Obsessive compulsive disorder - OCD treatment and therapy from NOCD

5 Ways OCD May Show Up in the Workplace and How You Can Manage

10 min read
Stacy Quick, LPC
By Stacy Quick, LPC

While obsessive-compulsive disorder (OCD) is often misrepresented as a preoccupation with being clean and organized, the truth is that this serious, often debilitating condition can affect a person’s ability to function in every area of life, including the workplace. We often spend a great deal of time at our jobs, and they can serve many important purposes, providing income, social interaction, and even emotional fulfillment. Because of this, it can be particularly devastating when they’re impacted by OCD.

The ways in which OCD shows up at work will vary for each person, with some being more visible than others. However, whether they’re visible or not, each of these issues can feel exhausting and overwhelming. Fortunately, with the right knowledge and support, you can manage your symptoms and have a successful career with OCD.

Here are 5 common ways you might notice OCD in the workplace, and what you can do to navigate these challenges:

1. Reduced productivity

The two main symptoms of OCD are distressing, unwanted thoughts, images, urges, or feelings, known as intrusive thoughts, and compulsions, physical or mental behaviors performed in an attempt to relieve the distress brought on by intrusive thoughts. Both of these symptoms have the potential to become time-consuming, resulting in a loss of productivity. Depending on how productivity is defined in a person’s workplace, this can become a significant issue.

Compulsions and repetitive behaviors can interfere with the completion of important tasks. The intense need to “check” or redo things—an experience common among people with Checking OCD, as well as numerous other OCD subtypes—can make it difficult to fulfill one’s job responsibilities.

People with OCD may also be more prone to concentration issues due to the constant onslaught of intrusive thoughts that they often experience. In positions where focus is necessary and the lack of it can even be detrimental, this can have devastating effects.

An example of productivity issues resulting from OCD:

Susan is a nurse at a world-renowned hospital, where she works with some of the top doctors from around the country. She has always struggled with OCD but for most of her career, she’s been able to keep it under wraps. Unfortunately, this all changed following the COVID-19 pandemic.

The stress of the pandemic resulted in increased OCD symptoms that have become more and more difficult for Susan to hide from her co-workers. She’s struggled to remember important patient details and concentrate on what she’s doing. Her mind seems to be in a constant state of chaos. Lately, her chronic forgetfulness has gotten her into more and more trouble with her supervisors.

2. Difficulty making decisions

Decision-making is a core responsibility of many jobs, but people suffering from OCD may find it difficult to make even the smallest decisions. The excessive feelings of doubt and uncertainty that characterize OCD can lead them to second-guess everything, resulting in countless hours spent analyzing and reassessing the problem, or what they perceive to be the problem.

A key characteristic of OCD that can contribute to this is distress intolerance, or the belief that one cannot possibly tolerate uncomfortable emotions. This distress intolerance can make people with OCD feel an overwhelming fear of making the “wrong” decision, or believe that it would be unacceptable to make any decision they don’t feel 100% certain about. This indecisiveness may wreak havoc in their careers, especially in professional roles where quick and effective action is required.

Individuals struggling with this indecision may inadvertently rely on others to make important choices, or constantly seek approval or validation to reassure them that they’ve made the “right” decision. Excessively asking questions or clarifying what is needed can be another sign that someone is having a difficult time making decisions on their own and trusting their instincts.

An example of decision-making issues resulting from OCD:

George is a well-known lawyer locally. He is considered one of the area’s best, and his attention to detail and organizational skills are second to none. He has worked very hard to achieve this level of success. Last year, however, following the death of his wife, George noticed that his OCD, which was previously well-controlled, began to spike.

George is expected to be able to quickly make decisions that can have extreme implications for his clients. Lately, he has been getting stuck and feeling unable to make these important decisions. He has found himself constantly seeking advice from his colleagues, who he can tell are getting impatient with him—after all, they have high caseloads and stressors of their own.

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3. Strained work relationships

OCD can also create strain in a person’s relationships with their coworkers. While progress has been made in our society’s understanding of OCD, there is still stigma surrounding the condition, and many people still hold misconceptions about what OCD is and isn’t.

As a result, someone struggling with OCD may choose not to tell their coworkers what they’re experiencing. Coworkers who aren’t educated on OCD may be confused by the repetitive behaviors often involved in compulsions, or frustrated by the condition’s other manifestations, such as constant reassurance-seeking.

These misunderstandings may lead to feelings of isolation, and a significant decrease in job satisfaction for the person suffering from OCD. The stress of this relational tension may also result in an increase in symptoms, potentially leading to further conflicts with coworkers.

An example of workplace relationship issues resulting from OCD:

Barry works at a pet store, where none of his coworkers knows that he suffers from OCD. His diagnosis is very recent and he’s still learning all of the ways in which OCD affects him. His job is also fairly new. He loves animals and was happy to find a local pet store in need of help. 

Although Barry loves working alongside the animals, he’s noticed that his coworkers don’t seem to like him. Of course, he can’t be sure that they don’t, but he still suspects this because they don’t seem to be very talkative with him. He also senses that they get frustrated by some of his behaviors, like the very specific way he does his closing routine in the store. He completes all of the tasks he’s supposed to, but is strict about doing them in a particular order.

If someone at the store doesn’t follow his routine, Barry can become very agitated. On a couple of occasions, he has made some negative remarks to his coworkers out of frustration. He feels bad about this, but he also feels it is important to do things in the order he has determined. If things are done in another order, he fears something terrible will happen.

4. High levels of stress and anxiety

On top of the everyday stressors and demands of work, people with OCD can also struggle with added anxiety due to the nature of OCD. Dealing with constant intrusive thoughts, images, and urges that go against your values while trying to meet the demands of your job can be taxing, and may lead to a depressed mood.

People with OCD can also feel like they’re under a great deal of pressure, and may struggle with fears of making a mistake. These intense feelings of doubt and uncertainty can hold them back from pursuing job opportunities.

An example of workplace stress and anxiety resulting from OCD:

Ian works at a local homeless shelter. He loves his job and values the fact that his work makes a difference. He has many friends at his place of employment, but none of them are aware that he suffers from OCD. He’s become an expert at hiding his symptoms.

The one thing Ian hasn’t been able to hide, though, is his high level of stress and how it impacts him physically. He’s been reprimanded by his supervisor a few times in the past year for calling in sick at the last minute. He really does feel sick when he calls, but he also knows that this usually happens when he’s feeling overwhelmed by his OCD symptoms.

Certain tasks at the shelter, like serving food, are very triggering for Ian. He struggles with intrusive thoughts that he could unintentionally contaminate the food. He knows he’s going to experience much higher levels of anxiety leading up to Tuesday, the day he’s in charge of serving food, and every Monday evening, his stress and anxiety make him physically ill. The next morning, he almost always calls in sick.

5. Low self-esteem

As mentioned previously, people with OCD may suffer from pervasive doubt. This doubt can make people question anything, even who they are as a person. OCD can make people think something is deeply wrong with them. While these beliefs are untrue, this sense of not knowing who they are or if they are “good enough” can still be an intense and difficult experience.

Due to the nature of intrusive thoughts, people with OCD may feel intense shame and guilt, or believe that they’re unworthy of good things happening to them. This belief can spill over into their careers, causing them to doubt that they’re deserving of a promotion, recognition, or other forms of appreciation.

An example of self-esteem issues resulting from OCD:

Lena feels stuck in a dead-end job. Although she is highly qualified and well-trained in her line of work, she’s been unable to move forward in her career. She is in the same position she was in five years ago, when she first graduated with her Masters degree.

Every time an opportunity for a promotion arises, Lena finds herself second-guessing whether or not she is worthy of it. As a result, she ends up not going through with the interview. From the outside, she seems to have it all together, but the way she feels about herself impacts her on a deep level. It’s hard for her to explain to her family and friends just how severe the negative feelings about herself are.

These struggles don’t have to hold you back

When you’re struggling with untreated OCD and its impact in the workplace, managing your symptoms might feel like an unattainable goal. But even then, it’s possible. Having OCD doesn’t mean you have to give up on your aspirations, or that there’s any limit to what you’re capable of achieving.

With the right tools, you can flourish in your career. Of those tools, exposure and response prevention (ERP) therapy is the most effective. ERP can help you learn to effectively manage symptoms and navigate the challenges of OCD in the workplace. With decades of clinical research confirming its effectiveness, it’s considered the gold-standard treatment for OCD.

ERP is designed to break the cycle of obsessions and compulsions, helping OCD lose its power over time. At NOCD, all therapists specialize in OCD and receive ERP-specific training from some of the top OCD experts and researchers in the world. They’ll work with you to create a personalized treatment plan and manage your OCD symptoms in the long term, providing non-judgmental support every step of the way.

When practiced regularly, ERP can help you learn that OCD’s anxiety and distress are false alarms, and that uncomfortable feelings will eventually pass without you needing to do anything. You can learn how to make decisions and move towards your work goals, even when you’re having doubts or facing a trigger. ERP can also help you foster healthy relationships with coworkers and not rely on them for reassurance and validation.

If you have any questions about starting ERP therapy or need more information about the treatment, please don’t hesitate to book a free 15-minute call with our team. On the call, we can answer any questions you may have and assist you in getting started with a licensed therapist at NOCD.

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ERP therapy was developed specifically to treat OCD and has helped many people who struggled with the condition regain their lives. All therapists at NOCD have specialty training in OCD and ERP.

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