Do Obsessions and Compulsions Change Over Time?

Understanding How OCD Symptoms Work and Ways to Cope

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The obsessions and compulsions associated with obsessive compulsive disorder (OCD) though generally similar enough to be recognizable, do vary from person to person. But many people with OCD wonder if their obsessions and compulsions will change or be replaced by others over time. For most people, the answer to that question is not a simple yes or no.

Types of Obsessive Compulsive Disorder Symptoms

Numerous research studies have established that there are distinct types of obsessive-compulsive disorder symptoms.

 The most common include:

While it is certainly possible to experience one, some, or all of these symptom types, the vast majority of research indicates that once an OCD symptom type appears, it is very rare for it to disappear and be replaced by other symptom types. That is, the types of OCD symptoms you have tend to remain fairly consistent over time.

For example, if someone developed contamination-related obsessions and cleaning compulsions at age 13, they would be very unlikely to develop aggressive obsessions and compulsions or sexual/religious obsessions and related compulsions later in life.

On the other hand, it is possible for OCD symptoms to shift within the same symptom type.

Using the example above, someone with contamination-related obsessions and cleaning compulsions might first begin with fears centered on contracting the HIV virus, but later in life switch to fears around salmonella or some other pathogen.

How Severity of OCD Symptoms Fluctuates

It is also important to remember that the severity of OCD symptoms can and do fluctuate over a person's lifetime, which means you may have times when your symptoms are worse and times when they ease up.

This can be related to stress level, environment, the treatment methods you're using, and many other factors. 

Dealing with OCD-Related Anxiety

There are different ways to deal with the anxiety you feel from your OCD and each choice you make is either positive (accepting the OCD and learning to tolerate it), negative (trying to escape or get relief), or neutral (avoiding the problem or ignoring it). Try to choose the positive, which will help strengthen your ability to cope with your OCD.

Consider managing your anxiety by describing it to yourself, rating it, and deciding if you can endure it, and if so, for how long:

  1. Describe the anxiety. How does it make you feel? Do your palms feel sweaty? Is your heart beating faster? Are your muscles tense? Do you feel anxious and upset?
  2. Rate your anxiety on a scale of 0-10, with 0 being none and 10 being the worst anxiety you can think of.
  3. Decide if you can stand it. Can you endure the anxiety or do you need to seek relief? If you decide you can deal with it, pick an amount of time during which you will refrain from seeking relief. For instance, if you just shook hands with someone and you really want to break out your hand sanitizer, but you decide you can refrain for 10 minutes, do whatever you have to do to get through, whether it's deep breathing or focusing on something else.

    This is basically doing exposure therapy on your own and may help you feel more in control and less anxious.


    Mataix-Cols, D., Rauch, S.L., Baer, L., Eisen, J.L., Shera, D.M., Goodman, W.K., Rasmussen, S.A., Jenike, M.A.. "Symptom stability in adult obsessive-compulsive disorder: data from a naturalistic two-year follow-up study" American Journal of Psychiatry 2002 159:263-8.

    Rufer, M., Grothusen, A., Mass, R., Peter, H., Hand, I. "Temporal stability of symptom dimensions in adult patients with obsessive-compulsive disorder" Journal of Affective Disorders 2005 88:99-102.!managing-ocd/c1qmf

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