Understanding OCD, intrusive thoughts, and spiraling

Obsessive-compulsive disorder (OCD) is a mental health condition that causes unwanted obsessions and compulsions. Obsessions are repeated thoughts, urges, or mental images that cause significant distress, while compulsions are repetitive reactions to those obsessive thoughts. 

To be diagnosed with OCD, a person’s obsessions and compulsions must last for at least one hour per day and significantly impact their daily functioning. For some people, their obsessive thoughts and compulsive behaviors are so severe that they result in something called an OCD spiral. This is when a person temporarily becomes “stuck” in their intrusive thoughts and compulsive behaviors, making it hard to break the cycle and move onto something else.

What are OCD intrusive thoughts? 

Intrusive thoughts are unwanted and repetitive thoughts that you can’t seem to shake. They can be in the form of memories, feelings, impulses, or even mental pictures, and they often relate to sensitive topics. Intrusive thoughts are usually harmless and are actually pretty common. But for people with OCD, intrusive thoughts can turn into obsessions that contribute to an OCD spiral.

Some common ways that intrusive thoughts show up in people with OCD include:

• Fear of harming yourself or others
• Fear of forgetting, losing, or misplacing something
• Concerns about being a bad person or committing crimes
• Continuously fixating on unsolved problems or tasks
• Fear of germs or contamination
• Fear of something bad happening

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Five ways to manage an OCD spiral

Some people compare an OCD spiral to an “invasive weed” that spreads out of control. “It starts out with one little thought, and then slowly that becomes the only thought that you’re able to have,” describes novelist John Green (who lives with OCD). And the more frequent and intense the obsessions and compulsions, the more they can affect your daily functioning and quality of life. 

If you’re struggling with OCD spiraling, here are five strategies to help you end the unhealthy cycle of obsessions, anxiety, and compulsions. 

1. Label your thoughts. One of the first steps in breaking the OCD cycle is learning to label and accept your thoughts. It’s normal to want to block out distressing thoughts, but research suggests that suppressing intrusive thoughts can actually make things worse. Instead, remind yourself that these thoughts do not define you. 

2. Recognize patterns and triggers. Another tip for managing OCD spiraling is to recognize unhelpful thought patterns. This awareness can help you avoid triggering situations or prepare for them with healthier coping methods. 

3. Practice mindfulness and meditation. Mindfulness-based cognitive strategies and grounding exercises can help you focus on the present moment. They can also help you gain a sense of control over your thinking to prevent the situation from escalating to an OCD thought loop.

4. Remember self-care. Self-care is a great way to strengthen your mental and physical health while distracting yourself from your negative thoughts. Think of self-care activities that require mental and physical focus, like stretching, taking a walk with a friend, or cooking a healthy meal.

5. Consult a mental health professional. If intrusive thoughts and other symptoms of OCD are affecting your quality of life, it may be time to seek professional support. Talk therapy and medication are both used to help manage OCD symptoms. 

Types of therapy for OCD and intrusive thoughts 

When left unmanaged, OCD spiraling can cause shame, anxiety, and emotional distress. The good news is that there are several proven therapeutic techniques to help people understand and manage intrusive thoughts and compulsive behaviors.

• Cognitive behavioral therapy (CBT): CBT is a type of talk therapy that focuses on the connection between your thoughts, feelings, and behaviors. It shows you how to identify unhealthy thought patterns and replace them with a more balanced perspective. 

• Exposure and response prevention (ERP): ERP is a subtype of CBT that focuses on gradually exposing you to your OCD fears until you’re no longer afraid. It’s considered a first-choice treatment for OCD, with approximately 80% of people with OCD having a positive response to the method. 

• Acceptance and commitment therapy (ACT): ACT is another type of CBT that’s often used to help manage OCD. With ACT, the goal is to change a person’s relationship with intrusive thoughts instead of changing the thoughts themselves. By increasing your awareness, you can learn to reduce the anxiety and shame associated with the condition and create a more positive relationship with yourself.  

Find care with Rula

If you’re struggling with intrusive thoughts and other symptoms of OCD, consider meeting with a mental health professional. Talk therapy, like CBT and ERP, can teach you how to manage distressing symptoms, improve your communication skills, and live a more fulfilling life. 

Rula’s therapist-matching platform allows you to find a therapist who specializes in whatever you’re dealing with. Plus, you can find someone who takes your insurance and can meet with you virtually, from the comfort of your home, as soon as tomorrow.

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