Obsessive compulsive disorder - OCD treatment and therapy from NOCD

What Happens if You Don’t Get Treated for OCD?

By Dr. Keara Valentine

Jan 26, 20247 minute read

Reviewed byPatrick McGrath, PhD

what happens if ocd is not treated

As a clinician, I can tell you that everyone experiences obsessive-compulsive disorder (OCD) differently. But there are two key characteristics of this mental health disorder: obsessions and compulsions. 

Obsessions are invasive, unwanted thoughts, images, or sensations. To get rid of the distress they cause, you will engage in compulsions that are meant to alleviate your worries—like washing your hands over and over if you’re afraid of germs. But ultimately these compulsions only reinforce your obsessions and fears, creating a cycle that’s hard to break.

So what happens if you let the condition go untreated? Let’s explore the topic and look at solutions for getting your health—and  life—back on track.

How untreated OCD can affect your life

Obsessive thoughts can make it extremely difficult or even impossible to concentrate. They can cause you to spend hours engaged in mental or physical activities that greatly diminish your quality of life. You may spend hours ruminating on your fears, for example, instead of spending time with family or friends. Over time, you may isolate yourself from the people who care about you, and in an effort to cope with the isolation, you might spend even more time engaging in compulsions

When OCD compulsions get worse, you might find that you:

  • Avoid going outside
  • Steer clear of social gatherings
  • Isolate yourself from family members or friends 
  • Are consumed with thoughts and can’t focus on work 
  • Stop doing hobbies or other things that matter to you, and engage in compulsions instead
  • Miss work or school

Some people with mild OCD are able to adapt to their condition, noticing that their symptoms interfere with their life in minor ways. However, this “mild OCD” is usually only temporary. OCD symptoms tend to start gradually and then, if untreated, can become more severe over time. 

Let’s take contamination OCD, for example. This is a subtype of OCD characterized by intense fears of getting germs or spreading them. A compulsion might begin by putting your clothes in a plastic bag to be washed every time you come home from a public place. But it could escalate to needing to throw away your clothes if you were in an enclosed space. 

That’s because the more your compulsions drive you, the more you feel distress and try to prevent those feelings. That anxiety makes you lean on your compulsions to cope, causing a cycle that’s hard to break.

Compulsions can also lead to physical symptoms. For example, you might develop skin complications from excessive hand washing, or have aches and pains from engaging in repetitive acts. All of these symptoms are part of the disorder.  

What Causes OCD to Get Worse?

OCD usually emerges in a person’s childhood, teenage or early adult years, and it varies in severity throughout someone’s life. While it’s difficult to predict when or how symptoms of OCD can become exacerbated, there are a number of common reasons for increased severity:

  • Stressful periods, even positive ones
  • Traumatic events
  • Substance use
  • Engaging in compulsions, which always makes OCD worse

Over time, people with untreated OCD can also experience a change in the focus of their obsessions and compulsions. In other words, you may find that the underlying obsessive-compulsive cycle transfers to a different theme with different associated thoughts and actions. For instance, if you have contamination-related obsessions and cleaning compulsions that are initially centered around germs, later in life those fears may become about contracting sexually-transmitted diseases.

How OCD disrupts daily life, work, and relationships

OCD can affect someone’s life in many ways, and can lead to significant disruptions in quality of home, work and social life. Some are visible and easy to spot, while others might be impossible to notice. 

For example, a cleaning compulsion can lead to spending hundreds of dollars per week on sanitizing alcohol and other cleaning products. Someone living with pedophile OCD, a subtype of OCD where someone feels afraid that they may be or act like a pedophile, might avoid their younger family members out of fear, losing family ties and ending up more socially isolated. Someone with relationship OCD might feel an unbearable sense of anxiety over the idea that their relationship is unstable, and only reassurance can neutralize these feelings. This can lead to relationships becoming more difficult and potentially ending. The mental toll that obsessions can take on a person can also make it difficult to concentrate and perform at a job. One study found that people with OCD lost an average of 46 workdays per year due to their symptoms. 

Often, symptoms of OCD result in social isolation, where a person cuts themselves off from the world and the people in their life. This can lead to severe depression or other mental health conditions. Research shows that 90% of people with OCD meet the criteria for another mental health disorder, like anxiety or depression. 

In an effort to deal with the emotions of OCD, many people turn to drugs or alcohol to self-medicate. Using substances to cope with OCD can create other health risks, and often makes OCD symptoms far more severe in the long run, driving people into a vicious cycle of OCD and addiction. This is a major problem, which studies show affects around 25% of people with OCD.

At its most severe, OCD can lead to suicidal ideation or action. This can happen when the symptoms of OCD have fully taken a hold on a person and their entire life revolves around responding to OCD obsessions and compulsions. The depression a person can feel from devoting their entire life to managing a disorder they do not have control over can be devastating to the point of taking their own life.

It is easy to brush off OCD as an idiosyncrasy or a personality trait, but it’s important to remember that there are often devastating consequences to this condition.

Getting treatment for OCD

The most successful treatment for OCD is a form of behavioral therapy called exposure and response prevention (ERP). Unlike traditional talk therapy, which can backfire and make OCD worse, ERP—which was developed specifically to treat OCD—is clinically proven to be highly effective in the majority of people.

Here’s how it works: 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. Then, you’ll work together to rank your fears or triggers based on how stressful they seem. To begin with, your therapist will typically prompt you to face a fear that brings on only a mild amount of distress. For example, your therapist might simply show you a photo of a room where things aren’t lined up perfectly. The fear thoughts—like the idea that something terrible will happen when things in your environment aren’t perfectly symmetrical —will likely come up, but instead of responding with a compulsion, you’ll learn to tolerate the discomfort. By making this conscious choice and seeing that nothing bad occurs, or realizing that you handled the discomfort better than you thought you could, your brain gets the message that there was nothing to fear in the first place.

As your therapy progresses, you’ll tackle triggers that elicit a bit more distress, to conquer bigger fears. With an ERP therapist guiding you, you’ll practice confronting your fears in your everyday life, too, instead of just the controlled setting of therapy. 

Most of the time something amazing happens as a result of this therapy: You won’t be riddled with distress from intrusive thoughts, images, or urges. Your need to engage in compulsions goes away. And the things that matter the most to you won’t be at risk of slipping away.  For instance, when you spend time with a loved one, you’ll be able to focus on the connection between the two of you—rather than on whether the salt and pepper shakers on the table are in a perfectly straight line. In essence, you’ll get to live the life you would choose to live if OCD did not exist. 

Working with an OCD specialist to address the thoughts and situations that cause you distress is more accessible than ever thanks to virtual ERP therapy. In fact, peer reviewed research shows live teletherapy sessions of ERP can be more effective, delivering results in less time than traditional outpatient ERP therapy, often in as little as 12 weeks. 

Want to begin your ERP therapist search? We encourage you to browse the NOCD Therapist Directory. Every NOCD therapist is not only specialized in ERP but trained to deliver treatment online. Choose your therapist and we do the rest, including helping with scheduling and payment. Of course, if NOCD Therapists aren’t the right fit, you can also explore the International OCD Foundation Therapist Directory.

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