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Long-term OCD or Chronic OCD: questions from our readers

Long-term OCD or Chronic OCD: questions from our readers


This month we will talk about Long-term OCD or Long-lasting OC. Most people who suffer from OCD come after having suffered from OCD for about 8 to 10 years. Which is something that for us is horrible,considering the fact that this is one of the disorders that people suffer most from. This is why we consider it so important to come to visit the psychologist or another health professional such as a psychiatrist as soon as you start noticing the first symptoms 

or you start to suffer from them. 

And this is something only you can decide when you notice that you are suffering from the symptoms. No one else can decide it from you. 

What is very important to regard from this is that symptoms can start already in infancy. People can already go, as a family, to see a health professional. 

Here, in the center, for example, we have a team which is specialized in OCD in infancy and adolescence as well. So it’s very important to know that you don’t have to wait that long. And the sooner you start the treatment, the better the outcome is, in the sense that the treatment usually lasts shorter. Know that after a long time suffering from OCD you can also have a good outcome in the sense that the symptoms can disappear at a very significant level in most cases.


 Is OCD a chronic disorder or chronified disorder?

It is a really important question because many health professionals, especially in the medical sector or psychology (or health psychology) do consider it to be a chronic disorder that needs to be treated mainly with medication, and especially throughout your entire life. And this is something that many patients of ours feel very sad and disappointed about, when they hear this. And I think it creates suffering on its own. 


So what is very important is that we do not consider OCD to be a chronic disease. We actually consider that it’s a disease that can be treated through focusing on what is causing the symptoms. And I think that’s a big difference with many other approaches in which they focus on controlling the symptoms or just dealing with the symptoms and accepting that you have that. 


Here, we actually focus on the cause of the symptoms, which is the elevated level of anxiety, and many times repressed wishes, desires, feelings… 

So what we do is start unblocking these repressed feelings, we start activating the person’s instincts. And what we see is that, in response, the anxiety levels drop and the symptoms start dropping. Which is why, with this different focus, people can actually reach really low levels of symptoms or even have them nearly disappear in most of the cases.


 It is very important to notice it, because many times people wait to come to the psychologist for a long period of time, either because they think it’s chronic and nothing really can be done anyways and you just have to learn to accept this. This is a very important reason why people don’t come to see a health professional. 


But also oftentimes, people just don’t recognise they have OCD. They think they just have behavior that other people have as well. Particular behavior like they say: “Oh, I’m just really organized”. They make jokes about it sometimes. Like “Oh, I’m really OCD”. But they don’t recognise they actually have it. 


This is also very common with some types of OCD, such as for example, homosexual OCD or pedophilia OCD, which is not commonly known and many people do not recognise it. Or they think they have something really weird, which is not the case, it’s something very common, by the way. We see these are one of the most common types of OCD that we see here in the clinic. So that’s important to know as well.


Another reason why people don’t come to see a health professional can be that the symptoms sometimes disappear for a period of time in their life. And this usually happens when they actually are in a period of activated instincts or more closely connected to their desires or they are expressing their emotions more. For example, we see this when people go on holidays for example, or they temporarily live in a foreign country. You can see the symptoms can disappear. 


Well, this is really important, because OCD is not chronic. It can be resolved to a large part in most cases. And that is why we recommend you come to see a health professional as soon as possible, especially when the first symptoms start appearing. You can already see a psychologist even in infancy, as parents with your child. We have a specialized department in child and adolescent patients with OCD. So this is what we recommend: come as soon as you can. 


After how long is considered long-term OCD ?


It can be considered approximately from 4 or 5 years old, but obviously an obsessive disorder, given the high degree of suffering, can take a long time for the patient from the first moment. Therefore, it is essential to act as soon as possible to tackle the situation.


What is it like to live with long-term OCD?

– Many people usually have been dealing with OCD for many years since they were diagnosed. We often get middle-aged patients who were diagnosed when they were young.

– They usually have tried different therapies and with many psychologists during all those years.

– Many of them claim to have had periods of relative improvement, but then have recovered the symptoms.

– Many patients have lost hope in overcoming OCD.


Why is this happening and what can we do?

In many cases, therapies focus on controlling symptoms. But people with OCD have a rigid mental structure, which cannot be controlled simply by becoming more rigid. OCD comes from a high internal anxiety, which materializes in the form of obsessions and compulsions. That is why we are committed to going to the root of the problem and breaking the person’s mental blocks, combating that anxiety and achieving a real change of life, adapting to the needs of people.


What kind of life can you have?

There is no specific profile that assures a person’s prognosis. The improvement depends on multiple factors: severity of the case, personal circumstances, involvement of therapy and many other possibilities.

For this reason, we have an integrating methodology that seeks to involve the patient a lot and take into account all possible factors. Overcoming is something that cannot be guaranteed without knowing the person or their circumstances, of course. But we have had many cases of people who manage to live a life free of obsessions or, if they have them, they do not currently experience the suffering they previously had.

Why does this occur? The key we focus on is working on anxiety at the roots of OCD. Anxiety causes the appearance of obsessive symptomatology. Therefore, we look for the factors of appearance and maintenance of anxiety through a therapeutic analysis. We study not only how the person has reached this situation, but also what mental blocks they have, what their mental structure is that makes them live an unsatisfactory life, we observe the environment that is blocking the person instead of allowing the improvement… Then we break those blocks through exercises and analysis. We seek to give the person greater strength to be able to face situations that generate anxiety. In this way, anxiety decreases and thus, little by little, obsessions decrease. Finally, we also work so that the person can establish a series of vital objectives and fulfill them.

As we said, working in this way, you can have a good prognosis even in long-term cases.


What about taking medication for a long time? 

In many countries around the world, OCD is considered a chronic disorder that cannot be cured. For this reason, treatment with medication is usually started, which is then maintained for a long time, even years. The important thing is to know that OCD is not only overcome with medication, it also has to be combined with therapy. We have verified here at Ipitia that OCD is not chronic, but rather that it can be substantially improved in most cases. When you begin to notice improvement, you can stop the medication progressively until it is removed, under the supervision of a psychiatrist.


Long-term OCD and Changes in Life


When a person has suffered from an obsessive disorder for many years and has tried different therapies, they may feel that there is no way out. This is often due to focusing on symptom improvement without removing the underlying anxiety. Eliminating that anxiety is essential to begin the process of possibly overcoming OCD.

If we don’t do it, in case of experiencing a suffocating situation, that anxiety can reappear and, with it, OCD as well.


Among the ways to combat this anxiety, it is very important to establish challenges and vital changes.

Anxiety usually appears when we are living a life that is not the one we really want. We are not really ourselves, and we do not express our opinion or our wishes. Instead, we do what others expect from us or what we consider to be the right thing to do.

All these things create great rigidity and mental blocks, which produce a high level of anxiety. Obsessions and compulsions are a manifestation of anxiety.


Although OCD can occur for a variety of reasons, there is always a lot of underlying anxiety attached to these mental blocks. People with OCD tend to be perfectionists or worry a lot about what is right, about what others think… They often give up the lives they would like to live and that causes them greater suffering. This situation continues for years and is one of the factors of appearance and maintenance of OCD over the time.


For therapy to be most effective, it is not enough to control obsessions and compulsions, to take medication and continue with that unsatisfactory life, because over time everything can happen again. For this reason, along with exercises and therapeutic activities (and along with medication for those who need it), we must support the introduction of some vital changes that show the person that they can be themselves, that they can express themselves and they can achieve some goals.


Depending on the needs of the person and the circumstances of their life, those changes may be more strong and profound, or they may be smoother, but all of them will be a relief and a way to gain autonomy, dependence and freedom, which is very beneficial for a person with obsessive disorder.


What changes can help you if you have long-term OCD?


When you have OCD, it is very beneficial to be able to make some life changes. This helps the person to break down their blockages, freeing their instincts and emotions (which reduces mental pressure) and gradually leading the life they want.


The problem is that achieving life changes is not always easy. Especially if you have long-term OCD.


Many people with long-term OCD have become accustomed to a series of routines and mental blocks. They also tend to live under the yoke of obligations, of what is “the right thing” and of the gaze of other people.


Middle-aged people with long-term OCD find it especially difficult to make changes in their lives that help their disorder because of:

  • The dependency of the family. 
  • Job duties.


This gives rise to a stressful situation: anxiety increases, OCD perpetuates itself.

What can be done in these cases?


The way out is to continue making vital changes, but less radical ones. Although they are simpler, they will be equally liberating because the person with OCD will perceive a break with the previous situation.


Some examples:

Work on assertiveness and achieve some small goals to improve relationships with others.

Small work improvements: a change of position, a promotion, finding a better company.

Build healthy relationships within the family.

Learn to find your own space and time for yourself.



The key is that, even if the person cannot make big changes (such as moving to another city or a big professional change), there are always small victories to be achieved on a day-to-day basis, which help the person with OCD to see that the blocks can be broken and that they can lead a better, healthier and anxiety-free life.


Long-lasting OCD and Your Personal Space


When you have Long-Term OCD, it is very important that you allow yourself to have your own space.

In that space, you will be able to implement small changes in your life. These changes introduce spontaneity and freedom, and allow you to develop aspects of your personality that OCD has blocked.

Therefore, it is very important that you find a space for yourself.

That space can be physical (a place to relax and be yourself), but also psychic. For example, a moment that is just for you. Or psychological boundaries with others.


Ways to have your own space and free yourself from anxiety:

  • Acknowledge your own desires.
  • Reserve spaces of the week for you, in which you are really free to develop the activity you want without guilt.
  • Develop activities to release anxiety.
  • Defend your needs. Many people find it self-centered to stand up for their own needs. However, when you begin to ask for and stand up for what you need, you will become a healthy element in the family. If you feel better, everyone will be better too. So there is nothing self-centered about starting this process.


If you go to therapy, and you have chronic OCD, what else can you do to reach a more optimal or healthy level?

On the one hand, it is necessary to ensure that therapy is not focused only on the symptoms, but also on the root of the problem: the anxiety that causes the appearance of obsessive symptomatology. We are committed to an in-depth analysis to find out the factors of appearance and maintenance of OCD and exercises to break the person’s blocks that have led to this anxiety. We also seek to change her most rigid mental structures and help her overcome fears and doubts in order to achieve her life goals.

All this is in the therapy itself, but in addition, it is also important to combine therapy with intense activities that help the person to free himself from that anxiety.


 Is it really possible to overcome OCD? 


The process of overcoming an obsessive disorder can be long and require a lot of effort and therapy. A cure cannot be guaranteed a priori, since many factors influence it.

In any case, in order to reduce the obsessive symptomatology, we must first focus on reducing the underlying anxiety. An immersive and powerful therapy is essential to put the patient back in control of their own life.


Is it cured when you have a High Self-esteem and stop giving importance to rituals?

When you start to free yourself and start a process of individuation, little by little you become more authentic and the inner conflict is resolved. The free expression of emotions, opinions, assertiveness or creativity and all these aspects that may be blocked within you usually help in this process. Likewise, raising self-esteem incorporates several of these elements.