Have you ever entered a room and instantly assumed the people in it are all silently judging you? Or are you someone who spends far too much time in front of a mirror just making sure things are perfect, without even a single minor flaw in sight?
If you experience these feelings and they become even more distressing at work and during everyday tasks, you may be experiencing more than just shyness. This problem is called social OCD. Many other people struggle with this alone because they feel they’re “too sensitive” or “weird.”
The first thing is that you’re not lacking, and you’re certainly not alone. Second is that social OCD is a treatable mental health condition. Last but not least, OCD and social anxiety sometimes coexist. Therefore, people with OCD and anxiety disorders have seen significant improvements in their symptoms with treatment from a specialist, such as an anxiety doctor or an anxiety specialist near me. Let’s first understand what social OCD is and how it manifests in everyday life, and most importantly, how you can get your life back.
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What is social OCD?
Social OCD is a type of obsessive-compulsive disorder that focuses on social situations. It’s different from the typical anxiety you experience before a big seminar. In social OCD, thoughts of being bad, doing something wrong, being disliked, etc., constantly run through your mind.
For example, when you’re at a coffee shop, the person with social anxiety might be slightly nervous asking for a cup of coffee. But for a person with social OCD, this could look like:
- Spending 20 minutes going over what to say in every step
- Making a decision may last hours.
- Worried the staff in the coffee cafe might think you’re dumb
- Avoidance behavior: not visiting that coffee shop.
How does social OCD manifest in your daily life?
OCD consists of two parts: the obsessive part and the compulsive part, which are fairly easy to understand. Obsessive thoughts include:
- Always thinking the worst thing you could say
- Worrying about how people will judge your looks
- Believing you’ll be rejected or humiliated
- Imagine a situation where you’ll be the joke at a party
- Worrying about being judged for a mistake
Compulsive behaviors include:
Repeatedly checking the mirror before going out to check if everything is okay
- Avoiding eye contact when talking to a friend
- Repeatedly recalling things from memory
- Pretending not to be yourself during dates to avoid making mistakes
- Addiction to spending so many hours on social media trying to see who to imitate
These things may provide relief in the short term, but in the long term, they increase anxiety.
Why does social OCD occur?
There is no exact cause. However, expert belive some triggers cause social OCD:
- Biological causes: Studies have found that OCD is usually genetic, as the condition runs in families. Brain imaging research also suggests that people with OCD have differences in how certain parts of the brain function.
- Life experiences: Being bullied, publicly mocked, or excessively criticized can trigger OCD symptoms in social situations.
- Personality traits: People who can’t resist the urge to stick to their routine and get irritated whenever someone points out their behavior may be more likely to develop social OCD.
Case study: Michael’s journey with social OCD
Michael was 28 years old and had been working as a teacher for a year when he began experiencing symptoms of social OCD. Initially, his daily anxiety about standing up and speaking in front of his students became so overwhelming that he couldn’t teach properly.
Early signs:
It started when Michael began to dread teaching his lessons for hours. He would anxiously rehearse his lectures in his living room, fearing that his students wouldn’t like him at all. Not just the task of checking attendance, but even small, basic things like calling a student’s name or mispronouncing a word were causing him stress.
In less than two weeks, he reached the point where he started arriving at least two hours early to work so he could see how he looked, clean his desk thoroughly, and, of course, practice his lines. He also became increasingly irritated by teachers judging him in the lounge area.
Also, he felt as if someone was reading his mind. However, he didn’t confirm it by asking someone, because he was absolutely sure he was right.
The problem worsened:
Soon, by the third month, Michael’s OCD was slowly destroying him, and in fact, he wasn’t attending a single staff meeting. He would spend hundreds of hours in his spare time rehashing everything that had happened to his coworkers, explaining things to other staff members over and over again.
He also abandoned his friendships outside the work environment. He stopped going to dinners with his friends and refused to attend parties. When he was out, he would often go to the bathroom to check himself and talk to himself alone.
He also experienced physical symptoms that were extremely debilitating:
- Regular headaches due to worry
- Waking up frequently due to overwhelming thoughts
- Extreme stress due to the uncertainty of social interactions
- Muscles overstimulated due to being constantly on alert
Impact on his life:
Michael felt that, first of all, his relationships were suffering. His friends were disappointed that he was constantly canceling plans, and his family was becoming more worried and anxious about the emptiness he was sinking into. Also, his job was becoming a hindrance because he was so careful not to get involved in anything that would make him look bad in front of others. Trying to stay away from the situation actually made it worse.
Over time, Michael realized there was a problem, but he felt trapped and unable to escape. The more he avoided such places, the more they bothered him. He realized how difficult it was becoming every day to find the real Michael and free him from this whole ordeal.
Seeking help:
After eight months of suffering, Michael sought professional help. It wasn’t an easy decision, as he struggled with the stigma surrounding his mental health. As a teacher, he recognizes the value of seeking expert support. During the psychiatric evaluation, the doctor told Michael that he was actually suffering from social OCD, not just social anxiety. This was a relief for Michael, as he finally knew the names of his internal problems and that treatment was available.
Treatment approach:
Michael’s treatment plan included cognitive-behavioral therapy and medications:
Cognitive Behavioral Therapy (CBT): One of the approaches Michael tried was negative thinking pattern training, which uses evidence-based reasoning to promote positive thinking. He overcame the thought, “Everyone thinks I’m a terrible teacher,” by asking himself, “Where’s the proof?”
Exposure and Response Prevention (ERP): This involved gradually confronting his fears without engaging in habitual compulsive behaviors. To start, Michael had to speak at least once in a staff meeting.
- Practicing conversations with a colleague.
- Planning lessons without much preparation.
- Going to lunch with friends every week.
Medication: His psychiatrist recommended taking an SSRI (selective serotonin reuptake inhibitor) to help reduce his anxiety symptoms and make CBT more effective.
Recovery process
It took Michael about ten months to overcome his social OCD. He still continued to receive regular treatment (like a regular checkup people take for their diabetes). He had a bit of a hard time during the first few weeks because his anxiety levels would spike when he faced his fears directly. However, he always noticed that the scary things he used to be afraid of no longer seemed as scary.
In addition to treatment, he is using nerve-calming techniques, which are very effective in managing his frustration. He learned that repeating a few mistakes wasn’t the end of the road. He’s happy to be hanging out with friends again, actively participating in staff meetings, and feels his teaching skills are in good shape.
The Help is There!
If you’re dealing with issues similar to Michael’s, know that you’re not broken. Your brain has just learned a way to do things that was once useful and protective but is no longer. You can still learn a new and productive pattern to follow. Besides, it is thought that only younger adults get OCD. This is not the truth. Older people get OCD, too.
Many people of all ages, when receiving timely treatment from a mental health professional, such as a board-certified psychiatrist NYC, have seen improvements not only in social interaction but also in symptoms of obsessive-compulsive behavior. Now it has become easy to take advice from psychiatrists through online platforms.
At GABA Telepsychiatry, Dr. Gundu Reddy (MD) has more than 15 years of extensive experience in treating mental health conditions, including OCD. She considers multiple factors (e.g., genetics, developmental factors, medical illness, nutrition, hormones, and environmental and dynamic factors) when diagnosing and treating a patient online to provide comprehensive psychiatric care.
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