What Happens if OCD Is Not Treated? Here’s What You Can Expect

Everyone experiences obsessive-compulsive disorder (OCD) differently, but there are two key characteristics of the mental health disorder: obsessions and compulsions. Obsessions are invasive, unwanted thoughts, images, or sensations. To get rid of the distress they cause, people engage in behaviors known as compulsions that reinforce their obsessions and fears.

So what happens if you don’t get treatment for OCD? Leaving the condition untreated can lead to difficult and often devastating circumstances. Untreated OCD can take a toll on your mental and physical well-being. Let’s explore the real impact of untreated OCD and discuss solutions for getting your health—and your life—back on track.

Ways untreated OCD affects your life 

Obsessive thoughts can make it extremely difficult or even impossible to concentrate. They can cause you to spend hours engaged in unnecessary mental or physical activity and can greatly decrease your quality of life. You may spend hours ruminating on your fears instead of spending time with family or friends. Over time, you can become isolated 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
• Avoid social gatherings
• Prevent yourself from seeing specific family members or friends 
• Are consumed with thoughts and cannot focus on work 
• Isolate yourself from the people in your life
• Stop doing hobbies or other things that matter to you to engage in compulsions instead
• Miss work or school

How untreated OCD gets worse over time

Some people with mild OCD find themselves able to adapt to their condition, noticing that their symptoms interfere with their life in only 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 intesne fears of becoming contaminated, contaminating others, or spreading germs. 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. 

In many cases, OCD is a downward spiral. The more your compulsions are driving you, the more you feel distress and try to prevent them. The more distress you feel, the more you lean on your compulsions to cope. When the obsessions and compulsions increase, either from stressful circumstances or another cause, it becomes impossible to manage OCD without it interfering with everyday life.

Compulsions can also lead to physical symptoms. For example, a person might develop skin complications from excessive cleansing or using harsh chemicals. They might experience 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 OCD can get worse, there are a number of common reasons for increased severity:

• Stressful periods, even positive ones
• Traumatic events
• Substance use
• One thing always makes OCD get worse: engaging in compulsions

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, someone with contamination-related obsessions and cleaning compulsions might first begin with fears centered around germs, but later in life become obsessively fearful of 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.

How to get treatment for OCD

The good news is that effective treatment is available for OCD. Undergoing exposure and response prevention (ERP) therapy with a specialty-trained ERP therapist is the best course of treatment for all themes of OCD, and works for people of all ages.

ERP, which is considered the gold-standard approach for tackling obsessive-compulsive disorder, encourages patients to intentionally face the situations that cause them the most distress. By gradually exposing people to the source of their obsessions, and then working to withhold the compulsive actions, great progress can be made—often quickly.

Most people begin to see results within eight to 16 weeks. If you want to learn more about how ERP can help you recover from OCD, I encourage you to read about NOCD’s evidence-based, accessible approach to OCD treatment. At NOCD, all therapists specialize in OCD and receive ERP-specific training.