Living With (Someone Else’s) OCD
How to help a loved one with obsessive-compulsive disorder, without losing yourself.
You’re dressed and ready to go to your sister’s holiday dinner. The kids are ready, too, waiting by the door to put their shoes on. They don’t put their shoes on until their father says it’s time; if they walk around the house with them on, they’ll track dangerous outside germs all over the house.
Before you can leave, your husband has to wipe down the entire kitchen floor. Wipe, not mop. He’s down on his hands and knees, scrubbing a corner that no one has stepped in since the last time he wiped down the floor. After he finishes, he’ll have to take a long, very hot shower to get the bleach smell off — and then change into his clothes. He spent an hour the night before ironing the shirt he plans to wear, but he will have to iron it again to get new wrinkles out. The wrinkles come from sitting too long in one place.
Stealing a glance at your phone, you notice you are already half an hour late. You gingerly suggest heading over to your sister’s house without him, so he can get ready without feeling rushed. But he balks because he has developed a profound fear of driving in the last few years. What if he hit someone? The kids tumble onto the couch, knowing it is going to be a while.
Taken together, all these rituals and anxiety are impacting your family’s routines and social engagement. His anxiety made it impossible for him to keep his job. You haven’t been on time to a get-together, appointment, or school event with him in years. Your kids never have friends over to visit.
You are living with a loved one who has Obsessive-Compulsive Disorder. In fact, it’s almost as if OCD has moved in as an unwanted boarder. The disorder itself is imposing its demands on all of your lives. What can you do?
What is Obsessive-Compulsive Disorder?
Obsessive-Compulsive Disorder is a relatively common disorder. The National Association on Mental Illness estimates 1.2 percent of adults in the US has OCD, or about 3.6 million people.
It’s commonly referenced in popular culture or even casual conversations, but it’s not widely understood. Everyone thinks they can diagnose OCD in themselves or other people by observing an odd repetitive behavior.
But only a licensed mental health professional or therapist can diagnose OCD. In general, they look for three main symptoms:
- The person has obsessions — Obsessions are unwanted thoughts or urges, often accompanied by fear or an uncomfortable feeling that things aren’t right.
- The person does compulsions — Compulsions are repetitive behaviors that the person does to try to deal with their obsessions.
- The obsessions and compulsions have a negative impact on daily life because they take up a lot of time or prevent participation in activities that are important to the person.
What it isn’t: People often use the acronym “OCD” to describe being insistent about doing something their own particular way, like putting things away and turning out the lights at night. OCD isn’t being “anal” or picky about a particular thing at a particular time. You can’t be OCD about one thing and function normally otherwise.
It isn’t a preference or personality trait. It’s a brain-based disorder that can be utterly debilitating to a person and their family.
How do you know it’s OCD?
Some signs you can look for if you worry a family member is developing OCD can include behavior changes or strange explanations for why they are late. You can’t see inside their head and know what they’re obsessing over, but you can see what they do.
A few signs to watch for:
- Have their diet or eating habits changed substantially?
- Are they suffering bouts of insomnia?
- Are they taking longer than usual to complete regular chores or self-care?
- Are they staying in the bathroom for an hour instead of 15 minutes?
- Do they express unfounded doubt and need constant reassurance?
- Are they unnecessarily repeating activities, like checking the locks, hand-washing, or teeth-brushing?
- Do they avoid important things they should be doing?
- Are they irritable with you when you ask about their behavior or whereabouts?
- Do they lie about how they spent their time?
Most people have some kind of compulsive behaviors or obsess about something at some point in their lives. What makes OCD different is that these obsessions and compulsions spin out of control and start to dominate a person’s life. If you think you or a loved one may have OCD, consult a mental health professional.
How can you help manage OCD in a loved one?
Learn about the disorder. Read and research, and find some support from others who live with OCD. The International OCD Foundation is a good place to start.
Gently urge therapy. OCD can take over your life. People with OCD are at as high a suicide risk as those with other serious mental disorders. According to the International OCD Foundation, around 70 percent of people who get treatment benefit from therapy, medicine, or both. It may be a difficult conversation to have with a loved one, but if you worry they may be exhibiting signs of OCD, tell them you’d like them to see a mental health professional.
Be empathetic. Put yourself in their shoes. Remember that they aren’t OCD in order to control your life, they’re trying to get control of their own life and thoughts. They do things compulsively because they’re afraid of what will happen if they don’t do it that way. They don’t want to think the way they do. They’re often afraid that if they don’t do something, they’ll expose you to harm, too.
Don’t let your loved one’s OCD control your life.
There’s a difference between support and enabling. You have to maintain your own life. Don’t let yourself get pulled into time-consuming rituals or other things that isolate you from your social engagements or keep you from your own responsibilities.
Unfortunately, research suggests that 60 percent of family members get involved in the rituals of a person with OCD. These are called Family Accommodation Behaviors, and they enable OCD symptoms and make them worse.
Experts recommend being sensitive but setting limits on how much time is spent talking about OCD and being firm on the limits of how much the family will allow compulsions to infringe on daily life.
If you’ve got a loved one compulsively cleaning the house, what you don’t want to do is go to the store for them and buy bulk quantities of cleaner. If your loved one is spending three hours in the bathroom, you shouldn’t take on extra responsibility that normally would fall to them to make up for the lost time.
Don’t let yourself get pulled into time-consuming rituals or other things that isolate you from your social engagements or keep you from your own responsibilities.
Set limits and stick to them. If you don’t, your own mental and physical health can deteriorate. Talk to your loved one about what you will and won’t do. This is not being cruel or uncaring: this is for their own good.
Talk about OCD stressors. These are circumstances that can trigger OCD. If you can uncover what exacerbates compulsive behaviors, you can get a handle on them before they start.
Take time for yourself. Self-care is self-preservation. You need to be able to get a good night’s sleep, get out of the house, and eat a healthy diet — regardless of what your loved one is going through. If you aren’t taking care of yourself, how can you provide proper support for your loved one’s recovery?
Be gentle but firm. The International OCD Foundation recommends avoiding lengthy explanations or providing copious reassurance every time it’s requested. An OCD sufferer must learn to accept uncertainty as a part of life.
Recognize improvement. Each day can be different, especially if additional stressors aggravate the disorder, but it’s important to measure changes based on your loved one’s real life — not some abstract benchmark of what you think “normal” should be.
Imagine watching your husband lock the door. You get into the car. He asks you if you are sure he locked it. A simple yes will suffice, though it won’t likely comfort or convince him. What about the back and side doors? He may insist on double-checking anyway.
A positive step forward is accepting that he cannot hold up your plans by checking the locks again. When that uncertainty is accepted, and your loved one overcomes the urge to act on their obsession, it should be recognized as progress.
Reclaim family agency. Finally, you may want to draw up a kind of family contract that articulates your collective goals. This is a way for the family to reclaim the household activities that OCD rituals have entangled.
A therapist can help you draw up a contract or family plan — but as with the treatment and therapy itself, you have to have buy-in from the person with OCD or it will not work. That buy-in begins with caring communication.