Obsessive-compulsive disorder (OCD) is a condition that is characterized by a cycle of recurring and intrusive thoughts and behaviors. These thoughts, or obsessions, can lead to uncontrollable behaviors, or compulsions.
In the mind of a person with this mental health condition, the compulsions should help alleviate the obsessions. However, they rarely do.
Instead, the person performs the compulsions over and over again without resolution. The thoughts and compulsions can interfere with the person’s ability to:
- perform daily tasks
- hold a job
- leave their home
In most cases, these intrusive thoughts are worries or anxieties about things that might happen. You might leave the oven on and start a fire.
Sometimes, however, these obsessions may come from thinking about something that already happened. This type of OCD is called real event OCD.
According to the Anxiety and Depression Association of America, real event OCD is not a unique diagnosis. It is OCD that develops when responding to actual events.
Real event OCD occurs when you have obsessive thoughts about an event that occurred in your life. This obsession-compulsion cycle of real event OCD may look a bit different from other types.
Primarily, the compulsion is an inability to stop thinking about the event. You play it over and over again in your mind, seeking answers that you cannot find.
But like other forms of OCD, real event OCD can often be treated if it is recognized and addressed. Keep reading to learn the symptoms of real event OCD and who can help treat it.
The driving force behind OCD is doubt. You may ask yourself questions such as:
- Did you turn the stove off?
- Will the stove start a house fire if you didn’t turn it off?
- Did you lock the door before you got into bed?
- Will you be robbed (or worse) in your sleep?
- Is the door handle to your apartment dirty?
- Can you even clean the door handle well enough to avoid germs?
These are a few types of obsessive thoughts. They typically deal with theoretical situations, or something that might arise.
With real event OCD, however, the recurring thoughts are of a specific event that happened to you. That means the obsessive thoughts and compulsions are typically related to something you did or did not do.
Symptoms of real event OCD include:
- Mental review. People with real event OCD spend excessive time replaying events in their minds. They analyze them from every angle and perspective. They play every word, action, and event back in their minds. Often, they try to decide something black and white about the event: Do their actions make them a bad person? Did they make the right choice?
- Reassurance seeking. People with real event OCD cannot answer their worries. So, they may bounce the events and their feelings off other people in their lives to seek reassurance that the worst things they’re thinking aren’t going to come true or haven’t happened.
- Catastrophizing. People with real event OCD create cognitive distortions. In other words, they take something that would quickly pass through the mind of another individual and sit on it for longer than they should. They often twist or change it, so they find problems with it. From that, they draw the worst conclusions about what happened and about themselves.
- Emotional reasoning. People with real event OCD confuse feelings for facts. People with this condition might convince themselves that because they feel guilty, they must have done something bad.
- Urgency. To people experiencing this cycle of intrusive thoughts, finding resolution to situations can be increasingly important. They may feel that they have to find the answer now. This may make the compulsions worse.
- Magnification. People with this condition may have a difficult time separating themselves from the significance of an event because of the intense focus on the event. In other words, an inconsequential choice becomes highly significant and meaningful because of the distortions caused by OCD.
It’s unclear why some people develop real event OCD and others don’t. Even two people who experience the same event together may have different responses. One may develop OCD, while the other doesn’t.
For that reason, it’s hard to know precisely what types of events trigger real event OCD, but anecdotal evidence suggests that these situations may play a role:
- abuse
- neglect
- family disruption
- relationship changes or interpersonal issues
- traumatic events
Then again, the event may not amount to a single significant life event. It may result from a chronic stressful situation, or a stressful life event like moving.
Although events like these are ordinary, for someone with OCD the stress may be so significant that it triggers the obsessive thoughts and compulsions.
For example, someone with real event OCD may focus on an interaction they had as a student, decades before the time the obsessive thoughts begin. This focus may be the result of a similar experience.
It may also come back up if you see the other person again or if something happens to them.
OCD is a persistent state of doubt. Everyone has doubts from time to time, but people with this mental health condition face doubts and anxieties that are obsessive and intrusive.
Indeed, they feel that they cannot manage them. That, in turn, can interfere with daily life.
Your doubts and worries about something that happened in your life could indicate symptoms of real event OCD if you:
- feel “stuck” thinking about the same event(s) over and over
- cannot control the thoughts
- cannot find resolutions
- seek reassurance but don’t find the support sufficient
- experience significant problems in your daily life due to these thoughts
- have trouble focusing or being productive at school or work
- have strained relationships from your obsessive thoughts and doubts
- have previously experienced OCD
Real event OCD can be treated. As with other types of OCD, it may require a combination of treatments to find something that helps you. But you do not have to live in this cycle.
The most common treatments for real event OCD include:
- Medication. Serotonin reuptake inhibitors (SRIs) and selective serotonin reuptake inhibitors (SSRIs) are sometimes prescribed for people with OCD. These medicines impact the brain’s natural chemistry to help stop or slow the overactive thoughts.
- Psychotherapy. Therapies such as cognitive behavioral therapy (CBT) and habit reversal training are used for OCD treatment. These types help people with real event OCD learn how to stop and redirect the intrusive thoughts before the compulsive cycle begins.
- Exposure and response (ERP) therapy. This type of psychotherapy is used often with OCD. With this therapy, a mental health professional will develop ways to expose you to your triggers. Together, you will learn to unpair the real event from the feelings that have caused so much doubt and anxiety.
Online therapy options
Read our review of the best online therapy options to find the right fit for you.
(Video) Real Event OCD: What Did I Do Last Night?
In addition to traditional treatments, other practices may help you eliminate obsessive thoughts. These include:
- Mindfulness. Blocking or stopping thoughts may not work. The practice of mindfulness encourages people to experience thoughts and feelings, and “sit” with them. They can experience thoughts as they happen, and usher them out.
- Mental exercises. With a mental health professional, you can try mental health exercises to stop your compulsive examinations. They might include refocusing or negotiating with your mind. It will take time and attention to make this work, but recognizing the compulsive thoughts helps stop them.
- Take care of yourself. A tired mind may be difficult to manage. Get adequate sleep, eat a balanced diet, and exercise regularly. These practices can help your overall health and treatments.
If you think you’re experiencing real event OCD, consider talking with a healthcare professional to determine next steps. These resources can help:
- Your healthcare provider. Talk with a doctor, nurse practitioner, or other clinician to find a mental health professional in your area that may be able to help you answer questions and find treatment.
- Substance Abuse and Mental Health Services Administration (SAMHSA). Their treatment referral hotline (1-800-662-HELP or 1-800-662-4357) can connect you with resources in your area. Their Behavioral Health Treatment Locator can also be a good resource.
- National Institute of Mental Health (NIMH). The
NIMH Help for Mental Illnesses page lists a variety of resources that can guide you to the best providers.
Many people experience these feelings because of past events:
- regret
- shame
- stress
That’s typical. But what isn’t typical is an inability to stop thinking about those feelings.
People with real event OCD cannot always manage their obsessive thoughts and compulsive actions. They often seek to clarify what happened and find a “resolution.” But that’s not always possible.
However, with treatment and continuing mental health exercises, people with real event OCD can find relief from their obsessive thoughts.
And they may manage their daily lives without the worry of these doubts and anxieties overrunning their minds.
FAQs
How I cured my real event OCD? ›
The best course of treatment for real events OCD, like all types of OCD, is exposure and response prevention (ERP) therapy. The idea behind ERP is that repeated exposure to obsessive thoughts, without engaging in compulsions, is the most effective way to treat OCD.
Does real event OCD get better? ›Compulsive actions follow in an effort to manage the anxiety triggered by the obsessions. Real event OCD is typically treated with medication and/or behavioral therapy. Healthy lifestyle habits and mindfulness may also be beneficial.
What is severe real event OCD? ›Real event OCD is not a subtype of OCD, but a symptom of OCD. It involves having obsessive thoughts about an actual event that occurred and having compulsions related to those thoughts. The obsessions often focus on what you did or didn't do in a specific situation.
What is the best medication for real event OCD? ›The most common treatments for real event OCD include: Medication. Serotonin reuptake inhibitors (SRIs) and selective serotonin reuptake inhibitors (SSRIs) are sometimes prescribed for people with OCD. These medicines impact the brain's natural chemistry to help stop or slow the overactive thoughts.
How do I get out of an OCD loop? ›- #1 Change Your Focus. ...
- #2 Become the Witness. ...
- #3 Use Creative Visualization. ...
- #4 Set Aside Time for Your Thoughts. ...
- #5 Have a Plan in Place.
Trauma, stress, and abuse all can be a cause of OCD getting worse. OCD causes intense urges to complete a task or perform a ritual. For those who have the condition, obsessions and compulsions can begin to rule their life.
Can real event OCD turn into false memory OCD? ›When you have OCD, you may experience false memories that feel like real experiences. This may lead you to doubt your recollection of important events or your memory performance in general. This lack of confidence, in turn, may lead you to more false memories.
Is real event OCD genetic? ›It is not yet fully understood why some people develop Real Event OCD while others don't despite experiencing the same events, but we can assume that multiple factors come into play to trigger the development of Real Event OCD: Genetic/hereditary factors.
What is the highest level of OCD? ›Total severity scores are usually assumed to indicate the following levels of OCD: subclinical (0–7), mild (8–15), moderate (16–23), severe (24–31) and extremely severe (32–40).
What's the worst type of OCD? ›Primarily obsessional OCD has been called "one of the most distressing and challenging forms of OCD." People with this form of OCD have "distressing and unwanted thoughts pop into [their] head frequently," and the thoughts "typically center on a fear that you may do something totally uncharacteristic of yourself, ...
What is crippling OCD? ›
People with OCD suffer from obsessions and compulsions. Obsessions are anxiety-producing thoughts that repeat themselves over and over. Compulsions are behaviors that people with OCD perform repeatedly to get rid of the distressing obsessions. Without treatment, OCD can be crippling and disabling.
What is the best vitamin for OCD? ›Vitamin B12 and folate are thought to be effective in OCD treatment due to their associations with neurotransmitters. Depending on their antioxidant effect, zinc and selenium can be used in augmentation therapy for OCD.
What is the best mood stabilizer for OCD? ›- Clomipramine (Anafranil) for adults and children 10 years and older.
- Fluoxetine (Prozac) for adults and children 7 years and older.
- Fluvoxamine for adults and children 8 years and older.
- Paroxetine (Paxil, Pexeva) for adults only.
Adderall and other stimulant medications are not a first-line treatment for OCD. In some anecdotal cases, they may worsen OCD symptoms. There is also a higher risk of dependency. However, doctors commonly prescribe them for people who have both OCD and ADHD.
Can you see OCD on a brain scan? ›The fact is, the vast majority of the time, a brain scan in someone with OCD looks completely normal. What about outlier cases?
What part of the brain is overactive in OCD? ›Thalamus. The thalamus shows more activation in patients with OCD compared to healthy comparison subjects. This is likely related to the role of the thalamus as a relay and integrative site for other brain areas activated in OCD, such as the basal ganglia and the OFC.
Can a neurologist treat OCD? ›Functional neurology also addresses OCD by calming that emotional limbic response. Retraining the motor patterns initiated by the basal ganglia, indirectly retrains the cognitive (thought) patterns that are also produced by the basal ganglia.
What does an OCD episode look like? ›Doubting and having difficulty tolerating uncertainty. Needing things orderly and symmetrical. Aggressive or horrific thoughts about losing control and harming yourself or others. Unwanted thoughts, including aggression, or sexual or religious subjects.
How do you beat severe OCD? ›- Practice mindfulness to manage stress. Two key characteristics of OCD are high anxiety and the presence of intrusive thoughts. ...
- Get plenty of exercise. ...
- Sleep well and enough. ...
- Avoid nicotine and alcohol. ...
- Reach out to family and friends. ...
- Find an ERP therapist.
Unfortunately, OCD doesn't just go away. There is no “cure” for the condition. Thoughts are intrusive by nature, and it's not possible to eliminate them entirely. However, people with OCD can learn to acknowledge their obsessions and find relief without acting on their compulsions.
Is OCD a brain glitch? ›
Many people describe OCD as a “brain glitch,” in which the brain sends false messages—such as “the door is still open,” or “there are harmful germs on the light switch”—and the affected person needs to perform rituals to shut off the voice delivering the message.
Can OCD turn into schizophrenia? ›OCD is a common comorbid condition in those with schizophrenia and BD. There is some evidence that a diagnosis of OCD may be associated with a higher risk for later development of both schizophrenia and BD, but the nature of the relationship with these disorders is still unclear.
How do I stop obsessing over something that happened? ›- Decide what you are ruminating about. ...
- Examine your thinking process. ...
- Allow yourself time to ruminate. ...
- Use a journal. ...
- Write down pleasant thoughts. ...
- Use behavioral techniques to help stop ruminating. ...
- Focus on the lesson learned. ...
- Talk about your worries with a trusted friend or relative.
Although both OCD and ASD have similar symptoms, they are different conditions. OCD is a mental health disorder, whereas ASD is a developmental condition. ASD is a condition that a person is born with. OCD can develop during a person's lifetime.
How is real event OCD different from PTSD? ›The difference is that while the repetitive behaviors of OCD are performed to prevent an imagined threat from occurring, the repetitive behaviors of PTSD are done to avoid reexperiencing traumatic memories.
How common is real OCD? ›Diagnosable OCD is found in 1.6-2.5% of the population, though only a fraction of that number actually receive a diagnosis and get treatment. Do people with OCD really believe those irrational thoughts? Most people with OCD are well aware that their obsessions and compulsions are irrational.
When does OCD turn into psychosis? ›Someone who's considered to have OCD with poor or absent insight might not readily acknowledge their thoughts and behaviors as problematic or unreasonable. This can be considered psychosis. OCD with poor or absent insight is when symptoms of psychosis might appear.
What kind of trauma causes OCD? ›The onset of OCD is not limited to the original meaning of trauma; rather, traumatic experiences such as unexpected exposure to contaminants or various stressful life events often cause the onset of OCD.
What meds are given for extreme OCD? ›Medications that have been shown to help improve the symptoms of OCD include Prozac, Fluvoxamine, Anafranil, Zoloft, and Paxil. Other medications may be prescribed as needed, based on the specific features that accompany the OCD.
What does high functioning OCD look like? ›Some people with OCD are high-functioning. This means they have the fears, anxieties, obsessions, and compulsions that other people with the condition do, but they are better able to manage them or hide them from others. You may function well at work for now, but without treatment your symptoms can get worse.
What triggers OCD episodes? ›
An OCD episode can be triggered by anything that causes, stress, anxiety, and especially a feeling of lack of control. For example, if a person with OCD develops cancer, which can certainly trigger obsessions and compulsions, especially with cleanliness.
Is OCD the worst mental illness? ›OCD is listed and classified in the publication under 'neuropsychiatric disorders', where it is listed fifth amongst the most disabling burden of mental health conditions.
When does OCD become severe? ›The doctor rates obsessions and compulsions on a scale of 0 to 25 according to severity. A total score of 26 to 34 indicates moderate to severe symptoms and 35 and above indicates severe symptoms.
What does extreme OCD feel like? ›Repeating compulsions can take up a lot of time, and you might avoid certain situations that trigger your OCD. This can mean that you're not able to go to work, see family and friends, eat out or even go outside. Obsessive thoughts can make it hard to concentrate and leave you feeling exhausted.
Why is living with OCD hard? ›People with OCD are usually aware that their obsessions and compulsions are irrational and excessive, yet feel unable to control or resist them. OCD can take up many hours of a person's day and may severely affect work, study, and family and social relationships.
How do you stop OCD Hyperawareness? ›Treatment for Sensorimotor OCD and Hyperawareness OCD
Sensorimotor OCD and Hyperawareness OCD can be treated using the combined approaches of Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), and mindfulness based approaches, such as Acceptance and Commitment Therapy (ACT).
For most of us, these thoughts seem “messed up” or funny, because they're so out of place. But for someone with OCD, these disturbing thoughts might feel like real possibilities — even if that person knows their thoughts are probably irrational.
What meds are used for somatic OCD? ›The main family of medicines used to treat OCD are known as Selective Serotonin Reuptake Inhibitors, or SSRIs. SSRIs enhance your natural serotonin activity and are used to treat major depressive disorders and anxiety conditions. Examples include Lexapro, Prozac, Paxil and Zoloft.
How do you fight OCD sensorimotor? ›In short, sensorimotor obsessions can be outsmarted by voluntarily paying attention to the relevant bodily process or sensation. Patients are instructed to allow the sensation to be present and to invite in any such awareness (exposure) with a casual, dispassionate focus.
Why is my OCD getting worse? ›Trauma, stress, and abuse all can be a cause of OCD getting worse. OCD causes intense urges to complete a task or perform a ritual. For those who have the condition, obsessions and compulsions can begin to rule their life.
What mental illnesses coincide with OCD? ›
Although OCD is a severe mental illness to have, other mental illnesses also often occur with it, such as Body Dysmorphic Disorder, Panic Disorder, Generalized Anxiety Disorder (GAD), and depression. Unfortunately, a dual-diagnosis has the potential to make treatment a bit more severe and complicated sometimes.
Are you born with OCD or is it trauma? ›However, while there are some genetic underpinnings that can contribute to a person developing OCD, the causes of OCD are typically a combination of genetic and environmental factors — meaning that both your biology and the circumstances you live in have an effect on OCD development.
How do you get rid of OCD rumination? ›Treatment for Rumination OCD
All types of OCD can be treated with Cognitive-Behavioral Therapy (CBT), specifically with treatment approaches called Exposure with Response Prevention (ERP), and Mindfulness-Based Cognitive-Behavioral Therapy.
People who overthink things regularly, psychologists believe, are often those who may have larger self-esteem or acceptance issues, Dr. Winsberg explains. If you're constantly overthinking (more on that later), however, it may be a symptom of clinical anxiety and depression or even obsessive-compulsive disorder.
What is obsessive rumination disorder? ›Rumination is defined as engaging in a repetitive negative thought process that loops continuously in the mind without end or completion. The pattern can be distressing, difficult to stop, and unusually involves repeating a negative thought or trying to solve an evasive problem.