You may feel that you have completed the course of treatment and managed to successfully manage OCD, but one trigger ruins everything and brings you back to square one. You may think that it is impossible to recover from a relapse, but there is hope instead. While obsessive thoughts don't always go away, it's important to have a plan to deal with them when they come back.
Steps
Part 1 of 3: Dealing with Relapses and "False Steps"
Step 1. Deal with feelings of doubt and guilt
Both are considered the main aspects of the disorder. The former manifest themselves in practically any situation, for any subject, event, person and are often futile; guilt plays an important role, you feel personally responsible for things that have nothing to do with you and you keep thinking: "If only…". Always remember that you are responsible only for yourself and that in general you do your best. You may experience negative emotions, especially after a relapse; you don't have to ignore them, but neither should you continue to ruminate, otherwise you just feed the disorder.
If you find yourself feeling uncertain (you wonder if you have done all you could, if you are really sane, if you will become a criminal or if you can ever get over your mental problem), deal with these emotions. Try to analyze if such feelings arise for a legitimate reason or are triggered by obsessive-compulsive disorder and do the same with guilt
Step 2. Understand the difference between relapse and "misstep"
You may enjoy a period in which the disorder does not manifest itself and then experience the obsessive thoughts again in a sudden way. Once the latter have resurfaced, you may feel the need to engage in compulsive behaviors; this mechanism is considered as a "momentary slip". A relapse, on the other hand, foresees that when the obsessions re-emerge a rigid or absolute thought is established, for example you may believe that you have wasted all the therapy and have completely relapsed into the vicious circle of the disorder; this kind of thinking is related to a relapse.
For example, the use of a dirty public bathroom could trigger the obsessive-compulsive reaction in a person with the fear of contagion, forcing him to wash repeatedly; in this case we speak of a "false step"
Step 3. Get organized to handle these events
Anticipate situations that could cause symptoms to flare up or cause you to fall into a circle of fears or obsessive thoughts. If you know that you will have to face a moment of great discomfort (for example you suffer from a fear of contagion and you will be surrounded by many people), be prepared for these inappropriate thoughts. Recognize that their presence is caused by the stress you are experiencing, partly due to the mental disorder, and that it is not a failure.
Tell yourself that you are aware that you are in a difficult situation, that fears or obsessions may arise, but that this does not necessarily imply a therapy failure
Step 4. Manage missteps
If you have identified one, consider what triggered it and how you can prevent it in the future; you may find that there are many situations responsible for these phenomena, so it is vital to have an action plan to manage them. Reflect on the issues you faced during therapy and try to repeat the process yourself. When you feel the symptoms are about to return, expose yourself to the object of fear, force yourself to stop compulsive rituals, deal with the anxiety, and repeat the process.
Remind yourself that you are perfectly aware that you are living in a stressful situation, but that you are able to handle it; exposure to fear helps you work on past anxieties and you don't need to resort to compulsive rituals
Step 5. Accept that the recovery isn't perfect
Nobody is, so you don't have to set too high standards. Sometimes, you may forget about medications or get carried away by obsessive thoughts; instead of breaking down for being "off the track", focus on your efforts and start again.
- No need to feel guilty or ashamed, forgive yourself and pick up where you fell off.
- If you keep a rigid approach to treatment and successes, such behavior could backfire on you; be aware that obsessions will never completely go away and that you may be exposed to fears and triggers.
Part 2 of 3: Manage Symptoms Effectively
Step 1. Deal with obsessions immediately
These usually occur because you want to avoid a situation that scares you and compulsive behaviors arise from this attempt to avoid it. Relapses are the result of this mechanism that you lose control of and that pushes you to fall into rituals to resist fear; on the other hand, it is essential to face fears as they arise and to manage them correctly as soon as possible.
For example, it is possible to feel fear of germs; However, if you don't fight it immediately, this emotion may force you to wash your hands or clean the house repeatedly in an attempt to calm your anxiety. To deal with that fear, you have to recognize that you are experiencing it, that germs exist and that sometimes people get sick, but that you have done your best to clean the house and yourself by reducing the risk of contagion
Step 2. Expose yourself to the causes of anxiety
The more you deal with the things that make you feel anxious, the better you manage them. Resist or delay the compulsive reactions that are triggered by these factors; increased exposure allows you to gradually reduce the intensity of negative emotions you feel until they are completely gone. Thus you realize that you have less fear and more control than in the past.
For example, if you feel the need for objects to be arranged symmetrically, try to leave something out of place on purpose and wait 30 seconds before rearranging it. Repeat this exercise recognizing each time that the lack of symmetry generates less and less discomfort
Step 3. Anticipate obsessive thoughts and the need for compulsive behaviors
If you have compulsions or obsessions that occur often, start anticipating them and fighting the "rituals" they trigger. If you continue to monitor the actions you have performed (for example, closing the doors, the windows and turning off the stove), you create a mental image of the task completed; you can also say aloud "I closed the windows".
If the obsessive ideas or fears show up, take note and remember that it is an obsessive thought and that you know you have done that particular action
Step 4. Try to get distracted
Obsessions are normal and you should expect to experience them when dealing with a mental disorder of this nature; don't fret about their presence, instead find a plan to push them away when they show up. For example, find an activity that distracts you until the thought subsides and the need to engage in a compulsive ritual passes; you can go for a walk, read a book or listen to music.
Admit that having these kinds of thoughts is not a cause for shame, but that it is important to have an action plan to manage it
Step 5. Try to live a balanced existence
Commit to getting enough sleep, eat a healthy diet, and get regular physical activity; spend time with friends, build social relationships and find a balance to avoid excessive stress. Balancing the various elementary aspects of life allows you to recover and minimize difficult times.
Outer balance helps you maintain inner balance and make each day predictable
Part 3 of 3: Recovering Through Therapy and Social Support
Step 1. Talk to a psychologist
If you have interrupted the sessions or have never turned to this specialist, the time has come to do so; inform them that you are having difficulty with the disease and that you have recently had a relapse. Work to prevent future relapses and to learn symptom management techniques. Work with your psychologist to identify specific triggers to avoid them.
The best therapeutic approach is the one defined as "cognitive-behavioral" (TCC), but therapy of exposure and prevention to triggers (a type of TCC) is also useful. In this second case, the patient is progressively exposed to objects or situations that could trigger a relapse and is taught how to best manage anxiety and obsession
Step 2. Find social support
It is perfectly fine to ask for help and support from friends and family; share your experience with someone who loves you, who wants to listen to you and support you. Make an effort to spend time with friends, family, and to maintain an active social life even when you would prefer to isolate yourself.
If you withdraw into yourself, you increase the risk of suffering from anxiety due to obsessive-compulsive disorder; Instead, surround yourself with people who love you
Step 3. Join a support group
It is the best way to meet people who are struggling to cope with anxiety and the symptoms of the disease. You can share your experiences, give and receive advice, share tips and feel that you belong to a community, as well as make new friends. Consider joining a self-help, support group, or group psychotherapy sessions for patients who have difficulty managing anxiety and disorder.
- If there is no such initiative nearby, search for a group online.
- You can get more information by contacting your family doctor or psychologist.
Step 4. Continue the treatment
If you decide to stop taking medication because you feel better, you could cause a relapse. You may believe you were "cured" or that OCD was just a "phase". Unfortunately, this is a chronic condition that must be treated and prevented; it can be managed effectively, but there is no definitive "cure". Treatment usually involves a combination of drugs and psychotherapy; you must never stop any therapy, in order to keep the symptoms in silent phase and to be in control of life.
- Drug therapy is based on antidepressants including: clomipramine, fluoxetine, fluvoxamine, paroxetine and sertraline.
- Never stop taking antidepressants without your doctor's approval, as they can trigger serious side effects that are sometimes referred to as withdrawal syndrome.
- Drugs alone are seldom effective, usually their action is best when used in conjunction with psychotherapy.
