Most of us have experienced the excruciating suspense of waiting for a text back from a crush. Or the potent anxiety of wondering if the person you're seeing wants to be exclusive. Or the uncertainty of not knowing who you're going to spend the rest of your life with. Or maybe you tend to experience all of these feelings at once, all of the time, to the point at which it interferes with your life. Perhaps you've even wondered if your constant relationship worries are a sign of a more serious mental health condition, such as obsessive-compulsive disorder? Well, that's a very tough question to answer, but they can be.
"Relationship OCD" or "relationship substantiation" are terms that are often used to describe obsessive-compulsive symptoms that are centered around a person's close relationships, explains Guy Doron, PhD, associate professor at the Baruch Ivcher School of Psychology in Herzliya, Israel, who has studied relationship OCD. Although "relationship OCD" isn't an official diagnosis in the DSM-5, the manual used to diagnose mental disorders, it's viewed as a a "presentation" of obsessive-compulsive disorder. OCD is an anxiety disorder that's defined as having recurring, unwanted thoughts, ideas, or sensations that make you feel driven to do something repetitively, according to the American Psychiatry Association. For people who exhibit "ROCD," these thoughts and ideas have to do with their relationships.
ROCD is a complex and newish phenomenon, Dr. Doron explains. Although many people tend to casually throw around the term "OCD" to describe organization or habits, it's important to point out that ROCD is way different than simply worrying about your latest Bumble match. While most of us have had doubts about our relationships, or have stressed about some specific aspect of our partner's personality, ROCD symptoms can be extremely disabling, he says. "For people with ROCD, these doubts, dilemmas and preoccupations are painful, time-consuming, excruciating, and may interfere with the persons daily functioning," he says. Conflating the all-consuming anxiety of OCD with a personality quirk minimizes minimizes the experiences of people who have clinically diagnosable OCD.
It's tough to pinpoint what exactly ROCD "looks like," because everyone's relationships are different and nuanced. ROCD can appear in romantic relationships, but it can also affect friendships, and even parent-child relationships, Dr. Doron says. Typically, ROCD symptoms are either relationship-focused or partner-focused, and can include: obsessively doubting whether you really love your partner; being extremely preoccupied with whether you're in the "right" relationship; or developing disabling obsessions with your partner's flaws, he says. For example, a person with ROCD in a romantic relationship might obsessively question whether they really love their partner, or are truly attracted to them, and "spend hours monitoring her body for signs that she feels love and attraction to her partner," he says. They might also compare their relationship to others, or avoid social situations where they know they'll be around other couples.
As you can imagine, this can interfere with people's relationships big time. The good news is that ROCD seems to be treatable with cognitive behavioral therapy, which is a type of therapy aimed at recognizing and changing certain negative thinking patterns, Dr. Doron says. While CBT is highly effective for treating OCD, researchers are just beginning to figure out how to tailor treatment for relationship-oriented OCD symptoms, specifically. Treatment can include focusing on extreme or catastrophic "love beliefs," addressing someone's self-esteem issues, as well as challenging their fears of abandonment, he says.
However, any subject that makes you anxious or stressed — whether it's the status of your love life or your workload — is worth exploring further, especially if it's interfering with your daily life. While you may never know the answers to those big relationship questions that bother all of us, you can find more productive, healthy ways to deal with the uncertainty.
If you are struggling with obsessive compulsive disorder and are in need of information and support, please call the National Alliance on Mental Illness at 1-800-950-6264. For a 24-hour crisis line, text “NAMI” to 741741.