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By Dan Jones

What causes OCD to get worse? Although I do not speak for everyone suffering from OCD, I can speak from my own personal observations. Below are factors I have experienced that exacerbate my OCD symptoms. I also include a series of recommendations for each factor in hopes that those who are going through (or will go through) some of these situations may find some help.

What causes OCD to get worse?


With respect to stress, it is important to note that it comes in different forms. Major life changes that are often perceived as good (e.g., marriage, a new job, new child, a major move in living location) are likely to shift our security and disrupt our routines. Thus, these are still stressful.

Those major life events frequently perceived as bad (e.g., death in the family, losing a job, divorce) are both disruptive and often emotionally painful. Both types of major life stress can have a profound negative impact on OCD. For me, OCD symptoms often get worse following these types of major life events.

A man holding his head in his hands.

Physiological changes

What causes OCD to get worse? Research has shown that OCD often spikes during times of endocrine, hormonal, or physiological change. For me, I saw two times when OCD became worse — puberty and midlife. These types of physiological changes disrupt our neurochemistry and often can lead to an exacerbation of OCD symptoms.


Depending on the type of OCD from which one suffers, guilt may be a potentially toxic force that exacerbates symptoms. Feeling like one “deserves” to suffer, feeling like one has done something negligent with respect to a central obsessive fear, or has been somehow violated a personal standard, can create higher OCD severity.

These types of risks may be exacerbated among individuals with OCD who also suffer from other comorbid conditions such as depression, where sensitivity to low self-image is a particular concern. Similarly, PTSD-related OCD may also be sensitive to fluctuations in guilt. If an individual suffers from survivor’s guilt, or guilt related to the traumatic event, then guilt may trigger increases in the severity of OCD symptoms.


Stress solution

Mindfulness meditation, yoga, and moderate physical activity (NOT excessive activity) often relieve stress. In my most recent bout with an acute spike in symptoms, a friend who is a mindfulness instructor encouraged me to meditate. When I told her that sitting quietly with my mind is one of the most difficult tasks, she reminded me that even 10 seconds quietly counting or breathing will help.

A person seated with their hands on their lap.

Guilt solutions

Although I struggle with this myself, self-compassion, self-forgiveness, and acceptance are critical features to fending off guilt. You are human, you are flawed. You have and will continue to make mistakes. Forgive yourself. In a way, your very concern over others is proof that you are not a “bad” person.

Compassion meditation, even aimed at oneself, may be a critical solution here. Allow negative thoughts, like any thought, to go in and out of your mind without grappling with them. Acknowledge what you think and feel and move on. You do not need to be perfect; you merely need to embrace who you are.

Dan Jones is an IOCDF Advocate


  • angeles

    in children, being tired or sick often worsens the symptoms

  • Sally Koch


  • Thank you for sharing. I am a bilingual therapist in Long Beach, California, and primarily work with children and adolescents with obsessive compulsive disorder, ADHD, and other forms of anxiety. Many of my clients battle with depression, even at young ages and experience. Intense levels of guilt. I found this to be helpful and plan to share it with at least one of my families. I am on the waitlist to attend a training and hope to hear back from you guys soon.

  • Jennifer Janik

    I am looking for a therapist for my 16 year old son. He hopes to find a therapist that has had their own personal journey with OCD in the north east Ohio area.
    Jennifer, Medina, Ohio… 35 minutes south of Cleveland

    • IOCDF Logo White
      International OCD Foundation

      Hello Jennifer! You might find our Resource Directory helpful. There you can search for providers in your area. Here’s the link: Best of luck!


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