A common question from people living with obsessive compulsive disorder (OCD) is: “Why do I sometimes feel like my OCD is getting worse?” Often this question is accompanied by frustration, fear or self-blame, especially when someone feels they were “doing better” and now find themselves stuck again.
The short answer is that OCD symptoms can intensify for several reasons, and this does not mean one is failing, regressing, or doing therapy wrong. OCD is a condition that often comes with ups and downs. Understanding this can help one take a more self-compassionate stance when experiencing temporary worsening of symptoms.
Below, I’ll outline some common reasons OCD symptoms can worsen, and how these factors can interact with the way OCD works.
Stress and life changes
Stress often triggers increase in OCD symptoms. Major life events such as relationship changes, work pressure, illness, loss, or even positive changes like moving house or starting a new job can increase anxiety levels.
Because OCD symptoms are essentially anxiety driven, they often intensify during stressful periods. This doesn’t mean stress causes OCD, but it can lower your ability to resist compulsions and tolerate distress, which can make you feel like the OCD is getting worse.
Increased avoidance and compulsions
OCD can worsen when compulsions or avoidance behaviours gradually increase. Compulsions, such as checking things or engaging with rituals, may bring short-term relief, but they strengthen OCD in the long run by reinforcing the belief that anxiety is dangerous and must be neutralised.
Over time, this can lead to more rituals, stricter rules, or expanding triggers. What often feels like “coping” in the short-term can in the long-term increase symptoms.
Trying to get rid of thoughts or feelings
A common response to OCD is getting carried away with, believe in, or fight against intrusive thoughts or uncomfortable feelings. Unfortunately, this can backfire. The more we engage with, fight, or buy into thoughts, the more attention OCD receives. This can make thoughts feel more frequent, distressing, or convincing.
OCD often escalates when the goal becomes certainty, reassurance, or relief, rather than learning to live with uncertainty. It can be helpful to focus on seeing thoughts as just thoughts when they come up and let them go, to disengage from compulsions, and to accept the temporary discomfort this leads to (which will be reduced in the long-term after disengaging from the thoughts and compulsions).
Reassurance seeking (from others or yourself)
Seeking reassurance, asking others if something is “okay,” replaying memories, checking your feelings, or mentally reviewing situations, can also worsen OCD over time. While reassurance can momentarily calm anxiety, it keeps the OCD cycle going by teaching the brain that doubt must be resolved before you can move on. Over time, reassurance tends to lose its effect, leading to more frequent or urgent checking, and heightened anxiety.
Changes in routine, sleep or self-care
Lack of sleep, irregular routines, illness or burnout can make OCD harder to manage. When we are physically or emotionally depleted, our ability to sit with distress and resist compulsions is reduced. This doesn’t reflect weakness or lack of motivation. Rather, it reflects the reality that mental health symptoms often worsen when basic needs are not met.
Meaningful themes and personal values
OCD often latches onto what matters most to you: relationships, morality, responsibility, health or identity. When something touches a core value, OCD can become especially loud.
For example, becoming a parent, entering a new relationship, or taking on greater responsibility can intensify OCD themes because the stakes feel higher. This can be confusing and distressing, but it also reveals how deeply you care, which is not something to be ashamed of.
Progress can sometimes make OCD feel worse
Interestingly, OCD can feel worse when you start changing how you respond to it. When you stop engaging with thoughts, reduce your response to compulsions or begin exposure-based work, anxiety often increases temporarily.
This can give the impression that OCD is escalating, when in fact the usual coping strategies are no longer being used. While uncomfortable, this phase is often part of meaningful recovery rather than a sign of deterioration.
What this means for you
If your OCD feels worse, it does not mean you are broken, weak, or back at square one. OCD is highly sensitive to context, stress, and the ways we respond to it. Rather than asking, “Why can’t I control this?” it can be more helpful to ask, “What might my OCD be feeding on right now?”
Working on OCD usually involves learning to respond differently to thoughts, urges, and feelings, not trying to eliminate them. With the right support, it is possible to reduce OCD’s impact, even when symptoms feel intense.
If your OCD feels overwhelming, persistent, or confusing, speaking with a psychologist trained in approaches such as cognitive behavioural therapy (CBT), Compassion focused therapy (CFT), acceptance and commitment therapy (ACT), or trauma-informed therapy can help you understand what is maintaining your symptoms and how to move forward in a productive and compassionate way.
You are not alone in this, and worsening symptoms are not a personal failure, they are a signal that something needs attention and care.
