It was 2017 when Hannah*, 33, had her first obsessive thoughts about her husband and their relationship of over 15 years. "Within days, I had a complete nervous breakdown and ended up in A&E," she recalls. Increasingly anxious about coping with a mortgage and two children, Hannah started having panic attacks and was then diagnosed with obsessive-compulsive disorder (OCD), a condition she now believes she has had since her teens.
"I would spend my days worrying, What if we lose our house? What if I have a car accident? and then one day I had this thought, What if I don’t love my husband? – and that one stuck," she says. It became the only thing she could think of, up to 40 times a minute, all day, for days on end. "It consumed everything, I was extremely distressed and the thought of not being together and breaking up our family would then fill me with such anxiety [that] I would have a panic attack."
OCD is a common mental health condition causing persistent, unwanted thoughts and compulsive behaviours. Cleaning rituals and repetitive checks are probably its best known symptoms but OCD can manifest in other ways, often unheard of. With Hannah, it made her doubt she’d ever been in love and she would compulsively google relationship information, before cognitive behavioural therapy (CBT) helped her break the exhausting cycle. "I had to be very careful who I entrusted with my struggles," she warns, "as all it would take would be for someone who didn’t understand to say 'Sounds like you just don’t love him anymore' and that would be enough to trigger weeks of horrendous anxiety."
When OCD has relationship-related symptoms, it is sometimes referred to as 'relationship OCD' or 'rOCD' – especially online, on message boards or in support groups – but these are not official medical terms, as clinical psychologist and columnist Linda Blair explains. Charities like OCD UK also discourage their use, to avoid confusion.
"It’s certainly common for people with OCD [to] overthink anything that is important to them," Blair says. When it comes to romantic relationships, that can include obsessively questioning whether someone is 'the one', comparing to others, researching relationships online, suspecting infidelity or to have cheated themselves and not remember it, even. Despite being absolutely torturing, these specific symptoms are not very frequent, according to Blair, who has almost 40 years of clinical practice. They might be more likely if there is a particular concern with the person’s past or current relationship experiences, though.
"If there’s actual doubt out there as well, that makes your OCD a lot worse," says Valerie*, a 27-year-old from the East Midlands, who managed to come out of a very triggering, long-distance relationship. "A lot of things [my ex] used to say to me didn't add up, basically, there was a lot of distrust and the obsessions and thoughts would come in," she remembers. Social media also made it worse, enabling more compulsive checking and obsessive thinking: "I went through this shit time of not eating, lying on my bed, doing nothing, literally refreshing Facebook page, then Instagram page and Facebook page and Instagram page, just to see what was going on." The more she checked, the more she thought she had reasons to check and jump to the worst conclusions; it was all-consuming.
Obviously, anyone can question their relationship or become fixated with monitoring their partners but that – as problematic as it may be – doesn’t mean they have OCD, Blair points out: "OCD has to be all-pervasive, in other words [it] has to interfere with what we call activities of daily living, the things that you would normally do."
Diagnosed at 16, after a series of panic attacks made it hard for her to attend school, Valerie says she’d always been very self-deprecating and often second-guessed why anyone would want to be with her. Being with an honest and supportive partner for the past year and a half has really made a difference, but she still finds herself uncontrollably questioning her boyfriend’s motives and thinking he might leave. "Sometimes I'll focus on specific people and be like: 'Why don’t you want her? She’s great, she can do this and this.'" And having had to take time off work to take care of her mental health and start a new cycle of therapy hasn’t helped with her fear of not being good enough.
Blair says that with such obsessive thoughts it would be helpful to try and avoid confronting your partner continuously to get reassurance, because if their patience wears out a bit, you may end up feeling even more anxious. If possible, confide in a trusted friend or family member to put things into perspective, she suggests. "If you don't get any relief there, then I would seek professional help," she adds. "I would go first to my GP and say: 'Look, I'm so troubled by these thoughts. I don't have proof for them, but I am troubled by them and they're causing me not to be able to function well.'"
Talking to someone calm and objective, who can challenge you in constructive ways – a mental health professional, usually – can help. With therapy, it’s possible to reduce the amount of time when obsessive thinking and compulsive habits take over and find appropriate thought-blocking techniques – things that make it impossible to think about anything except what you’re doing, Blair explains: "Like counting backwards from 500 by 13, or naming all the different shades of blue or figuring out all the songs of your favourite rap artist." Finally, you would work towards adding more enjoyable things to your life than being consumed by OCD.
Getting better is absolutely possible, as Chris, 42, proves. This father of two from Norfolk has been with his wife for 20 years; his OCD first started at 17, when he left a medical training course because of violent intrusive thoughts. "I was imagining doing horrible things to patients, so I had to walk away from that," he says. He didn’t seek help and the condition died off for a few years, until his obsessive thoughts came back, this time focusing on his wife and family. "I started to experience [thoughts] that my wife would be cheating on me, or leaving me, or that something was going to happen with the boys," he remembers.
Things got to the point where he had to stop working, as he couldn’t leave his wife or his children alone, he had to be with them constantly. "The fact that I thought I was going crazy caused me to go to some very dark places, I started self-harming and doing some very nasty things to myself that could have been disastrous," he admits. Following a mental breakdown, 12 years after his first symptoms, he finally sought help: "Seeing the GP is the best thing I ever did," he says, encouraging anyone in a similar situation to do the same, as soon as possible.
"[Now] I’m a lot better, the relationship OCD is minimal," he says. After several cycles of therapy, including CBT, Chris has learned to manage his obsessive thoughts about something happening behind his back or to his wife and family. "Ten years ago, [relationship-related] OCD was never talked about, now it’s starting to be discussed," he notes. "It’s a good thing, it can only lead to more acceptance."
*Names have been changed to protect the subjects' identities.