Does OCD get worse with age?

If you’re living with obsessive compulsive disorder (OCD), it’s natural to wonder how your symptoms might change as you get older. Many health conditions can become more pronounced with age, and you might be concerned if that’s the case for your OCD. To understand how OCD may evolve over time, it helps to first look at what drives the condition itself.

OCD is characterized by persistent, unwanted intrusive thoughts, feelings, or ideas that can cause significant distress. In response, many people with OCD turn to compulsions— mental or physical behaviors—as a way to find temporary relief. These rituals, whether it’s repetitive behaviors like hand washing or mental actions like constant reassurance-seeking, might provide short-term comfort, but they don’t address the underlying anxiety. Instead, they reinforce a cycle of obsession and compulsion, making it harder to break free in the long run. You might wonder if this cycle worsens over time, or if it leads to even more frequent or intense compulsions that come with age.

What causes OCD to get worse?

To answer the question directly, worsening OCD symptoms are not necessarily correlated with age. NOCD therapist Tracie Zinman-Ibrahim, MA, LMFT, CST says, “Age doesn’t have anything to do with OCD symptom intensity. OCD symptom intensity is different in everybody and it changes over time depending on other factors. Compulsions are one of the biggest factors. If you are performing compulsions at any age, your OCD symptoms get worse.”

While it’s possible for symptoms to become more pronounced as you grow older, it’s equally possible for OCD to improve over time, through evidence-based treatment like exposure and response prevention therapy. 

The real factor that determines whether OCD gets worse isn’t age itself—it’s whether you learn to manage your symptoms long-term. Living with untreated OCD can lead to a gradual intensification of symptoms or an OCD flare-up, making it feel as if things are getting harder over the years. An OCD flare up happens when intrusive thoughts and compulsive behaviors feel stronger or more frequent than usual. They can be triggered by stress or changes in your routine, making things  a bit harder to manage than usual. Without treatment, OCD can become more ingrained, and the obsessive-compulsive cycle can strengthen—compulsions may become more frequent, more elaborate, or harder to resist. So while aging itself doesn’t necessarily affect OCD, untreated symptoms may give you that impression, especially as life circumstances change and stressors evolve.

That being said, OCD can also fluctuate throughout a person’s life, regardless of age. Stress is one of the biggest factors that can make OCD worse. Major life transitions—like moving to a new home, starting a family, or experiencing a loss—can heighten anxiety and lead to an increase in OCD-related thoughts and behaviors. During stressful times, it’s common to rely more heavily on compulsions for relief, which reinforces the OCD cycle.

Co-occurring Conditions

Research shows that 90% of people who live with OCD also experience a co-occurring mental health condition, such as depression, social anxiety disorder, and generalized anxiety disorder. When these conditions become more intense, OCD may also feel more challenging to manage, especially if you’re used to engaging in compulsions to find relief.

For instance, when depression is present, the lack of motivation or energy can make it harder to resist compulsions, which then further fuels the OCD cycle. Similarly, anxiety disorders may amplify intrusive thoughts, causing more distress and leading to even greater reliance on compulsions for temporary relief.

Dr. Keara Valentine is a clinical assistant professor at Stanford University School of Medicine in the Psychosocial Treatment Clinic and OCD Clinic, where she specializes in the assessment and treatment of OCD and related disorders. She provides an example of how this might occur: Sam has recurrent panic attacks, and he’s worried they will get so bad that something terrible will happen to him. He also has a mild form of religious/scrupulosity OCD that causes him to experience ongoing and intrusive thoughts about something bad happening to him if he doesn’t pray perfectly. To ease this anxiety, he spends a little extra time praying each day. His compulsions take him only a couple of extra minutes per day, so Sam doesn’t feel the need to seek out treatment. 

However, because Sam’s panic attacks are so bad, he starts to have obsessive thoughts that these panic attacks are happening because he hasn’t been praying enough and they are a way for God to tell him he’s sinning. As a result, his compulsive prayer increases as Sam begins to view prayer as his only chance to make his panic attacks stop.

In Sam’s case, his worsening panic attacks are fueling his OCD compulsions, making them more frequent and severe. On the other hand, if Sam’s panic attacks were to improve, he might find that his need to engage in compulsive prayer decreases as well. This illustrates how his panic attacks and OCD symptoms are closely linked—when one condition worsens, it can trigger a worsening of the other, and vice versa.

Life changes

Significant changes in your life such as jobs, relationship status, home life and more can also create an increase in OCD symptoms, sometimes making your condition feel worse. 

Dr. Valentine illustrates how life changes can affect OCD: Joe has “just right” OCD and needs to make sure his emails are perfect before he sends them. He rereads each email multiple times before clicking send, and sometimes asks a friend to look over them. The process usually takes 10 minutes per message. Joe feels this is inconvenient, but 10 minutes doesn’t impose a huge burden on his day, and since he’s been doing this compulsion for so long, he’s learned to factor in the extra time. Plus, Joe is convinced this is the only way he can write a good email, so he never seeks out an alternative.

Fast forward a few years. Joe now has a new job that requires him to send dozens of emails per day. He can no longer afford to spend 10 minutes per email, because his work and productivity will suffer. His life circumstances have made his condition unmanageable. Joe has reached a point where he needs to manage his OCD or he will be incapable of performing well at his job. 

Starting therapy can be challenging, and many people with OCD wait to seek treatment until their symptoms become more severe or directly impair their ability to function in daily life. For others, the cost of treatment or lack of access to care can be prohibitive and prevent them from getting the help they need. 

No matter the reason for delaying treatment, it’s important to recognize when OCD is interfering with your quality of life. Seeking help early can prevent symptoms from becoming unmanageable, allowing you to adapt to life’s changes without being held back by compulsions.

Hormonal changes

According to the Anxiety and Depression Association of America, studies have shown that hormonal imbalances can trigger or worsen symptoms of OCD. OCD symptoms tend to worsen during premenstrual periods, pregnancy, and postpartum. For some people, OCD symptoms may intensify at different stages of their cycle, with hormonal shifts triggering more frequent or distressing intrusive thoughts.  

Two important hormones to look at are progesterone and estrogen. Zinman-Ibrahim explains, “Estrogen plays a role in augmenting feelings of anxiety, so high levels of estrogen can increase OCD symptoms. Conversely, progesterone tends to inhibit anxiety, so a deficiency in that might lead to similar effects on OCD symptomatology.”

During pregnancy or postpartum, hormonal changes combined with the emotional stress of a big life change can exacerbate OCD, sometimes leading to the onset of perinatal OCD. These hormones increase in production during pregnancy and decrease while in postpartum, causing the severity of OCD symptoms to change with hormone levels. The symptoms can affect each person differently, depending on how much their hormones are changing and how their body adjusts. 

PMDD (Premenstrual Dysphoric Disorder), a severe form of PMS, can cause mood swings, anxiety, and OCD symptoms to worsen in the days leading up to menstruation. Menopause is also linked to significant drops in estrogen and progesterone levels and can also lead to changes in OCD severity, as hormone levels influence mood, anxiety, and stress responses.

If you think hormonal changes might be affecting your mood or your OCD, it’s important to reach out to your doctor. They can help you understand what’s going on and work with you to manage any changes you’re experiencing.

Can OCD get better with age?

While OCD doesn’t have a predictable trajectory, it’s certainly possible for symptoms to improve with age. One key factor is treatment—specifically, exposure and response prevention (ERP) therapy, which is highly effective in treating OCD. With consistent treatment, ERP can help you learn how to resist compulsions and manage intrusive thoughts in healthier ways, which can lead to significant improvements in symptoms over time.

Support systems also play a crucial role in managing OCD, and as we age, we may find ourselves with stronger, more reliable sources of support—whether from family, friends, or even support groups. Having a network of people who understand OCD and can offer encouragement during challenging moments can make it easier to resist compulsions and engage in healthier coping mechanisms.

Additionally, lifestyle changes that naturally come with age can contribute to improved mental health. Many people adopt healthier habits as they grow older, such as better stress management techniques, mindfulness practices, or even more regular exercise. These habits can help reduce anxiety and stress, which are major triggers for OCD. For example, regular physical activity has been shown to improve mood and decrease anxiety, which can make it easier to manage OCD symptoms.

As we age, we may also gain more insight into how our minds work, becoming more adept at recognizing and challenging harmful thought patterns. We may also become more willing to seek professional help or commit to therapy when it is needed. This self-awareness, combined with healthy coping strategies, can make it possible for OCD to become less disruptive over time. So while OCD may not disappear with age, many people find that, with the right tools and support, it becomes more manageable.

OCD treatment

If you are experiencing symptoms of OCD at any age, the best way to get better and manage your symptoms is through exposure and response prevention therapy (ERP). It is important that you don’t wait for your OCD to get worse to seek treatment. If you think you have a mild form of OCD, it’s recommended that you seek help, even if your symptoms feel like they’re manageable. This will help ensure your condition does not get worse.

ERP therapy is clinically proven to help alleviate OCD symptoms. ERP works by targeting your obsessions, thoughts or triggers and gradually exposing you to them in a controlled environment. From there, the therapist will guide you to learn how to sit with the discomfort these thoughts bring without acting out on the compulsions you usually use to find relief. 

While it can seem daunting, ERP helps make lasting changes. By giving you a strategy to avoid falling into the pattern of obsessions and compulsions, you’ll have a longer lasting alternative to relieve anxiety and stress. ERP works regardless of age, and the best thing you can do to manage your symptoms is give it a try.

Tips for living with OCD

While ERP treatment is the best way to find relief from your OCD symptoms, there are a few lifestyle changes you can make to improve your overall well being.

Zinman-Ibrahim shares a few points on how to live with OCD and manage your symptoms. The number one thing she recommends is building ERP habits into your daily life. She calls this living an ‘OCD recovery lifestyle.’

“That means building ERP into your daily life, especially the response prevention part—and understanding that OCD is going to come up in different ways,” she explains. “The best thing you can do is be on the lookout and don’t stop or think that you’ve gotten to a point where you no longer have to resist compulsions. It’s a lifelong thing that we have to stay on top of.”

Zinman also recommends focusing on holistic self-care, which involves managing your stress, eating well, creating good sleep habits, and practicing mindfulness. All of these things can set you (and your brain) up for success in managing OCD symptoms.

Bottom line

OCD is a complex condition in that its symptoms can increase or decrease throughout various points in your life. While age itself does not make OCD better or worse, the habits you develop as you age and the strategies (or lack thereof) you implement to help deal with your condition can both help you or hurt you. 

If you have OCD, there is never a wrong time to begin treatment—there are tools to help you conquer your condition at any age.