A teenager thinks that OCD episodes may be why she feels out of control.

OCD Episodes May Be Why You Feel Out of Control

February 19, 2024

5 min.

Also known as an OCD spike or OCD attack, an OCD episode involves a notable escalation in the frequency and severity of OCD symptoms—but with proper help, it’s manageable.

By: Ethan Cohen BSN, RN

Clinically Reviewed By: Dr. Don Gasparini

Learn more about our Clinical Review Process


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Table of Contents

Living with obsessive-compulsive disorder (OCD) can make life feel unmanageable at times, especially when symptoms are intense. When intrusive thoughts (obsessions) and behaviors (compulsions) linked to OCD intensify, it’s referred to as an OCD episode (also known as an OCD attack or OCD spike). 

During an OCD episode, it can be challenging to complete daily tasks and engage in life in a meaningful way. That being said, having OCD doesn’t mean you can’t live the life you want. Whether you’re in the midst of an OCD episode or not, managing OCD symptoms is possible. Continue reading to learn more about OCD episodes, what causes them, and how to seek help.

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What is an OCD episode?

Also known as an OCD spike or OCD attack, an OCD episode involves a notable escalation in the frequency and severity of OCD symptoms. During these episodes, symptoms become more frequent, distressing, and challenging to manage. Individuals may find themselves grappling with an overwhelming surge of obsessive thoughts and an increased urgency to perform compulsive behaviors or mental rituals.

It’s important to recognize the variability in the duration and intensity of OCD episodes. They can range from brief episodes or spikes lasting a few hours to more prolonged episodes spanning several days. Understanding the nature of OCD episodes is crucial for people with OCD and their support network. Gaining a deeper understanding of your OCD episodes can help you develop targeted coping strategies as well as give you insight into the need for professional intervention.

What are common signs of an OCD episode?

Common signs of an OCD episode include:

  • Intense and persistent thoughts, images, or urges that cause distress
  • Compulsive behaviors or rituals performed to reduce anxiety or prevent perceived harm
  • Feeling unable to control these thoughts or behaviors despite efforts to resist them
  • Spending a significant amount of time engaging in compulsions 
  • Experiencing distress or impairment in functioning due to OCD obsessions and compulsions

OCD episodes can manifest differently from person to person. Some common themes of an OCD episode include fear of contamination, checking behaviors, obsession over symmetry and order, intrusive thoughts, fear of harming others, hoarding tendencies, perfectionism, and religious or moral obsessions. Any aforementioned intrusive thought can lead to compulsive behaviors like excessive cleaning, checking locks, arranging items, mental rituals, avoiding certain activities, hoarding possessions, striving for perfection, and engaging in religious rituals.

What triggers OCD episodes?

An OCD episode can be brought on by various factors. Stressful life events, major transitions, or trauma have all been associated with an increase in OCD symptoms. Additionally, disruptions in routine, sleep deprivation, and changes in hormonal levels are known to contribute to the onset of OCD episodes.

Claire Streeter, PMHNP, ARNP, an expert on anxiety disorders and OCD who works as a Psychiatric Mental Health Nurse Practitioner at Charlie Health, says uncertainty can often be a driving force behind OCD episodes. “One of the primary challenges for individuals with OCD is learning to tolerate uncertainty. We can use this as a tool to understand why symptoms may worsen at certain times—for example, when we are anticipating a move or a change in jobs or schools,” she says. “There is a natural amount of uncertainty about the future that comes with such changes, which can lead to an increase in intrusive thought and associated compulsive behavior.”

It’s important to note that the relationship between various triggers and OCD episodes is complex, and not everyone with OCD will experience spikes in response to stress. Yet, those who find that they experience OCD episodes with greater frequency and intensity during stressful life events or during times of change and uncertainty can take steps to get ahead of their symptoms. As Streeter puts it: “Uncertainty is an inevitable part of day-to-day life, so managing OCD is about being proactive in recognizing symptoms and seeking out evidence-based treatment.”

Treatment for OCD episodes

As mentioned, recognizing potential triggers and addressing them in therapy can be a crucial aspect of managing and preventing OCD episodes. Thankfully, there are several effective treatments for managing OCD symptoms. It’s important to note, though, that OCD treatment choice often depends on the severity of symptoms, your individual preferences, and your specific needs. Here is a list of some well-established treatments for OCD:

Cognitive-behavioral therapy (CBT)

Exposure and response prevention (ERP) is a specific type of CBT that involves exposing individuals to thoughts, images, or situations that trigger anxiety (exposure) and preventing the accompanying compulsive behaviors (response prevention). Over time, this helps people with OCD reduce the anxiety associated with their obsessive thoughts and behaviors. 


Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed to help manage OCD symptoms by increasing serotonin levels in the brain. They are often used in conjunction with therapy to improve mental health and well-being. 

Many individuals find that a combination of medication and therapy is the most effective approach to address their OCD symptoms and anxiety. Medication can help alleviate symptoms, while therapy provides coping strategies and tools to manage OCD obsessions and compulsions.

Mindfulness-based therapies

Techniques derived from mindfulness, such as mindfulness-based stress reduction (MBSR) or acceptance and commitment therapy (ACT), can be beneficial in helping people with OCD observe their thoughts without reacting to them, fostering a more accepting and present mindset.

Support groups

Joining support groups or engaging in group therapy with individuals who share similar experiences with OCD and OCD symptoms can provide a sense of community and understanding. Learning from others’ coping strategies can be a valuable tool in the treatment journey.

Family therapy

Involving family members in therapy can enhance the understanding and support available to your loved one with OCD. It can also provide tools for family members to assist in the management of symptoms. Expressing a willingness to participate in family therapy can help your loved one know you care.

A teen is in virtual family therapy for treatment for OCD episodes.

OCD treatment at Charlie Health

If you or a loved one are struggling with obsessive-compulsive disorder (OCD), Charlie Health is here to help. Our virtual Intensive Outpatient Program (IOP) offers more than once weekly therapy for young people and their families struggling with complex mental health conditions, including OCD, anxiety disorder, and OCD episodes. Our expert clinicians incorporate evidence-based therapies into individual therapy, group sessions, and family therapy to give people the tools and personalized care to address OCD. With this kind of holistic treatment, managing any obsession or compulsion is possible. Fill out the form below or give us a call to start healing today. 

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