Obsessive compulsive disorder (OCD) affects everyone differently. One of the better known ways that OCD manifests itself is through a fear of contamination, which can cause people to wash or clean excessively, but did you know that OCD can impact your relationships, too?

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Some people find that OCD can place a strain on their relationships, whether that’s with a romantic partner, a friend, a family member or a colleague. For example, they may develop a fear that their spouse doesn’t truly love them, meaning they become highly sensitive and ask for constant reassurance, or perhaps they perform lengthy rituals so they’re always late or prone to cancelling plans.  

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Naturally, this means that people with OCD can find maintaining relationships more stressful than others, and it can also be tough for the person who they have the relationship with. Even people with an understanding of OCD may feel exasperated or find the relationship difficult to manage at times. However, patience and support go a long way, and learning about OCD can be beneficial for both people.  ‍

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What is OCD?

OCD is an anxiety-related mental health condition which causes someone to experience obsessions and compulsions. An obsession is a recurring unwelcome thought, image or urge that makes you feel anxious, uncomfortable or repulsed. A compulsion is a repetitive physical or mental behaviour that you feel as though you need to carry out to relieve the feelings brought on by the obsession.  

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Obsession example: You worry that you’re going to contract a serious illness. ‍

Compulsion example: You do everything in your power to reduce this risk, such as constantly checking for signs of illness and excessively cleaning your home to prevent the spread of germs.

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While a compulsion may help you to feel better in the moment, this relief is short-lived. Soon, the obsession will resurface and you will feel the need to carry out the compulsion again. This creates a vicious cycle that is very hard to break free from. ‍

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How OCD can impact relationships

OCD can manifest itself in different ways depending on the relationship.  

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With a romantic partner or spouse:

• You may question your partner’s feelings towards you, or you may worry that they are going to leave you, which causes you to repeatedly ask them for reassurance. If your partner is constantly having to validate the relationship with no resolution, they might start to feel exhausted and frustrated at the situation.
• You may find yourself doubting whether you and your partner are compatible. Perhaps you fixate on your differences and wonder whether these are reasons that you shouldn't be together. You might voice these concerns to your partner, causing them to worry that you’re uncertain about the relationship and not fully committed.  
• Your compulsions may begin to include your partner. For example, if you worry about bringing germs into the house, you may ask them to remove their clothes as soon as they come home to ease your anxiety. However, they might feel that this behaviour is controlling and become resentful.
• You may have a low sex drive due to anxiety, or, if you worry about germs, you may have a fear of having sex. This can have an impact on intimacy within the relationship.

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‍With family and friends

• You may feel the need to repeatedly ask for reassurance from your friends and family members. This could be about anything, from the relationship between the two of you, to asking their opinion about how you acted in a certain situation. You might have the same conversation repeatedly - needing to hear their affirmation over and over, which can be tiring for them.
• You might feel compelled to perform certain rituals, for example turning every light and plug socket switch on and off several times before leaving the house. These rituals can be time-consuming and it requires the people around you to be patient.  
• You might feel embarrassed or ashamed about your mental health, which makes you want to avoid people. Similarly, your obsessions and compulsions could be triggered by certain social situations which can stop you from going out. If people don’t understand the reasons behind this, this can be confusing and it could put distance between you.  ‍

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‍With work colleagues

• Severe compulsions can be time-consuming which can impact your productivity at work. This can place strain on your relationships with your colleagues, especially if they don't know that you have OCD or they don’t have an understanding of OCD.
• Similarly, you may worry about making a mistake on a task and become convinced that this would have disastrous consequences, which leads you to check every piece of work multiple times and causes you to miss deadlines.
• You may worry about opening up about your mental health at work for fear of being discriminated against. This could make you feel lonely and isolated from your colleagues.

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‍How to support someone with OCD

Supporting someone with OCD can be difficult. You may struggle to understand their thoughts and actions, and you may be confused about the best way to respond. Here are some tips that might be useful:

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1. Learn about OCD

The more that you understand about OCD, the more that you can empathise with how the person is feeling. There are many resources out there, such as Mind and OCD UK, or this page might be a good place to start. Remember, OCD affects everyone differently, so your research should involve asking the person about their own experience.

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2. Recognise compulsions

Getting to know a person’s compulsions can help you to realise when they’re struggling. For instance, if they are constantly checking something, cleaning or asking you for reassurance, this could be a warning sign that they’re going through a wave of OCD.

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While compulsions provide short-term relief from an obsessive thought, ultimately they only feed the OCD cycle. So, in the long run, it’s better to help the person resist compulsions, even though this can be difficult when you’re in the moment.

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It’s a good idea to have an honest and open chat about how to manage this between the two of you, so that you both know what to expect when compulsions take place. You might agree to gently remind them that repeatedly checking something isn’t going to change an outcome, or that giving them reassurance will just make their OCD worse.

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3. Be kind and patient  

When supporting someone with OCD, it’s important that you’re not judgemental or dismissive of what they’re going through. It can be really hard for someone to open up about their fears and they might feel very vulnerable at that moment. Creating a safe space for them will help to build trust between you and give them someone to talk to.  

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If you can see that someone is struggling with their obsessions and compulsions, it can be helpful to let them know that you understand the difference between the behavioural symptoms of OCD and the person by saying, ‘I know this is not you, this is your OCD.’  

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Remember, the road to recovery is not always linear or fast-paced. They may have setbacks, and while this can be frustrating to watch, it’s normal and it doesn’t mean that they’re not trying. Be patient with them and congratulate them whenever they make progress, no matter how big or small the achievement, as this will spur them on.

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4. Support them getting treatment

Getting treatment for OCD is important, but it can be a daunting prospect for someone who has lived with the disorder for a long time. They may be sceptical or apprehensive at first, so try to be encouraging. You could offer to go with them to their first appointment, check in about how the treatment is going and ask if there’s anything therapy exercises that you can support them with.

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5. Take care of yourself, too

Looking out for someone with OCD can be draining, demanding and often confusing. Sometimes, it can be difficult to know whether you’re doing ‘the right thing’, which might make you worry and second-guess yourself.

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Be mindful not to neglect your own wellbeing and ask for support if you need it, whether that’s from the people in your life or a health professional. Above all, show yourself compassion; you’re not going to get it right every time and that’s okay. Mistakes teach us lessons - so forgive yourself and move forwards, using your experience to inform your actions next time.  ‍

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Treatment for OCD

Sometimes, people with OCD can be reluctant to get help because they feel embarrassed. Obsessions and compulsions can be very difficult to talk about and you may worry about being judged. Remember that OCD is nothing to be ashamed of and there is support available.  

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If you’re experiencing OCD, talking therapy can help. Cognitive behavioural therapy (CBT) is an effective way to treat OCD - it involves working with a therapist to understand and challenge the beliefs and behaviours that are causing you problems. Read more about how CBT works here.

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ieso offers online CBT that’s flexible, confidential and non-judgemental. Patients can login from wherever they are and ‘speak’ with a therapist privately by typing back and forth. Our service is free for some NHS patients. Sign up to see if you’re eligible here.