"What if something terrible happens to her because of me? I must pray 10 times for her safety."
Have you ever experienced this intense fear and the strong urge to neutralize the panic, maybe after you jokingly told your friend you didn't want her at the party? Your friends laughed it off and moved on, but you couldn't. You couldn't shake away the thought of harming her from your mind. If you forget the number of times you prayed, you restart again because it has to be exactly 10 times.
This is what OCD social anxiety can feel like. Others may see you zoning out from the interactions. They may even realize that maybe something is off, but hardly anyone understands the gravity of what you are going through.
Remember, though, you are not alone in this exhausting experience. In the past year, OCD affected roughly 1.2% of the people in the United States, as per the National Comorbidity Survey Replication (2001-2003).
Data from the same source notes that around 7.1% of American adults suffered from social anxiety last year. And many of these people experience both conditions simultaneously. Thus, if you ever felt “there must be something wrong with me” or something like that, please know that's not the case.
Social anxiety and OCD can affect more than your thoughts. That is what we will discuss further: how both conditions can affect your social life, how exactly they are different from each other, and the treatment options available.
How OCD can affect social life?
OCD directly affects your relationships, whether it's friendships, romantic relationships, or with colleagues. The most challenging thing about OCD is how it takes up a significant amount of your mental capacity.
As illustrated in the example at the beginning, having to repeat certain phrases internally while at the same time being in a conversation requires a lot of energy. You may prefer to stay at home and avoid hanging out with others, owing to this mental fatigue.
Plus, when the intrusive thoughts keep distracting you from the present, your conversation partners are left feeling ignored. They can feel further distanced when you cancel or keep showing up late at major events.
Maybe rituals like making sure each door and window is locked took longer than you anticipated. While your friends who know about your OCD can be understanding, it is also possible for them to be upset on some occasions.
Socializing becomes more difficult with certain types of OCD, like scrupulosity that is related to moral or religious fears. If you have moral OCD, you may worry about saying something hurtful or discriminating without meaning to. You play the conversations in your mind over and over and question whether your words were appropriate. Even routine conversations turn into high-stress moments.
The cycle of intrusive thoughts, rituals, fatigue, and distance can cause your social circle to shrink with time. This avoidance may look similar to social anxiety on the surface, but deep down what makes you behave this way is very different most of the time. And thus it's important to understand how both conditions differ for an accurate diagnosis and effective OCD and social anxiety treatment.
OCD vs social anxiety
Treatment for OCD and SAD
OCD and social anxiety both need precise and personalized diagnosis. Otherwise, the treatment may not be effective. A thorough psychiatric evaluation is necessary to identify the underlying roots contributing to your symptoms.
Cognitive behavioral therapy (CBT) is the most recommended and evidence-based care available for both conditions. CBT in OCD treatment focuses on exposure and response prevention (ERP). ERP carefully allows individuals to confront their fears without engaging in rituals. When the outcome they are afraid of does not happen, their uneasiness gradually decreases. You're basically challenging the assumptions you have by testing them.
You may avoid shaking hands with others or sitting too close to them if you have contamination OCD. ERP may encourage you to sit at the shared sofa and touch the objects present there, but without washing your hands immediately. This is only a hypothetical situation. Actual recommendations will be made by your mental health professional.
CBT for social anxiety focuses on reframing the thought patterns to change an individual's behaviors and emotions. Exposure therapy is even more effective for social anxiety. People with social anxiety often have a biased assumption regarding social situations. You may be exposed to anxiety-inducing situations within a controlled environment so you can see for yourself if they're as harmful as you thought.
For both OCD and social anxiety, selective serotonin reuptake inhibitors (SSRIs) are the first-line pharmacological options. Other medications for OCD are recommended when these fail to work, while for social anxiety, medications, particularly for the physical symptoms, also exist.
Several medications are available for both disorders, and a certified professional can identify which of them is appropriate for you. Sometimes the prescribed medication may not be effective, or its dosage may need adjustment or completely changed. It is essential that you and your healthcare provider are in constant touch so they can monitor how you respond to treatment.
When to seek help?
You do not have to wait for your symptoms to become unbearable to reach out for help. Consider speaking with a mental health professional if:
- Intrusive thoughts or compulsions take a significant amount of your time
- You are avoiding social situations more
- Fear is affecting your everyday responsibilities, your relationships, your education, and work
- You are repeatedly performing the rituals to ease anxiety
- You are unsure what you are experiencing
Some symptoms can overlap, and a professional can help figure it out better. If you are unable to visit a clinic for social anxiety or any other reason, virtual treatment can be the bridge. With Gaba Telepsychiatry, you can connect with an online psychiatrist Florida from your home.
Remember, finding the right treatment may take time, and it is okay if your care plan changes. Progress is not a one-way road. What's important is that small improvements will eventually add up to make a meaningful change in your life.
Healing begins with understanding
Living with OCD or social anxiety can make you question yourself. "Why can't I simply stop thinking? Why do I need to perform these rituals? Why do situations that others find ordinary make me so overwhelmed?"
These experiences can change.
Treat these experiences as symptoms of a treatable mental health condition and not a definition of who you are. Recovery doesn't always look like being free from every unwanted thought or suddenly becoming the most confident person in a crowd. It can mean reaching a place where they no longer control you.
OCD and social anxiety can both become manageable with the right understanding and professional support. Remember, you are not the intruding thoughts you get, not the compulsions you perform, not the fear you feel when someone looks at you.
There is a part of you beyond all of that, and you can take one step at a time to move towards it.
