My husband has obsessive compulsive disorder (OCD). A year into marriage, he’s learning what it means to reveal the dark corners of his mind to someone, and I’m learning how OCD impacts me.
I knew Jonathan had OCD before we started dating and I thought about it a lot as we moved towards marriage. What does it mean to partner for life with someone with OCD? What even is OCD?
OCD is an anxiety disorder of obsessive thoughts and compulsive behaviors. The thoughts are recurring fears or anxieties, and the behaviors are rituals meant to quell those anxieties, except that the relief is always short-lived and the cycle starts again.
A familiar example of OCD may be someone who is afraid of germs. Her fear is encountering germs and being unable to get rid of any she does encounter. Her compulsive behaviors are specific rituals that she does to avoid germs, like washing her hands for a specific amount of time.
My husband has what some call “pure OCD,” where his obsessions and compulsions are all in his mind. He doesn’t have any visible compulsive behaviors but, instead, he tries to quell his anxiety through mental rituals. OCD’s anxiety makes him feel like he can untangle the obsessive thoughts if he dedicates enough time to analyzing them. When he’s mentally looping like this, he says it feels like simultaneously pushing the gas and the brake to the floor.
Researchers are still learning, but OCD likely has biological roots. A recent study of a few dozen patients found measurable chemical imbalances related to internal brain communication. The patients had higher than normal levels of glutamate, which promotes communication, and lower than normal levels of GABA, which quells communication.
But what’s often left out of the conversation about OCD is how it affects loved ones.
Family members are certainly told what to do – how to help, how not to hinder. For example, family accommodation – when loved ones essentially “endorse” an individual’s OCD – can lead to enablement; family members should not reassure about obsessions or adapt to compulsions. Resources also talk about how to structure the home environment to best serve the individual with OCD.
But family members are not told how to cope. And the emotional burden can be heavy.
One small study found the family burden of OCD comparable to the family burden of schizophrenia. The partners and parents in the study worried about their loved ones and experienced relational tension with them because of OCD.
For me, the hardest part is feeling helpless. The mental looping – oscillating between obsessions and compulsions – simply isn’t logical. Jonathan knows that, too. But OCD plants and waters seeds of doubt, making him think that maybe this time he’ll get answers and long-lasting relief.
This cycle means family decisions can be hard. Conversations can take longer. Jonathan can’t focus. The to-do list stays undone until his mind finally clears late at night.
He finds it frustrating. I do, too.
Despite this, there is little out there to help partners and parents deal with the stress. Advice seems limited to “take time for yourself” and “consider a support group.” (The study on family member burden mentioned above did find that family therapy was helpful at alleviating some of the stress and tension.)
In my experience so far, the best advice for loved ones is actually for the individual with OCD to get help. Standard treatment is focused on psychotherapy – such as cognitive behavioral therapy – and medication. Sometimes it requires both inpatient and outpatient care but, regardless, it is a life-long commitment.
Jonathan went through intensive treatment before we started dating, including everything mentioned above. Over time, his treatment plan slimmed down and now he only takes daily medication. The OCD onslaught that used to be his everyday has been reduced to an occasional really bad day and more common “sticky” days, where his mind feels stuck in first gear.
The bad days do affect our life but we both agree that our marriage is as successful as it is thus far because of his intensive treatment. In other words, we had a good leg up because he did a lot of personal work ahead of time.
The bottom line is that Jonathan’s OCD is not my battle to fight; it’s his. That is true for any loved one. But it’s also true that we’ve been thrown into the game without a playbook and we need to talk more about the disease’s impact on us.
For now, though, the best support for us seems to be treatment for them.