No matter how much work we do to manage our anxiety and OCD symptoms, there will always be circumstances where those symptoms reappear or increase due to environmental, social, or internal triggers. While we may have a solid routine that keeps us regulated and balanced, there will be times when we need to adjust our routine to accommodate for a little extra self-care and self-compassion. It’s important to learn how to recognize these triggers so we can plan and prepare for them when they occur.
Sometimes it’s obvious why we’re feeling more anxious – we have an upcoming exam or job interview, we have to speak publicly at an event, or we are experiencing a personal or family crisis. But other times, we may recognize that we feel more anxious but not realize why. This requires a little more reflection. Perhaps we are going to a family dinner next week and we realize we’re holding some stress because we know that when Aunt Bonnie comes to dinner she always picks a fight with someone about politics. Or maybe we can’t find something we’ve been looking for and in the search process we realize our house is more cluttered than usual and that has been causing us tension. Or perhaps we’ve been procrastinating on completing a task, and it’s leaving us feeling unsettled and overwhelmed without us being aware of it..
For the past two weeks my OCD has been showing up with a vengeance. I know my OCD is not happy because I’ve been diligently doing ERP (Exposure Response Prevention) therapy and becoming quite good at responding with uncertainty and allowing myself to experience the anxiety that comes with resisting compulsions. OCD hates when we stop paying attention to it, so as we disengage, it’s going to get more creative with how it creeps in and attacks our values where and when we don’t expect it.
I realized fairly quickly that my anxiety had increased recently because I have an upcoming dental surgery. Sure, I expected my anxiety to be relatively higher leading up to the procedure, but I didn’t recognize the role of my OCD or make the connection between the two until I spoke to my therapist about it. In everyday activities I was becoming more concerned with symmetry and order, and the overall need for things to feel “just right” before I could move on. Subconsciously I thought I could control the outcome with my actions. In addition, I noticed that I hadn’t been getting to bed on time, I was distracting myself with social media, I wasn’t eating well, I was ruminating, scenario building, and seeking more reassurance and certainty than usual.
When dealing with OCD symptoms, it can be difficult to differentiate ourselves from our OCD. For example, I was looking up articles about dental implant surgeries which seems perfectly rational to me. I wanted to be prepared for the procedure– What to do beforehand… What to expect with the recovery process… What are the possible risks? It’s important to learn about things so we can approach them with preparedness and feel confident and well informed. However, when you struggle with OCD, this seeking of information can become a never ending hole and no matter how much information we find to “satisfy” our curiosity, it’s never enough. The “what ifs” never stop and the uncertainty of outcomes and possible scenarios will only grow with more information. This is where we have to respond to OCD with something other than what it’s asking for. When deciding if my research into my upcoming procedure was me or my OCD, I had to decipher the function of the behavior. Was I looking up information because I simply wanted to learn about this amazing smile-saving procedure, the advancement of dental technology, or the miraculous healing ability of the body? Perhaps in the beginning. But once I acknowledged that I was seeking certainty, safety, reassurance, and trying to reduce my anxiety about the whole thing, I had to stop answering my OCD demands and disengage.
Some Causes of Heightened Anxiety
Anticipation: Anticipatory anxiety is often worse than the event itself. Symptoms can present far in advance of the perceived threat or dreaded situation.
Negative thought patterns: Anxious thoughts and catastrophic thinking patterns can exacerbate anxiety leading up to and during stressful events.
Fear of uncertainty: Individuals with OCD often experience an intense fear of uncertainty, leading to increased anxiety and compulsive behaviors in situations that lack clear outcomes or certainty and that create a feeling of things being out of our control.
How to Cope
- Engage in activities that promote relaxation and well-being, such as exercise, maintaining a healthy diet, getting sufficient sleep, hydration, baths, even indulging in your favorite treat.
- Practice mindfulness techniques. Some examples are deep breathing, progressive muscle relaxation, body scan, journaling, and grounding.
- Introduce cognitive-behavioral techniques like cognitive restructuring, reframing, and positive self-talk as effective coping skills.
- Plan downtime. Allow yourself time for rest before and after the event. This can help reduce overall stress levels and provide a buffer for managing OCD symptoms.
- Seek professional help. Therapy is helpful when anxiety becomes overwhelming or interferes with daily functioning. Work with a qualified therapist experienced in treating anxiety and OCD. They can provide guidance, support, and evidence-based therapies such as Exposure and Response Prevention (ERP) to help you manage your symptoms effectively.
When someone anticipates that their OCD symptoms will intensify during an upcoming event, it's crucial to have strategies in place to manage and cope with the challenges.
Develop an OCD Management Plan:
- Identify triggers. Reflect on the specific OCD triggers that tend to worsen during events. Recognizing these triggers can help you prepare in advance.
- Understand your patterns. Take note of your typical OCD patterns and rituals, including the thoughts, behaviors, and compulsions that tend to arise. Being aware of these patterns can help you develop strategies to interrupt them.
- Create an exposure hierarchy. Collaborate with a therapist or mental health professional to create an exposure hierarchy specific to your upcoming event. Gradually exposing yourself to anxiety-inducing situations can help reduce OCD symptoms over time.
- Resist or delay compulsions. If you find it difficult to resist compulsions completely, you can still take power away from your OCD by delaying them. Instead of immediately engaging in compulsive behaviors, try delaying them by a few minutes. Gradually increase the delay over time to reduce reliance on compulsions, and eventually resist them completely.
- Utilize grounding techniques. Use grounding exercises, such as focusing on your senses or engaging in mindfulness, to anchor yourself in the present moment and redirect attention away from obsessive thoughts.
- Communicate with trusted individuals. Share your concerns with understanding and supportive friends, family, or a support group who can provide encouragement and empathy.
Remember that managing anxiety and OCD is a journey, and it's essential to be patient and kind to yourself. It’s important to recognize that heightened anxiety during stressful events or even just certain circumstances outside of our normal routine is a common experience. We can’t eliminate anxiety from our life completely, but we can choose to respond differently and more effectively to it when it arises. Don’t underestimate the impact of self-care, stress management, and seeking support to navigate anxiety during these challenging times.