Obsessive compulsive disorder - OCD treatment and therapy from NOCD

I’m always worried that people are mad at me. Can therapy help?

By Elle Warren

Oct 17, 20238 minute read

Reviewed byApril Kilduff, MA, LCPC

You’re at a gathering. Some of the people there are friends you’ve known for years, some of them are people you’re meeting for the first time. As you’re meeting a new person, one of your old friends comes up to you. You say hello, but continue listening to what this new person is saying. Your old friend walks away. 

You spend the rest of the evening, and the days after, worrying about your old friend being mad at you for “snubbing” her, even though you had no intention of doing so. Did she interpret it that way? Are you a bad or mean person? Did you hurt her feelings? You feel immense shame and guilt. You have this sinking feeling in the pit of your stomach, and you can’t help but replay the interaction over and over again in your head. 

If this line of thinking sounds familiar, you’re in the right place. Read on to uncover reasons why you may have this time-consuming, distressing, frequent worry that people are mad at you and how you can get help. 

Why are you always worried that people are mad at you?

Worrying that people are mad at you isn’t uncommon. Most people will experience this from time to time, but if this is a persistent part of your life, it might be a sign that it’s time to seek help. It could be emblematic of a variety of mental health conditions or other experiences that warrant some kind of intervention. 

The first reason you might feel chronically worried that people are mad at you is low self-esteem. Low self-esteem causes a lack of confidence in who you are and your abilities. You might feel you aren’t worthy and/or capable of love and belonging, and you might feel physically, mentally, and/or emotionally inept. As such, you might assume you are constantly in the wrong or doing something bad to cause other people to be upset. Though low self-esteem can occur outside of a diagnosis, it’s also associated with many mental health conditions, including depression, anxiety disorders, obsessive-compulsive disorder, eating disorders, body dysmorphic disorder, and more. 

You could also be experiencing perfectionism. Perfectionists have extremely high, often impossible standards for themselves, and as such, you may think everyone else has equally high—or even higher—standards for you. Therefore, you may have the feeling of constantly falling short or doing something wrong. Like low self-esteem, perfectionism on its own is not a diagnosis. However, it is typical in those with obsessive-compulsive disorder and anxiety disorders. Those who experience perfectionism might feel overwhelmed by how much is outside of their control, and this way of living allows them a sense of taking some control back, even if it’s harmful to their own mental health.

The next possibility is social anxiety disorder. People with this type of anxiety disorder fear being negatively judged, scrutinized, or embarrassed. They don’t trust their ability to interact with others “correctly” or “normally.” For example, if you go to a party, you might spend the evening wondering if you’re speaking and behaving in a way that is pleasing enough to others. If you think you might’ve missed the mark, you’ll likely wonder if people are mad at you for it. You may also experience physical symptoms of anxiety when in social settings, such as a racing heart, perspiration, shaking, and muscle tension. Eventually, you might try to avoid social situations altogether. 

Another condition that could cause you to worry excessively about whether people are mad at you is a subtype of obsessive-compulsive disorder (OCD) called scrupulosity OCD, which features feelings of hyper-responsibility for others’ emotions. This theme of the disorder causes intrusive thoughts, images, feelings, sensations or urges around moral or ethical codes, and possible consequences related to them—these are called obsessions. People with scrupulosity OCD then respond with compulsive behaviors or mental actions to relieve the distress they feel. 

Obsessions could sound like, “My friend seemed upset yesterday in class. Is he mad at me? I must have done something wrong.” or “I forgot to tell my friend that some of our other friends and I met up at the park. I’m a terrible friend, and she’s going to hate me.” Dr. Patrick McGrath, Chief Clinical Officer at NOCD, says that someone who’s worried that people are mad at them is likely to engage in reassurance-seeking behavior, a common compulsion across various OCD subtypes. It can sound like asking a friend: “Are you mad at me?” “Do you think that person is mad at me?” or repeating to yourself “I didn’t do anything wrong.” Other compulsions may include:

  • Mentally reviewing past interactions/scenarios to catch possible moments of offending/disrespecting/upsetting someone
  • Ruminating on whether or not the person in question is mad at you, as if you can just “think your way” to the answer
  • Avoiding social situations that could cause you to worry that you’ve done something “wrong” or “bad” 

You could also be experiencing depression, one of the most common mental disorders that affects people of all ages all across the world. It often occurs along with anxiety disorders and OCD, among other conditions. Depression routinely causes its sufferers to feel down about themselves, making it difficult to engage in things they previously found enjoyable, such as spending time with family and friends. Many people develop the urge to isolate, as depression tells them they’re either not worthy or not capable of engaging with others in a meaningful way. If you are isolating and spending less time with the people you love, you might begin to worry that they’re mad at you for it. 

If you think you might be experiencing any of these conditions, there is evidence-based treatment for all of them that can guide you to living a life that isn’t ruled by this worry.

How and when to get help

If constantly worrying that people are mad at you is negatively impacting your mental health, your relationships, your ability to function, or anything else, it’s probably time to get help. Even if the conditions mentioned in this article don’t resonate with you, that doesn’t mean there isn’t help available. A licensed mental health professional will be able to guide you, gain an understanding of your experience and decide on a course of treatment. 

If you think you have either low self-esteem or are dealing with perfectionism, the best place to start is with cognitive-behavioral therapy (CBT). CBT helps you understand the relationship between your thoughts, feelings, and actions. You will begin to identify long-held patterns. Once you understand how your thoughts, feelings, and actions are influencing each other, you can figure out how to stop the ones that are harming you. You’ll likely learn how to talk to yourself with more compassion, like you would to a friend, to build your confidence—and ultimately abate the chronic worry that people are mad at you. 

CBT will also be most helpful for depression. You’ll learn to recognize the thoughts, actions, and feelings that are feeding your depression. To be clear, depression, like any mental health condition, is not your fault. It’s not a personal failure. Having thoughts, actions, or feelings that are “feeding” your depression does not mean that you’re doing something wrong. It just means you have a condition in which you need help treating. It’s like needing physical therapy to repair a torn muscle. Just because you need guidance in what exercises can help you gain your functionality back doesn’t mean the injury itself was a failure on your part.

If you think you could be experiencing OCD or an anxiety disorder like social anxiety, the gold-standard treatment is exposure and response prevention therapy (ERP). In ERP, you and your therapist will work together to create a hierarchy of exposures that gradually introduce you to your feared stimuli—namely, social situations or intrusive triggers that cause you to worry that people are mad at you. Then, the crucial component is response prevention. This means resisting the urge to engage in compulsive behaviors, thought patterns, or avoidance. For example, if you were to have the thought, “That person must be mad at me,” you would learn to acknowledge the thought without spending time ruminating on whether or not it’s true. For social anxiety, if you’ve started avoiding social situations because they always make you worry that people are mad at you, your therapist would work with you to start engaging in social activities again. Dr. McGrath gives me a few examples of exposures he’d use with someone who’s always worried that people are mad at them:

  • Not holding the door open for someone
  • Not saying hello in an overly enthusiastic way 
  • Not saying thank you when someone invites you to hang out with them

Over time, you will become desensitized to your intrusive triggers and your urge to engage in compulsions or avoid the things you want to do will decrease. You’ll likely still experience a certain level of distress or anxiety when these situations and thoughts come up, but they’ll probably be less frequent, and they won’t get in the way of you living the life you want to live.

Where you can turn if you’re looking for help

It’s not uncommon to worry that people are mad at you, but that doesn’t mean you have to endure it indefinitely. Therapy can help you live a life full of secure relationships and self-confidence, and with less worry. If you think you may be struggling with OCD, anxiety disorders, or depression, I encourage you to learn about NOCD’s evidence-based, holistic approach to treatment

Whether you’re dealing with anxiety, OCD, depression, or a combination of conditions, please know that specialized, effective help is available—you can learn to feel more comfortable around others, even when you don’t know exactly what they think of you.

We specialize in treating Responsibility OCD

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