Exercise can help reduce symptoms of obsessive-compulsive disorder (OCD) but it works best when combined with evidence-based treatments like exposure and response prevention (ERP) therapy.
Whether it’s running, yoga, strength training, or even a daily walk, exercise can be incredibly helpful when integrated into treatment for obsessive-compulsive disorder (OCD).
OCD is a chronic mental health condition characterized by a cycle of obsessions and compulsions. Obsessions are unwanted intrusive thoughts, sensations, feelings, images, or urges that cause distress. In response, someone with OCD performs compulsions, which are repetitive behaviors or mental acts done to reduce anxiety, neutralize a thought, or prevent a feared thing from happening.
OCD not only involves intrusive thoughts and compulsive behaviors, but it also creates anxiety and stress that can further intensify its symptoms. This is where exercise can make a significant impact. Physical activity isn’t just good for your body, it also helps boost neurotransmitters in the brain, which can positively affect your mental health.
While exercise alone is not a cure for OCD, it can help alleviate some of its symptoms. When regular exercise is included alongside exposure and response prevention (ERP) therapy, it can help improve overall mood and reduce anxiety, which are two major factors that often exacerbate OCD symptoms.
Interested in incorporating exercise into your treatment plan? Here’s what you need to know.
Exercise and OCD
Exercise alone is not necessarily a cure-all, but it can be a good complement to ERP treatment, says NOCD therapist Heather Brasseur, LMHC, LPC. “Regular exercise can help you feel less stressed, improve mood, and overall mental health, which can support ERP’s effectiveness. Having structure and routine can sometimes carry over into practicing ERP too. Anything you do consistently tends to bring better results than doing it just once in a while.”
In a 2017 study published in General Hospital Psychiatry, 56 participants joined a 12-week moderate-intensity aerobic exercise program, which included the use of treadmills, elliptical machines, and cycling. The study found that 30% of those participants reported a decrease in depression, anxiety, and OCD symptoms. A follow-up study by the same team found when people with OCD used aerobic exercise to boost their heart rate, their OCD symptoms decreased faster than the symptoms of people who only saw a health counselor.
Generally, there is limited research on the effects of exercise on OCD. However, research on the broader benefits of exercise for mental health suggests that it can have a positive impact on anxiety, depression, and stress—all of which are often experienced by people with OCD.
How exercise affects depression and anxiety
Studies indicate that around 25 to 50% of people who have OCD also meet the diagnostic criteria for a major depressive episode. Persistent intrusive thoughts and compulsions can create a cycle of stress and frustration, which can contribute to depression. In turn, depression can make it more difficult for individuals to manage their OCD symptoms.
Similarly, anxiety is deeply interwoven with OCD, playing a central role in both the development and perpetuation of the mental health condition. Studies show that around 22 to 57% of people with OCD also experience co-occurring anxiety disorders. Obsessions that characterize OCD often trigger intense feelings of fear and distress, causing anxiety. In turn, someone with OCD does compulsions to self-soothe, only to be met with short-term relief before the cycle is repeated.
The cycle of depression and anxiety can be exhausting, but research suggests that incorporating physical activity into treatment may help break this pattern by promoting the release of mood-boosting neurotransmitters, such as serotonin, dopamine, and endorphins.
A 2004 study found that aerobic exercises like jogging, swimming, cycling, walking, gardening, and dancing were shown to reduce anxiety and depression. These improvements in mood were proposed to be caused by an increase in blood circulation to the brain and its influence on the hypothalamic-pituitary-adrenal (HPA) axis, a part of the brain that controls motivation and mood, memory formation, and fear response. The HPA axis controls the release of cortisol, a stress hormone, and plays a significant role in how we respond to stressors, including those associated with anxiety and OCD. Endorphins also contribute to the so-called “runner’s high,” a feeling of euphoria that many people experience after exercising.
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How to incorporate exercise in your OCD treatment
Your therapist can help to implement physical activity into your treatment plan, determining how and when to incorporate exercise in a way that aligns with your goals. Simply bringing up exercise to your therapist is the first step.
“One of the best things about exercise is that it’s accessible to nearly anyone,” says Patrick McGrath, PhD, Chief Clinical Officer at NOCD. “You don’t need to pay for a gym membership or even get up at 4:30 a.m. to run several miles. In fact, just five minutes of exercise can start to reduce your anxiety levels.”
Any exercise that you’re interested in and capable of doing safely, with doctor’s approval, can be beneficial for people diagnosed with OCD.
“Any exercise that you’re interested in and capable of doing safely, with doctor’s approval, can be beneficial for people diagnosed with OCD,” says Brasseur. “People often report engaging in activities such as walking, running, and going to the gym as part of their routine. They also frequently share that exercise helps them maintain a schedule, routine, and consistency, which can be beneficial for managing OCD symptoms.”
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Combining ERP therapy and exercise
While exercise can reduce anxiety, improve mood, and support overall mental health, it does not address the behavioral aspects of OCD—including obsessions and compulsions—which are crucial for long-term symptom management and recovery.
“I think it’s important to talk about how exercising can sometimes become a way to distract from intrusive thoughts, sensations, images,” says NOCD therapist MaryBeth Overstreet, MA, LPC. “When talking to individuals about exercise I have conversations about what they enjoy doing and what they want to get back to. We discuss the importance of doing this exercise regardless of how it may decrease symptoms or distract, but how to practice response prevention while doing the exercise.”
Exposure and response prevention (ERP) therapy, a specialized form of cognitive behavioral therapy (CBT), has been clinically-proven the most effective form of therapy for OCD. In partnership with a trained therapist, you’ll work to gradually confront your intrusive thoughts and triggers, while resisting the urge to do compulsions to decrease anxiety.
For example, if you have a thought that something bad might happen unless you perform an action, such as checking or cleaning, ERP will encourage you to expose yourself to what triggers you without performing a compulsion in response.
Purposely triggering your anxiety can be difficult and uncomfortable as it goes against the natural desire to avoid distressing situations. However, as you continuously work to face your triggers without engaging in compulsions—you’ll notice that the anxiety becomes less intense and easier to manage over time.
Other health habits that can help with OCD
Sleep and OCD
Sleep is also an important lifestyle factor that can significantly affect your mental health—including OCD symptoms. Poor sleep quality or insufficient rest can cause anxiety, increase irritability, and impair cognitive function, such as attention and memory, all of which can worsen symptoms of OCD.
However, having OCD can make sleep especially challenging. Some people with OCD experience insomnia, intrusive thoughts at bedtime, fears about sleep, or nightmares. OCD and sleep can become a self-perpetuating cycle, making it difficult to break free from both sleep disturbances and OCD symptoms.
On the other hand, having good sleep hygiene, such as maintaining a consistent sleep schedule and a calming bedtime routine, can improve emotional regulation and reduce anxiety. And, one of the many benefits of regular exercise is that it can improve your sleep quality. Mindfulness meditation has also been shown to help with relaxation and sleep, while other people may find that using acceptance and commitment therapy (ACT) is helpful for treating insomnia.
If you feel like stress, anxiety, or OCD is continually affecting your sleep, reach out to your healthcare provider for guidance.
Nutrition and OCD
Although research on OCD and nutrition remains limited, eating a balanced and healthy meal has been shown to increase serotonin, a key neurotransmitter in the brain that regulates mood and anxiety—all of which are essential in managing symptoms of OCD.
“Basic day to day self-care is part of the fundamental building block of doing therapy and working on OCD because it takes a lot of mental effort,” says NOCD therapist Taylor Newendorp MA, LCPC. “For example, if you’re overtired, or you’re going through some sort of significant stressful time in your life—all of that stuff tends to exacerbate the symptoms of OCD. Eating, sleep, physical activity, all that kind of stuff, we know in general, it’s just good for overall health.”
According to a 2022 study, having low levels of vitamin B12, which is found in meat, eggs, and cereals, may contribute to OCD symptoms. B12 is a necessary vitamin that affects neurotransmitters, which are chemical messengers that help to regulate mood.
“Adding B12 supplements to your diet doesn’t mean that your OCD symptoms will completely disappear,” says Dr. McGrath. “However, you can talk to your therapist about getting a simple blood test to measure your B12 levels to determine if supplements might help.”
Bottom line
Together, exercise, sleep, and nutrition can create a strong foundation for overall mental health, enhancing the effectiveness of your OCD treatment plan. Incorporating regular physical activity into your routine can help strengthen the work you’re doing in ERP therapy—even if it’s just a few minutes of exercise per day.
Key takeaways
- Physical activity, specifically aerobic exercises such as running, swimming, and cycling, helps to reduce anxiety and improve mood—all of which are essential in managing the symptoms of OCD.
- Exercise should be integrated into your treatment plan alongside evidence-based therapies, such as exposure and response prevention (ERP), which focuses on confronting your triggers and intrusive thoughts while helping you resist the urge to perform compulsions.
- Other lifestyle factors such as sleep and nutrition also play a crucial role in supporting the treatment of OCD by regulating mood and reducing anxiety.