I work with in therapy often say that triggers can seemingly come out of nowhere, immediately demanding their full attention. 

So what does a trigger look like? Perhaps you’re spending time with your partner when suddenly the feeling that you might not be attracted to them strikes. Maybe you’re in public and someone brushes against you, causing you to worry obsessively: “How old were they? Could they have been underage? Did I feel an attraction to them?” Or you could be driving home from work at night and hear a news story on the radio about a hit-and-run incident that makes you worry, “Did I drive by there? Could I have hit someone without remembering? I need to turn around to know for certain.” 

When OCD is triggered, these are not just passing thoughts or feelings; they set off obsessive thoughts, anxieties, or fears that can last a long time.

Why does it happen more when I am having fun?

I often hear from the people I work with that OCD triggers strike right when they’re having fun or relaxing. And it’s common to experience heightened anxiety during occasions like vacations, holidays, time off from work, or special events. This might mean that you aren’t able to look forward to these things the way someone without OCD might. I like to characterize this as OCD seeking control over your life when it senses that you’re feeling free and secure.

There can be many reasons for this. Perhaps you’re taken out of a comfortable routine, traveling away from home, not sure what to expect, or worried about needing to hide your symptoms. Some people even avoid participating in these situations because of the stress it can bring.

When something triggers OCD, you may feel a rush of emotion: frustration, fear, sadness, anger, and a need for control. You may want to isolate yourself from the trigger and the situation that caused it. Your first instinct may be a flight response or avoidance technique. Or you may have an opposite fight reaction, feeling angry and defiant.

The faulty alarm in our brains

When you’re triggered, your ability to remain present in the moment is compromised. Your brain’s danger-monitoring system has been tripped, and you can’t turn it off. On a biological level, your brain is doing what it is trained to do. It senses danger and seeks safety—and to manage that perceived threat, your brain may pursue a fight, flight, or freeze response. 

For example, where I live, there are bears. These animals roam my property from time to time. I am aware that they’re out there, but unless I am alone in the woods, I don’t think about them very much. However, let’s say I am out in the woods walking, and I come face to face with a bear. My brain should react. I hope it responds in a way that helps to protect me—that means my brain is doing its job and alerting me to a real danger. My senses kick in, and I can act to protect myself.

The problem with an OCD trigger is that your brain has the same response, but there’s a catch—it’s a false alarm. You’re not actually in danger. But your brain doesn’t quite realize this, and you feel the way you might in response to a real threat. 

For people living with OCD, thoughts, images, and urges aren’t dangerous—they’re nothing more than, well, thoughts, images, and urges, and they don’t need to have any further meaning. A person without OCD may experience similar things, but their brain simply filters out the noise and isn’t threatened by it. As a result, they feel no need to avoid their feelings.

What can I do about my triggers?

If certain circumstances or events trigger OCD episodes, the good news is that there is effective treatment that can help you learn new ways to respond to your triggers. You may have already realized that compulsions tied to OCD—things you do either internally or externally to get rid of anxiety in the moment—only help you gain momentary solace, but they don’t really relieve the discomfort. 

In fact, by engaging in compulsions, you inadvertently teach your brain that its faulty alarm is responding to real danger, and that your compulsion is what can deal with it. But this is not the case. Your brain needs to relearn how to react to triggers, to resist doing compulsions, and to sit in the discomfort and anxiety that comes with it. In doing so, your brain will learn that OCD triggers aren’t real danger. This will take commitment, but you can change the way that your brain works by changing your actions. 

The goal here isn’t to get rid of anxiety. We need healthy responses to danger, and when our brains are working properly, anxiety can actually be helpful. As I mentioned earlier, it can even save our lives. On the other hand, anxiety from OCD triggers is not useful, leads to confusion and doubt, and doesn’t serve to keep you safe from any real danger. 

To combat OCD, the most effective treatment is exposure and response prevention (ERP) therapy. It helps you resist compulsions (which, again, only temporarily relieve anxiety), and teaches you to accept upsetting and distressing thoughts, images, or urges. By resisting compulsions as a response, over time you will retrain your brain to recognize that you’re not in actual danger. The goal of ERP is to learn to manage OCD effectively and to provide long-term relief.

What is ERP, and how does it work?

How does ERP work? A trained therapist who specializes in OCD will take the time to understand your symptoms and create a custom ERP therapy plan specifically for you. Starting with something least likely to elicit anxiety — for example, your therapist may simply show you a photo of things out of order, if you have an obsession with symmetry — you’ll have the support and encouragement you need to resist a compulsive response. You’ll be given tools to engage in “self-talk” that eventually quiets the irrational thoughts going through your mind — such as the fear that something bad will happen if everything around you isn’t arranged in perfect symmetry — until your anxiety level declines. Only when you’re comfortable with the initial experiment will your therapy progress so you can conquer bigger fears.