Do Obsessions and Compulsions Change Over Time

Do Obsessions and Compulsions Change Over Time OCD Print How Obsessions and Compulsions Can Change Over Time By Owen Kelly, PhD Medically reviewed by Medically reviewed by Steven Gans, MD on August 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on October 04, 2019 Manchan/Getty Images More in OCD Causes Symptoms and Diagnosis Treatment Types Living With OCD Related Conditions The obsessions and compulsions associated with obsessive compulsive disorder (OCD) though generally similar enough to be recognizable, do vary from person to person. But many people with OCD wonder if their obsessions and compulsions will change or be replaced by others over time. For most people, the answer to that question is not a simple yes or no. Types of Obsessive Compulsive Disorder Symptoms Numerous research studies have established that there are distinct types of obsessive-compulsive disorder symptoms.  The most common include: Obsessions to do with symmetry and repeating and counting, and ordering compulsionsHoarding obsessions and compulsionsContamination-related obsessions and cleaning compulsionsAggressive obsessions and checking compulsionsSexual/religious obsessions and related compulsions While it is certainly possible to experience one, some, or all of these symptom types, the vast majority of research indicates that once an OCD symptom type appears, it is very rare for it to disappear and be replaced by other symptom types. The types of OCD symptoms you have tend to remain fairly consistent over time. For example, if someone developed contamination-related obsessions and cleaning compulsions at age 13, they would be very unlikely to develop aggressive obsessions and compulsions or sexual/religious obsessions and related compulsions later in life. On the other hand, it is possible for OCD symptoms to shift within the same symptom type. Using the example above, someone with contamination-related obsessions and cleaning compulsions might first begin with fears centered on contracting the HIV virus, but later in life switch to fears around salmonella or some other pathogen. How the Severity of OCD Symptoms Fluctuates It is also important to remember that the severity of OCD symptoms can and do fluctuate over a persons lifetime, which means you may have times when your symptoms are worse and times when they ease up. This can be related to stress level, environment, the treatment methods youre using, and many other factors.   Dealing With OCD-Related Anxiety There are different ways to deal with the anxiety  you feel from your OCD and each choice you make is either positive (accepting the OCD and learning to tolerate it), negative (trying to escape or get relief), or neutral (avoiding the problem or ignoring it). Try to choose the positive, which will help strengthen your ability to cope with your OCD. Consider managing your anxiety by describing it to yourself, rating it, and deciding if you can endure it, and if so, for how long: Describe the anxiety. How does it make you feel? Do your palms feel sweaty? Is your heart beating faster? Are your muscles tense? Do you feel anxious and upset?Rate your anxiety on a scale of 0-10, with 0 being none and 10 being the worst anxiety you can think of.Decide if you can stand it. Can you endure the anxiety or do you need to seek relief? If you decide you can deal with it, pick an amount of time during which you will refrain from seeking relief. For instance, if you just shook hands with someone and you really want to break out your hand sanitizer, but you decide you can refrain for 10 minutes, do whatever you have to do to get through, whether its deep breathing or focusing on something else. This is basically doing exposure therapy  on your own and may help you feel more in control and less anxious.