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Supporting Someone With Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a mental health disorder that involves unwanted, distressing thoughts or urges (obsessions), and repetitive mental or physical acts that a person feels he or she has to do (compulsions). When a person has OCD, his or her condition can affect others around him or her, such as friends and family members. Friends and family can help by offering support and understanding.
What do I need to know about this condition?
A person with OCD may experience obsessions, compulsions, or both. The person may try to ignore his or her obsessions, or he or she may try to stop or undo the obsessions with a compulsion such as a ritual. Compulsive acts may seem senseless or excessive to you. Your loved one may think that acting on compulsions will reduce or prevent his or her discomfort, but compulsions do not have this effect.
Examples of common obsessions include:

  • Fear of contamination with germs, waste, or poisonous substances.
  • Fear of making the wrong decision.
  • Violent or sexual thoughts or urges toward others.
  • Need for symmetry or exactness.

Examples of common compulsions include:

  • Excessive handwashing or bathing due to fear of contamination.
  • Checking things again and again to make sure tasks are finished, such as making sure a door is locked or a toaster is unplugged.
  • Repeating an act or phrase again and again, sometimes a specific number of times, until it feels right.
  • Arranging and rearranging objects to keep them in a certain order.
  • Having a very hard time making a decision and sticking to it.

Obsessions and compulsions can be time-consuming and can interfere with personal relationships and normal activities at home and school or work. OCD usually starts in young adulthood and continues throughout life. Many people with OCD also have depression or another mental health disorder.
What do I need to know about the treatment options?
OCD may be treated with:

  • Exposure and response prevention therapy. The goal of this therapy is to target and reduce compulsive behaviors. It involves exposing your loved one to things or situations that cause his or her obsessions to start (triggers), then preventing him or her from carrying out compulsions. This is considered to be the most effective treatment for OCD.
  • Cognitive behavioral therapy (CBT). This type of therapy teaches a person how to identify irrational thoughts that are associated with his or her obsessions, and how to replace those thoughts.
  • Antidepressant medicine. Medicine is most effective when it is used along with therapy.
  • Self-soothing methods, such as meditation, yoga, or muscle relaxation exercises.

How can I support my loved one?
Talk about the condition

  • Ask what your loved one goes through when experiencing obsessions, and what he or she intends the compulsions to achieve. Try to understand your loved one's experience.
  • Remember that OCD is a mental health condition, not a personal flaw. Your loved one cannot change quickly or change just because you tell him or her to do so.
  • Be supportive when discussing symptoms. Do not direct anger or frustration toward your loved one.
  • Communicate clearly, in simple terms. For example, if your loved one asks if he or she locked the door, respond simply with "yes" or "no." Explaining too much can cause greater stress for your loved one, and too much reassurance can make his or her rituals worse.

Find support and resources
A health care provider may be able to recommend mental health resources that are available online or over the phone. You could start with:

  • Government sites such as the Substance Abuse and Mental Health Services Administration (SAMHSA): www.samhsa.gov
  • National mental health organizations such as the National Alliance on Mental Illness (NAMI): www.nami.org

Think about joining self-help and support groups, not only for your friend or family member, but also for yourself. People in these peer and family support groups understand what you and your loved one are going through. They can help you feel a sense of hope and connect you with local resources to help you learn more.
General support

  • When your loved one is experiencing doubt and asks for reassurance, remind him or her that the uncertainty or anxiety is caused by his or her OCD. Do not give reassurance when he or she feels the need for it. Doing that can make his or her anxiety worse next time, and needing your reassurance may become part of his or her ritual. Be supportive but firm.
  • Make an effort to learn all you can about OCD.
  • Help your loved one follow his or her treatment plan as directed by health care providers. This could mean driving him or her to therapy sessions or suggesting ways to cope with stress.
  • Encourage your loved one to do his or her best, but avoid pushing your loved one too much. Stress can make symptoms worse.
  • Make sure that you and your loved one have opportunities for alone time.
  • Do not join your loved one in his or her rituals. You can provide support and encouragement while still being clear that your loved one's rituals are not productive.
  • Consider making a "contract" with your loved one that has specific directions about where or when OCD symptoms are allowed, and when they are not allowed. This can help to make it clear to your loved one that symptoms can be contained.

How should I care for myself?
It is important to find ways to care for your body, mind, and well-being while supporting someone with OCD.

  • Make time for activities that help you relax.
  • Consider joining a support group or going to therapy for yourself.
  • Consider trying meditation and deep breathing exercises to lower your stress.
  • Get plenty of sleep, eat a healthy diet, and exercise regularly.

Get help right away if:

  • You think that your loved one is having thoughts about hurting himself or herself or others.
  • You are in a situation that threatens your life. Leave the situation and call emergency services (911 in the U.S.) as soon as possible.

If you ever feel like your loved one may hurt himself or herself or others, or may have thoughts about taking his or her own life, get help right away. You can go to your nearest emergency department or call:

  • Your local emergency services (911 in the U.S.).
  • A suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255. This is open 24 hours a day.

Summary

  • A person with OCD may experience obsessions, compulsions, or both.
  • Therapy, medicine, and self-soothing methods may be used to treat OCD.
  • Be supportive and encouraging when discussing symptoms with your loved one. However, do not encourage his or her rituals.
  • Make time to relax and care for yourself.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.
Document Released: 05/01/2018 Document Revised: 05/01/2018 Document Reviewed: 05/01/2018
Elsevier Interactive Patient Education © 2018 Elsevier Inc.

 

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