Obsessive-compulsive disorder (OCD) is a mental health disorder where a person has uncontrollable, repetitive thoughts (obsessions) and behaviors or mental acts that they feel the urge to do over and over (compulsions). The OCD cycle is triggered and followed by a thought, image or urge, causing distress and ultimately the compulsion.
It’s important to remember that while OCD is different for each person, the “OCD cycle” typically looks the same once it’s triggered. It starts with an obsession that leads to anxiety, and it’s that feeling of anxiety that creates the urge to act on compulsions in order to gain relief. For some people, external factors can trigger their obsessions — whether those are intrusive thoughts, doubts, images, or urges — and for others, the obsessions can come out of nowhere with no external trigger at all.
A trigger is something in our environment or mind that causes us to experience a certain thought, feel a certain way or take a certain action. For people with OCD, triggers often cause an increase in symptoms.
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For example, let’s say you have a fear of being contaminated by germs and, while you’re grocery shopping, someone in the next aisle starts coughing. Hearing that person cough could trigger obsessions such as, “That person is sick and now I’m going to get sick,” or “I have to get out of this store right now or I’m going to get sick because that person is spreading germs everywhere.”
Another example of a trigger might be sitting down to watch the news only to see a feature story about a burglary where the suspect entered a home through an unlocked door. While it’s normal to be concerned about whether or not your doors are locked, this can become a trigger when it leads to a series of thoughts, fears, and/or obsessions that lead to compulsions like consistently checking to make sure the doors and windows are locked in your house.
Just as OCD is different for each person, so are triggers. There is an infinite number of things that can be triggering to someone, including thoughts, objects and sensations. Triggers can also be compounded by stress, trauma and life changes, meaning your triggers can change or intensify over time.
When you’re looking at external factors like stress and trauma, however, it’s important to notice that it’s not necessarily that stress itself is a trigger — it’s that stress can bring up obsessions or draw attention to a particular obsession.
Everyone has some level of stress, be it from school, work or family life, and research has shown Americans are among the most stressed people in the world. While some stress in small doses is normal, long-term stress can harm both physical and mental health, including triggering OCD.
The American Psychological Association defines trauma as “an emotional response to a terrible event like an accident … or natural disaster,” and studies have found a high rate of OCD among people with a traumatic history. Often when people go through a traumatic event, it causes extra stress on their mind and body, and it could even induce post-traumatic stress disorder (PTSD). Research shows an increased likelihood of OCD diagnosis within a year of being diagnosed with PTSD.
Change is a natural part of life, and it’s important to remember that while you might experience increased OCD symptoms as a result of a major life change, that doesn’t mean you need to avoid change or blame yourself for having experienced it. Many things can trigger an increase in OCD symptoms whether that’s hormones (puberty, pregnancy, post-partum, menopause), increased stress and pressure to perform (in college, at a new school, in a new job) or something entirely different. And, more often than not, the biggest trigger is simply increased uncertainty and the weight of the unknown.
There are things you can do to help identify, cope with and understand your triggers if and when you encounter one.
The phrase “self-care” is used often and for good reason — taking care of yourself can have many positive effects on your physical and mental health. Eating healthy foods, getting seven to nine hours of sleep each night, exercising for at least 30 minutes each day and avoiding drugs and alcohol are habits and practices you can use to manage your triggers — and in turn, your OCD. While self-care alone is not likely to completely manage your OCD — ERP therapy with a licensed practitioner offers the best chance of that — taking care of yourself is an important part of the treatment process and can make your symptoms more manageable.
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Knowing is half the battle. That saying is especially true when it comes to OCD. It’s important to know your triggers because the ultimate goal is to be able to face them without engaging in any compulsions, avoidance, distractions, substance use, etc. If you aren’t sure what triggers you, take time to reflect on your OCD and make notes if needed. If you still are unsure, reach out to a therapist or a supportive family member or friend who may be able to help.
Often referred to as the gold standard of OCD treatment, exposure and response prevention (ERP) therapy helps you regain control of the OCD cycle. It works by exposing you to thoughts and situations that trigger your obsessions in a safe place. With the help of your therapist, ERP aids you in making a choice to not do the compulsion once the obsession has been triggered. A therapist will guide you through the entire ERP therapy process, providing exercises and techniques to help you manage your OCD triggers and symptoms.
Experiencing OCD triggers can be overwhelming, but help is available. You can begin by scheduling a free 15-minute call with the NOCD clinical team. They’ll work to find a good match for you from the NOCD therapists that specialize in the treatment of OCD and are trained to provide ERP therapy. The best news is that this can all be done from the comfort of your home — NOCD offers video therapy and is available in all 50 states.