Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Should I get treatment for “mild” OCD? What experts say

By Elle Warren

Oct 31, 20239 min read minute read

Reviewed byApril Kilduff, MA, LCPC

It’s the inclination of so many of us to downplay, disregard, or invalidate our experiences. It’s hard to ask for help, so we too often avoid doing it until we’re in crisis. 

This is especially common for mental health concerns, something we experience largely internally and is associated with stigma. In recent years, talking openly about mental health has grown more common, but most of us probably didn’t grow up with that. As such, we have internalized the idea that mental health is either not real or is not something you should talk about.

You might hold the belief that going to therapy is for “crazy” people—there’s a lot wrong with that sentence, but I know that’s how I felt as a teenager and my doctor suggested I try therapy. I was functioning: I went to school, I got good grades. Why would I need therapy?

I didn’t appear to be in crisis, so I scoffed at the idea of therapy. The idea that therapy isn’t for anyone, with or without a diagnosis and regardless of severity, is the messaging a lot of us have heard.

What if you never had to reach a crisis point, though? What if you had intervention sooner? What if you committed to doing the best you can to care for your brain rather than settling for “good enough” or “not that bad”? Let’s dive in and discuss the decision to seek help for OCD in particular—even when we might get by without it.

Defining OCD

Because misleading phrases like “I’m so OCD” or “we’re all a little OCD” are so common, let’s establish a shared understanding of what OCD actually is. 

OCD contains two core groups of symptoms: obsessions (intrusive thoughts, images, urges, sensations, or feelings) and compulsions, which can be mental or physical actions. These intrusive triggers are often taboo or inappropriate in nature, and they are what professionals call ego-dystonic, meaning that they are unwanted and do not align with a person’s values, desires, or intentions. 

OCD can focus on a wide variety of themes, covering any aspect of life. Better known subtypes related to cleanliness and organization are only possible manifestations. Other common themes of obsessions include: harming oneself or others, being a pedophile, questioning your attraction to your partner, not knowing your “true” sexual orientation, being a “bad person,” needing to know the “purpose” of life or what happens when we die, among countless other examples. 

For people with OCD, intrusive thoughts about these topics bring feelings of distress, anxiety, guilt, shame, fear, embarrassment, and/or other uncomfortable emotions.

Compulsions are just as wide-ranging. They include anything done to relieve oneself of the uncomfortable emotions brought by obsessions, and typically consume a significant amount of time. Physical, or external, compulsions include:

  • Tapping/touching. This could look like picking up an object and putting it back down a certain number of times until it feels “just right,” tapping your knee a certain number of times, or having to close a door exactly the “right way.” This compulsion typically has no logical connection to the intrusive trigger itself, but rather just relieves discomfort (albeit temporarily).
  • Washing/cleaning. This is a common compulsion for people with contamination OCD, the theme of OCD that focuses on germs, bacteria, and a fear of contracting or spreading an illness. It looks like excessive hand washing, showering, and/or cleaning of household surfaces.
  • Checking. This can look like checking to make sure the stove is off, or the door is locked, or that you didn’t hit someone with your car.

Some common mental compulsions include:

  • Rumination. To put it simply, rumination is overthinking to an intense degree. It happens when you turn a thought, memory, situation, or question over and over in your mind with the hope of “solving” or “thinking your way out” of it.
  • Mental reviewing. This looks like combing through past events or situations to look for proof that your worries—specifically, your intrusive triggers—are or are not true.
  • Seeking reassurance from yourself. This can sound like saying to yourself: I’m a really good person; I would never do something like that; Everything will be fine, among other reassurances that are a direct response to the fear or worry caused by intrusive thoughts, and they offer a false sense of certainty.
  • Distraction. This looks like intentionally keeping your mind occupied in the hopes that the distraction keeps your intrusive thoughts at bay. For example, maybe you make constant social plans because you have fewer intrusive thoughts when you’re around other people.

Usually, when people use OCD as an adjective—such as “we’re all a little OCD”—it’s in reference to an activity or habit that someone enjoys, like being clean or organized. But if it’s not bringing you distress or interfering with your life in some way, it’s not OCD.

When should you get help for OCD?

The signal that it’s time to seek treatment for OCD is that it’s causing you any kind of impairment and/or distress. If it’s hindering your ability to function effectively at home, school, work, or do things you enjoy, treatment can help you live a more full life.

If you find OCD bringing up feelings of sadness or depression, guilt, shame, anxiety, or fear, treatment will help you build tolerance and resilience to those feelings and ultimately decrease their intensity in the future. 

Help is available, and you don’t have to suffer. Dr. Patrick McGrath, licensed psychologist and NOCD’s Chief Clinical Officer, says, “If you had a best friend who this was happening to, would you tell them not to worry about it, or to go get help?”

He points out that we have the tendency to believe that it’s fine for everyone but ourselves to get help. Challenge that, and remember that you, too, are worthy of feeling better—just as you’d want for the people you love.

Should you get help even if you perceive your condition as mild?

If you’ve been dealing with OCD for an extended period of time, you’ve probably learned to just “live with it,” but that doesn’t mean that it can’t get better. You may have adjusted to a certain baseline of how you feel, but that baseline can be improved—and sometimes, the benefit can be far greater than you expected.

There is no difference in clinical recommendations for treating OCD based on severity. Dr. McGrath says that the pattern of OCD, as with many physical and mental health conditions, is that it tends to get worse the longer it goes untreated. 

Therefore, no matter the severity of OCD, treatment is recommended to prevent the condition’s progression. That’s because OCD is not something people outgrow with time; in fact, it tends to just get worse when it’s not treated. Dr. McGrath poses a powerful question: “Even if [treatment] gave you an hour of your life back every day, wouldn’t that be worth it?” You can give that time back to the things that bring you joy, rather than OCD.

Consider this example:

For as long as she could remember, Sarah worried about death. She saw horrible images of her and her loved ones lying in caskets. As a kid, she’d spend hours thinking and thinking about what this means—was she a psychopath for picturing her loved ones dead? Was thinking so much about it going to make it happen? 

She tried to reassure herself, repeating over and over thoughts like, My family members and I aren’t going to die any time soon. I do not want this to happen. I love my family. As she got older, she learned that as long as she didn’t watch movies or read books that dealt with death, and as long as she stayed busy, the intrusive thoughts went away or at least quieted.

Once Sarah got into a serious relationship, and her partner saw her habits more intimately, she suggested that Sarah get help. It was clear to her how much Sarah’s life was impacted by OCD, even though Sarah was so accustomed to it. 

Once Sarah entered treatment, she began to realize just how much of her freedom had been sacrificed to OCD. After so many years, they seemed like benign habits or personality traits—but as Sarah started to break the OCD cycle in some areas of her life, she noticed all the other ways her condition had crept into everyday activities. She had been avoiding nearly all “serious” topics of conversation, steering clear of chatting with family members about their health, and repeating certain “safety” words in her head every single time she drove her car. 

All these things had felt “normal” to Sarah for years, but with proper treatment from a specialist who could help her identify them as OCD symptoms, she learned just how much less stressful, how much more free, these parts of her life could be.

Assess your overall mental health needs

You could also be interpreting symptoms of OCD as symptoms of anxiety. OCD is widely misunderstood and is often misdiagnosed as anxiety. They can occur at the same time, and OCD can bring feelings of anxiety, but they are two distinct disorders. 

It can be especially easy to mistake OCD for anxiety if your compulsions are primarily mental, and if you’re not fully aware of your intrusive triggers or mental compulsions. Those with anxiety may also ruminate, for example, but it’s not for the purpose of relieving distress brought by obsessive thought patterns.

Depression also has a high comorbidity with OCD. It’s thought that OCD can exacerbate or even cause depression, as the sufferer develops feelings of hopelessness over not being able to control their negative and distressing thoughts and reactions. 

Therefore, if you’re also experiencing depression, getting help for OCD could improve your symptoms of both conditions. 

A trained OCD specialist can help you determine what symptoms are related to OCD and which are emblematic of anxiety or depression. This is important in determining the best course of action to address all your needs—which is possible through proper treatment.

What is the treatment for OCD?

The gold-standard, evidence-based treatment for OCD is exposure and response prevention therapy (ERP). To begin, you and your therapist will work together to identify the nature of your obsessions, including what places, activities, thoughts, feelings, or other stimuli trigger them. You’ll also determine what you do in response to intrusive triggers—in short, your compulsions. 

Depending on how aware of your intrusive triggers and compulsions you are, this part of the process may feel natural. If you are not aware of all the ways OCD impacts your life, which is extremely common, your therapist can help you uncover them.

After you’ve identified your intrusive triggers and compulsions, you and your therapist will continue to work together to develop a hierarchy of exposures, or exercises designed to help you confront your triggers. 

This process is gradual, so you’ll start small, then work your way up to triggers that bring the most discomfort. You will not be forced into anything you don’t want to do or aren’t ready for, but you will be continuously encouraged to tolerate and accept discomfort.

Crucially, your therapist will guide you in resisting compulsions before, during, and after exposures. This is imperative in breaking the OCD cycle, as compulsions are the symptoms that keep us stuck and signal to our brain that our intrusive triggers are a threat. Over time, ERP will help you get better at tolerating uncertainty and discomfort, and the intensity of your symptoms can decrease significantly.

Where to go for help with OCD

I hope you come away from this article with a sense of empowerment to pursue help and a higher quality of life. 

If you’re interested in learning what expert treatment can do for your life, even if you feel that your OCD symptoms are “mild,” I recommend learning more about NOCD’s evidence-based approach to treatment for OCD, anxiety, and depression. Remember: what would you suggest a friend do if they were in your situation?

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