Can You Treat OCD on Your Own? 10 Tips From a Therapist

What Is OCD?

Obsessive-compulsive disorder (or OCD) is a debilitating mental health condition that leads to intrusive thoughts (obsessions) and rigid rituals and routines (OCD compulsions). Obsessions in OCD are often centered around unrealistic worries and concerns that the person uses compulsive routines to cope with.^{3, 4} For example, some people have contamination OCD, causing obsessions that lead to compulsive hand washing. In contrast, others have health OCD, leading to excessive medical appointments and expensive procedures.

Symptoms of OCD

The two hallmark symptoms experienced by people with OCD are frequent obsessions and compulsive mental acts or behaviors and routines. The type of OCD a person has can influence the way these symptoms show up, as well as the specific kinds of obsessions and compulsions they struggle with.^{3, 5}

Here are the main symptoms of OCD, with some common examples of the different ways they can show up:³

OCD Obsessions

OCD obsessions are repeated intrusive thoughts, images, or urges that are unwanted and often cause significant distress or anxiety.

Examples of OCD obsessions:

• Urges to check locks or doors
• Mental images of a loved one getting hurt
• Repeated thoughts of being diagnosed with cancer
• Intrusive worries about making a mistake
• Recurring doubts about your sexual orientation

OCD Compulsions

OCD compulsions are repetitive behaviors or mental rituals in which the person feels a strong urge to engage when they have obsessive thoughts. These compulsions usually help relieve anxiety or distress or neutralize intrusive thoughts. Most people with OCD recognize that the obsessions and compulsions are not based on reality, but they still feel driven to perform the behaviors.

Examples of OCD compulsions:

• Needing to check and re-check the locks
• Repeatedly calling to check on a loved one
• Doing hours of medical research
• Repeated spellchecking or editing of papers
• Frequent reassurance seeking from your partner or friend

To receive an OCD diagnosis, a person needs to experience both obsessions and compulsions that are frequent, severe, or distressing enough to affect their functioning. Also, OCD obsessions and compulsions need to be time-consuming enough to take up one hour or more per day.³

Can You Treat OCD on Your Own?

According to some research, only 4% of people with OCD get better without professional treatment.¹ OCD is one of the most debilitating types of mental illness, and most people with the disorder describe being moderately or severely impaired by their symptoms.⁶ For example, many people with OCD spend hours every day obsessively thinking, worrying, and feeling controlled by compulsive urges. Over time, OCD obsessions and compulsions often become more severe, more time-consuming, and harder to overcome without professional help.

While it may be possible for people with mild forms of OCD to use self-help resources to overcome OCD, most people need therapy (and sometimes medication) to manage their symptoms. This is partially because of how severe and debilitating OCD is and partially because the symptoms of OCD tend to worsen without professional interventions. Without help, many people with OCD ruminate on obsessions and engage in compulsions more often, not knowing these responses usually worsen their symptoms.¹

How Is OCD Treated?

Starting therapy is usually the first treatment recommendation for someone with OCD.

The length of OCD treatment a person needs varies depending on several individual factors, but many people require long-term treatment. Someone with OCD often benefits from therapy on an as-needed basis, with the option to increase or decrease therapy sessions according to their symptoms.⁸

Because it’s not unusual for someone with OCD to experience periods where their symptoms are more or less active, having an established relationship with a therapist is a good idea.⁴

Types of Therapy for OCD

Certain types of therapy might work better than others for someone with OCD, depending on the type of OCD they have and the severity of their symptoms. People who struggle with a lot of OCD compulsions like cleaning, checking, or hand-washing often benefit from therapies that use a combination of cognitive, behavioral, and exposure therapy approaches.⁷ People who struggle more with OCD obsessions than compulsions may benefit more from CBT or ACT therapies that do not include exposure therapy.⁵

Some of the most effective types of therapy for OCD include:⁷

• Cognitive Behavioral Therapy (or CBT): CBT for OCD has been widely researched and found to be effective in treating the symptoms of OCD. In CBT therapy, someone with OCD will be taught about the relationship between their thoughts, feelings, and behaviors. They’ll learn how to adjust or change unhelpful thoughts contributing to their symptoms and be encouraged to find healthier alternatives to replace their compulsive rituals and routines. Research suggests most people with OCD need 12-14 sessions for optimal results.⁹
• Exposure therapy: Exposure therapy is a kind of CBT treatment for anxiety that is also effective in the treatment of OCD. In exposure therapy, therapists will coach clients to develop a list of the people, places, and situations that trigger their OCD symptoms. Gradually, the client will be encouraged to face these triggers and use CBT and relaxation skills to manage the anxiety they feel. Certain ‘exposures’ may need to be repeated several times, but research suggests that including exposure therapy in CBT treatment often leads to better and faster results for people with OCD.⁴
• Exposure and Response Preventions (or ERP): ERP is an evidence-based treatment for OCD that aims to gradually expose someone to situations that trigger their symptoms. When exposed to an OCD trigger, ERP therapists will encourage the client to use mindfulness, relaxation, and other skills instead of using compulsive behaviors to cope. Over time, this helps to desensitize people to their triggers, reduce compulsive behaviors, and instill more confidence in using other, healthier coping skills in response to their OCD thoughts and urges.
• Acceptance and Commitment Therapy (or ACT): ACT is another evidence-based therapy that can be used to treat the symptoms of OCD. ACT therapists rely on the use of emotional acceptance and mindfulness skills to help people respond to difficult thoughts and feelings in healthier ways. ACT therapists also sometimes do core values work with their clients, which focuses on helping people identify and align with their core values. Research suggests that ACT is just as effective as CBT for OCD.¹⁰

Most of the therapies used to treat OCD focus on helping people respond differently to obsessive thoughts, resist compulsive urges, and learn healthier coping methods. Some of these skills are taught and practiced during therapy sessions, but progress will only be made when they’re applied outside of therapy as well. Breaking the cycle of obsessive thinking and compulsive routines can be hard for someone with OCD, and it’s common to experience periods of remission and relapse over the course of a lifetime.^{3, 6}

Medications for OCD

For a lot of people with OCD, therapy, in addition to medication, provides the best results.^{4, 8} The most commonly prescribed medication for OCD symptoms are antidepressants, which work on certain receptors in the brain linked to mood and anxiety. Less commonly, someone with OCD may be prescribed an antipsychotic medication, which can help reduce the number and intensity of obsessive thoughts.^{4, 5, 8}

10 Ways to Cope with OCD on Your Own

In addition to seeking professional help for OCD from a therapist and/or psychiatric medication prescriber, there are some things you can do on your own to improve your symptoms. Making healthy lifestyle choices about sleep, nutrition, substance use, and exercise can have many benefits for your physical and mental health.² Also, there are some more specific coping skills and strategies for OCD that can help to reduce the number and intensity of your symptoms.

Here are ten ways to cope with OCD on your own:

1. Educate Yourself About OCD Symptoms & Subtypes

People say knowledge is power because learning more about something can help you feel more comfortable and in control of it. This is often the case for people with OCD, who often find learning about OCD provides healthy reassurance that their thoughts, feelings, and behaviors are symptoms of OCD, and not a moral deficit or character flaw. Taking time to read about OCD subtypes can also be helpful to people with OCD, who often describe feeling less alone when they read about the experiences of other people with the same kind of OCD they have.

2. Identify How, When, & Where OCD Symptoms Show up

After learning more about the symptoms and subtypes of OCD, it’s a good idea to spend some time identifying your own OCD obsessions and compulsions and ways they show up. For example, someone with contamination OCD might not have realized that some of their cleaning and hygiene routines are actually compulsions related to their OCD. When you stop to identify how, when, and where your OCD symptoms show up, you’re better prepared to catch and interrupt them in real–time instead of feeding into the cycle unknowingly.

Here are some reflection questions to help you identify your OCD obsessions and compulsions:

• What kind of thoughts do you tend to get stuck overthinking, ruminating, or worrying about?
• Which specific thoughts create the most dread, anxiety, and distress for you?
• What urges do you have when these kinds of thoughts pop into your mind? What do you feel compelled to do, say, not do, or not say in these moments?
• When you mentally review your normal routine, what kinds of tasks or activities do you feel you NEED to do in a certain order or a specific way?
• What ‘rules’ does your OCD try to enforce on you throughout the day, and what do you fear will happen if you BREAK these rules?

3. Adopt Healthier Habits & Routines

People with any kind of mental health condition often find that making healthy lifestyle choices is a very important part of their journey to mental well-being. Getting 7-8 hours of nightly sleep, eating a nutritious and balanced diet, and getting outside and exercising can improve your mental health. Without these foundations, it’s a lot harder to manage OCD symptoms. Because anxiety is also a common feature of OCD, some people also benefit from cutting down or eliminating stimulants like caffeine, nicotine, and even sugary processed foods.²

4. Use Mindfulness to Get out of Your Head & Into Your Life

Most of the anxiety and distress associated with OCD results from being too stuck in your head, overthinking, and ruminating on OCD obsessions. Thankfully, mindfulness exercises like body scans, breath awareness, and guided meditations provide a simple and practical solution for this tendency. Even dedicating 15-20 minutes a day to mindfulness or meditation can help with OCD, as well as helping you practice spending more time in your life and less in your head. As an added bonus, mindfulness has also been proven to lower stress and anxiety, boost your mood, and make it easier to focus and concentrate.¹¹

5. Practice Using Impulse Control to Break Compulsive Habits

Compulsive behaviors are forms of impulsivity because they’re driven by strong urges and impulses to say, do, or think in certain ways. In OCD, most compulsive impulses are driven by fear and anxiety. Luckily, there are a number of impulse control strategies that can help you resist the urge to act on a compulsion. For example, stopping to count to ten, thinking through the consequences, or focusing on something else are all simple forms of impulse control that can help you break your compulsive habits.¹¹

6. Practice Flexibility in Your Daily Life & Routine

Many people with OCD have control issues that contribute to rigid routines and compulsive behaviors. While these can provide a temporary sense of relief, they often become very time-consuming and can interfere with the rest of your routine. If this is true for you, it’s a good idea to examine the rigid parts of your routine and look for small ways to switch things around, shorten a task, or do things in a different way. These are great ways to practice being more flexible and adaptable, which is one of the key elements of emotional resilience, which acts as a safeguard against mental health conditions like OCD.

7. Learn to Let Go of Difficult Thoughts & Feelings

Most people with OCD have some traits of a Type A personality, including being overly rigid and controlling. While this can be a strength in some situations, it can also lead to a range of problems and issues, including a worsening of OCD symptoms. Most OCD symptoms are at least partially a result of trying too hard to control specific unwanted thoughts or feelings like worry, anxiety, and self-doubt. A good way to practice letting go is to regard uncomfortable OCD thoughts and feelings as irrelevant to who you are, unimportant to your day, and unable to affect your actions.

Here are some examples of ways to let go of difficult thoughts and feelings:

• Visualize your anxiety as a wave rising up inside of your core and track the wave as it rises, crests, and eventually falls and washes away
• Resist the urge to obsessively “replay the blooper reel” of an awkward interaction or mistake, and instead remind yourself that no one is perfect & try to focus on the here-and-now
• Treat OCD thoughts or urges like they’re non-urgent SPAM emails that are trying too hard to get your attention, and visualize yourself moving them into the trash bin icon in your mind

8. Use Journaling to Express Thoughts & Feelings

Journaling for mental health can benefit your well-being and can be a healthy outlet for coping with OCD. Consider starting a daily journaling routine for 15-30 minutes, and use this time to write down any intrusive thoughts or negative emotions you’re experiencing. When the time is up, try to visualize yourself leaving the issues you wrote about on the page, closing the book, and then returning to the things you need or want to do. By giving yourself this time every day, you’re taking control of when and how long you dedicate to the thoughts and feelings linked to your OCD.

9. Rebuild Confidence & Trust in Yourself

Most people with OCD struggle with high levels of self-doubt, which can intensify their OCD obsessions and compulsions. Take some time to consider whether this is true for you and how a lack of trust in yourself may contribute to your OCD. Next, work on making a list of all of the behaviors and compulsions that are an expression of this self-doubt, and work on interrupting these habits when you notice them. Try to replace them with new behaviors that help to rebuild your trust and confidence in yourself.

Here are some examples of habits driven by self-doubt and replacement ideas to build self-trust:

• Calling friends & family to hear advice → Making decisions independently
• Spam texting your partner to check on them → Waiting for them to text you
• Hours of WebMD research on causes of fever → Take a Tylenol & a nap
• Excessively re-checking for typos → Setting a 5-minute timer & hitting send
• Checking & re-checking locks at night → Checking locks once before bed

10. Manage Your Stress & Anxiety

Stress and anxiety are normal experiences that everyone will have from time to time, but they shouldn’t be things you struggle with every single day. If they are, they’re probably worsening your OCD symptoms, so it’s a good idea to try to identify and address the root causes.² These might include certain circumstances or habits in your life, like a poor sleep schedule, long commute, or lack of work-life balance that you can try to improve. Other times, the sources of toxic stress are mainly internal, and include bad mental habits like rumination, worry, or being too self-critical that you can work on stopping.

In My Experience

OCD is a highly debilitating disorder that can cause people to feel trapped inside their own minds, watching a bad compilation of their scariest and most disturbing thoughts. To cope, people with OCD engage in rigid, controlling, and compulsive routines that provide temporary relief but end up making their OCD worse in the long run. While it can be hard to break this cycle without professional help, there are a number of lifestyle changes that can help. Prioritizing self-care, building self-trust, practicing mindfulness, having flexible routines, and learning better coping skills are all good options for people dealing with OCD symptoms.