How to Help Someone With OCD, According to Medical Experts

Nearly one in 25 American adults has serious mental illness, which means odds are someone in your life is coping with anxiety, depression, OCD, bipolar disorder or another debilitating condition. Still, shame about mental illness — likely a holdover from when people wrongly believed such conditions were character flaws or a mother’s fault — can make it hard to seek help or even know what to say to those who struggle. To shine a light on the daily realities of mental illness, Good Housekeeping and the National Alliance on Mental Illness (NAMI) surveyed more than 4,000 people, and found that over a third had a close friend or relative with mental illness. In our special package on how to support loved ones with mental illness, women who live with these widely misunderstood psychological issues share what it feels like, and how you can make a difference.

We often say we’re “obsessed” with something we’re really into, like matcha lattes or the latest season of The Crown. But if you have OCD, your brain may play a constant loop of disturbing or frightening images and ideas. “When you’re in it, it’s really scary — you can’t control your thoughts, and they come to you every day,” says Alison, 41, of Minneapolis, MN who was diagnosed with OCD 15 years ago. “My unwanted thoughts tended to be sexual — which is contrary to what I value in life. I had a fear that I’d lose control of my limbs and sexually assault someone.”

The second letter of OCD stands for compulsive, the nature of behaviors such as repeated routines and physical tics, which are the brain’s attempts to keep obsessions like the ones that pursued Alison at bay, explains Jeff Szymanski, Ph.D., executive director of the International OCD Foundation (IOCDF). “You may know that the compulsive behavior doesn’t make sense, but it makes you feel better,” he says. Alison’s compulsions were physical and mental: “I’d sit on my hands because I thought, This way, they can’t do something bad. Then I’d have to compulsively ask myself, I wouldn’t do that, right?” she recalls.

26% of people surveyed said they or someone they know have symptoms of OCD.

Jackie, 38, who is also from Minneapolis, had obsessions that took on religious overtones: “I had an intense fear of sin, to the point where I would have a huge amount of terror and anxiety if I accidentally brought even a paper clip home from work.” The only way for her to ease the anxiety was to compulsively confess to whomever she had “sinned” against (e.g., telling her boss about the paper clip). “I understood that it was ridiculous, but felt compelled to do it to make the anxiety go away,” she explains. “People don’t realize how intense the anxiety is, and that you would do anything to try to relieve it.”

Some medications, including serotonin reuptake inhibitors (SRIs), can be effective at controlling obsessive thoughts for the estimated 2 to 3 million adults with obsessive compulsive disorder. Also sometimes effective is a type of cognitive behavior therapy called Exposure and Response Prevention (ERP). Let’s say someone is plagued with the thought that she left the oven on, and she so compulsively keeps going back to check, that she’s late for appointments or stuck at home. With ERP, she’d check the oven once, then leave the house without going back, no matter how uncomfortable it made her feel at first. “We ask them to just sit with their anxiety and learn from it rather than treating the situation as dangerous,” says Szymanski. “As you stay with your fear and terror, your body starts to acclimate, and it eventually gives you freedom from your fear,” says Jackie. “I did ERP about 10 years ago. I still have OCD and intrusive thoughts, but it’s not the same level of intensity.” Approximately 70% of people with OCD will benefit from ERP and/or medication, according to the IOCDF.

There are also ways you can be an ally and help someone who is dealing with obsessive compulsive disorder:

  • Don’t use the term “OCD” lightly: Referring to healthy enthusiasms as OCD can serve to minimize the struggle of sufferers. “It’s not really helpful when someone says, ‘Everyone has a little OCD,’ ” says Alison. “I know they’re trying to tell you you’re not alone, but it’s not the same thing. There is a D in OCD — Disorder.” That is, the condition interferes with normal functioning.
  • Learn about OCD: “The biggest things my non-OCD friends have done to help is listen without judgment and read about the disorder so they really understand,” says Alison. “Acknowledging that I’m going through a rough time and making me feel seen is a huge help.”
  • Support without enabling: It’s very common for family members to want to soothe loved ones with OCD by, say, buying extra soap or answering the same question over and over, says Szymanski, but that just perpetuates the cycle. Jackie adds, “You should come up with a phrase like ‘It looks like you’re having an obsession and asking me to participate, and I’m not going to do that because I’m on your side, not OCD’s side.’ ”
  • Celebrate small victories: For a person with OCD, something as simple as making it through a meal without repeatedly realigning the silverware may be hard. By giving positive feedback, you can help her see that she can improve.

    The COVID-19 crisis has made life more challenging for everyone — especially those who are struggling with a mental illness. Visit NAMI’s COVID-19 Resource and Information Guide for additional advice. For more info about OCD, visit the International OCD Foundation.

    Additional reporting by Lambeth Hochwald