Understanding relationship OCD

Most people in romantic relationships question their connection with their partner(s) from time to time. For example, you might meet someone who initially seems like your perfect match. But then, those butterflies you experienced at the start of your relationship start to feel less like the excitement of early love and more like anxiety jitters. Soon, you might find yourself wondering if your partner still wants to be with you or if they’re interested in someone else. 

For the most part, these worries will subside with some time and a bit of reassurance from your partner. But for people living with obsessive-compulsive disorder (OCD), questions about their partner’s fidelity and commitment can persist in ways that can take a toll on their mental health. 

What is relationship OCD?

You cannot be officially diagnosed with relationship OCD (ROCD) because it is not a recognized mental health condition. Rather, it’s a term that describes a specific presentation of OCD. Many people use this term to describe the experience of someone whose OCD symptoms tend to revolve around their romantic partnerships. 

People living with OCD have frequent, unwanted intrusive thoughts called “obsessions.” In turn, they perform unwanted, repetitive behaviors called “compulsions” in an attempt to stop the thoughts. For example, someone might constantly worry about getting sick despite not being at increased risk for becoming ill. Their obsessive thoughts might lead them to think about cleanliness or the spread of germs all the time. This could then cause them to engage in compulsive behaviors like repeatedly wiping down the surfaces of their home or washing their hands over and over again throughout the day. Unfortunately, the compulsions usually make their anxiety worse instead of decreasing it.

For people living with relationship OCD, their obsessions, compulsions, and other OCD symptoms are relationship or partner centered. And unlike the typical relationship ups and downs we all experience, relationship OCD symptoms can lead a person to constantly worry about their loved one’s commitment no matter how much reassurance they receive. These anxieties become so severe that they negatively impact their ability to live their lives and maintain healthy relationships. 

It’s important to remember that relationship difficulties can happen because of many factors. And there are several different mental health conditions — such as post-traumatic stress disorder (PTSD), borderline personality disorder (BPD), anxiety disorders, and attachment disorders — that can cause relationship challenges. For this reason, it’s important to seek professional help and get a thorough evaluation. That way, you can make sure you get an accurate diagnosis and the right treatment for your unique needs.

Examples of relationship OCD

Every person living with relationship OCD has their own unique experience. But some common examples of the ways that OCD can appear in relationships include:

Relationship OCD obsessions

• Feeling anxious about your partner’s commitment to you and the relationship
• Constantly worrying about whether your partner is “the one” or if this is really the right relationship for you
• Questioning your partner’s love and wondering if they’re lying about their feelings for you
• Comparing yourself to your partner’s previous partners and worrying that you’re not as funny, smart, or attractive as they are 
• Analyzing your standards and wondering if your partner can ever realistically meet them

Relationship OCD compulsions

• Constantly checking in on your feelings about your partner to determine whether you’re really in love or still want to be with them
• Repeatedly comparing your relationship to other relationships (either real-life relationships or couples in movies, TV shows, books, etc.)
• Repeatedly looking for outside validation from friends, loved ones, or others about your relationship
• Setting up tests to gauge whether or not your partner gives you the “right” response
• Trying to change or control your partner’s thoughts, feelings, or behaviors to align with your vision of a perfect partner
• Repeatedly asking for reassurance from your partner about whether they still love you, want to be with you, etc.
• Engaging in a ritual or routine with the goal of lessening your anxiety about the relationship

Common symptoms of relationship OCD

Like other forms of OCD, there are some common signs and symptoms associated with relationship OCD. Learning to spot them can help you get the help you need. These symptoms include:

• Experiencing chronic worries and anxieties about your relationship that you can’t control on your own
• Constantly questioning the validity of your partner’s commitment, despite frequent reassurance from them
• Worrying about cheating, infidelity, or other breaches of trust (without evidence that the worry is warranted)
• Always looking for something wrong with the relationship, even when things seem to be going well
• Constantly yearning for validation and assurance, but feeling like you never get enough of it
• Finding it hard to be intimate or enjoy sex with your partner
• Feeling compelled to monitor your partner’s presence on social media or keep tabs on their exes 

What causes relationship OCD?

More research is needed to better understand what causes the symptoms associated with relationship OCD. However, researchers have identified some psychological, environmental, and genetic factors that may increase your risk for developing obsessive-compulsive disorder, including:

• Having a family history of OCD or other mental health conditions
• Having certain abnormalities in the area of the brain that are responsible for regulating serotonin 
• Experiencing trauma or major life events that affect you in profound ways
• Being someone who is naturally very meticulous, neat, or detail oriented 
• Experiencing heightened anxiety and feeling overly responsible for others from an early age
• Having a mood disorder like major depression

How is relationship OCD treated?

Although relationship OCD is not an official diagnosis, the current recommended treatment is the same as other types of OCD. The following treatments can be effective in helping people control their OCD symptoms:

• Cognitive-behavioral therapy (CBT): CBT is a form of talk therapy that helps people uncover and challenge their unwanted thoughts and interrupt dysfunctional behavioral patterns.
• Exposure and response prevention (ERP): ERP is a subtype of CBT that involves a slow, safe, gradual exposure to a person’s triggers. It occurs under the supervision of a therapist and is designed to help increase distress tolerance and change the way you respond to anxiety and discomfort.
• Medication: In some instances, medications, like selective serotonin reuptake inhibitors (SSRIs), can help reduce OCD symptoms. These medications require a prescription, and your doctor or psychiatrist can help you decide if this approach is right for you.
• Self-help strategies: While self-care isn’t a replacement for therapy or medication, it can help you manage your OCD symptoms. Make sure to get enough sleep, exercise, and adequate nutrition. Also, practicing mindfulness and self-compassion, challenging black-and-white thinking, and surrounding yourself with supportive friends and family can help. 

Find a therapist with Rula

If your OCD symptoms are taking a toll on an important relationship, know that you’re not alone and support is just a few clicks away. 

At Rula, we know how difficult it can be to live with unwanted thoughts and behaviors, and we’re here to make it easier to access the care you deserve. In just a few minutes, you can use our therapist-matching program to connect with a therapist who takes your insurance. And if couples therapy or medication ends up being part of your treatment plan, we can connect you to those services as well. 

Find a therapist with Rula