Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Can you “grow out of” OCD?

Mar 24, 20235 min read minute read

Reviewed byPatrick McGrath, PhD

Obsessive-compulsive disorder (OCD) most commonly develops earlier in life, with an average age of onset at 19 years old, but it can actually develop at any age, and it often develops in different ways.

As the intensity of OCD symptoms often varies over time, it’s not uncommon for the condition to become more manageable for periods of time. People with OCD, as well as their parents or loved ones, may wonder if these periods can lead to long-term remission, or if symptoms are likely to return if left untreated. In other words, can people actually grow out of OCD?

What is OCD, and when does OCD usually develop?

OCD is characterized by the presence of obsessions and compulsions:

Obsessions are defined as “recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress. 

Compulsions are “repetitive behaviors (e.g. hand washing, ordering, checking) or mental acts (e.g. praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.” Compulsions are done in an attempt to relieve the anxiety that comes from obsessions or to prevent a feared outcome.

In OCD the presence of obsessions and compulsions can be extremely distressing, take up multiple hours in an average day, and will most often cause impairment in day-to-day functioning. 

According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) 25% of cases of OCD start before the age of 14, and the average age of onset for OCD is about 19 years of age. It is rare for OCD to develop after the age of 35, but it does happen. Males typically experience an earlier age of onset than females, and 25% of males often see symptoms before the age of 10. OCD symptoms usually present gradually, more sudden or acute onset is not uncommon. 

Does OCD usually get better or worse over time?

The symptoms of OCD tend to wax and wane from time to time. They may become minimal during certain periods, only to return stronger unexpectedly. In general, however, when OCD is left untreated, engaging in compulsions tends to make symptoms worse over time. 

This is because engaging in compulsive behavior only strengthens the OCD cycle, reinforcing fears over time. A person will engage in compulsions anytime their obsessions are triggered, in an attempt to eliminate anxiety or prevent an unwanted outcome. These compulsions may temporarily relieve anxiety, but they inadvertently make fears worse, reinforcing the false belief that obsessions and doubts cannot be tolerated without compulsions.

Can people grow out of OCD completely?

It’s very rare for a person to truly grow out of OCD, and long-term remission often involves people developing the skills needed to manage the condition on their own, rather than their symptoms disappearing entirely or spontaneously. 

OCD is considered a chronic condition—while symptoms may fluctuate unpredictably, or respond strongly to specific life events, it is highly unlikely for OCD symptoms to go away completely. 

When should I seek treatment for OCD?

There is hope for people who are suffering from symptoms of OCD, whether their symptoms are at their most or least severe. In fact, proactive OCD treatment when symptoms are less severe can be effective in preventing difficult OCD episodes in the future. If your symptoms are causing distress and impairment in your life and you want a change, you can get better with exposure and response prevention (ERP) therapy. 

ERP is an evidence-based treatment and has shown by decades of clinical research to be highly effective in treating OCD. Most individuals who do ERP with a trained therapist experience a decrease in symptoms, reduced anxiety and distress, and increased confidence in their ability to face their fears. 

During ERP, people work with their therapist to build an exposure hierarchy and confront their fears, one trigger at a time. Usually an ERP therapist will start with exercises that bring about a low level of fear and anxiety, gradually working up to the harder exposures as confidence is built. 

When doing exposures, the goal is always response prevention: resisting the urge to respond to fear and anxiety by engaging in compulsions or avoiding triggers. Over time, this allows you to tolerate anxiety without relying on compulsions or avoidance to feel better. 

Can OCD come back after it goes away?

Even after treatment and long periods of freedom from OCD symptoms, people may experience a return of symptoms, or even new themes of OCD, whether corresponding with major life events or due to any number of other reasons. 

However, the results of ERP therapy remain, even if symptoms return: once you have done ERP therapy and developed response prevention skills, you will have the tools you need to deal with a relapse or return of OCD symptoms. Often people will recognize OCD for what it is, and while they may feel distressed by the return of symptoms, they are able to “be their own therapist,” using the skills they gained in ERP therapy to get back on track.

However, sometimes OCD may return with high severity or unexpected themes, and people may benefit from returning to treatment. By continuing ERP with a trained therapist, people can strengthen their prevention skills and manage OCD long-term.

If you’re struggling with OCD, you can schedule a free 15-minute call today with the NOCD care team to learn how a licensed therapist can help. At NOCD, all therapists specialize in OCD and receive ERP-specific training. ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP.

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