Disruptive. Disabling. Devastating. Those are just some of the ways you can describe the effect obsessive-compulsive disorder (OCD) has on your life.
If you have OCD, you’re inundated with distressing recurring and unwanted thoughts, ideas, or sensations, called obsessions. Because these obsessions can create so much discomfort and anxiety, people with OCD feel compelled to do something to neutralize it. That’s where compulsions come in, which are repetitive behaviors that are done to relieve or “fix” that distressing thought, idea, or sensation. Compulsions can be anything: excessive hand washing, repeating a phrase, arranging things, thinking specific thoughts, or asking others for reassurance are just a few.
On the surface, these behaviors may not seem so life-altering, but to the person experiencing OCD, the vicious cycle of obsessions and compulsions is time-consuming, isolating, and highly distressing.
In fact, people who have OCD have a lower overall quality-of-life and more symptoms of depression and anxiety compared to those without OCD, according to a 2018 study in Psychiatry Research. Even when the researchers controlled for anxiety and depression, those with OCD still had a worse quality of life due to their OCD symptoms.
When you have OCD, it can take a lot of energy and attention, especially because life has a way of triggering the obsessions that lead to compulsions. And that’s where we get to the topic of overstimulation: being overstimulated—a common occurrence for the OCD brain—can have a profound effect on your OCD. In this article, we’ll talk about what overstimulation is, how overstimulation plays into OCD, and coping strategies for better managing overstimulation.
Understanding Overstimulation
So, what is overstimulation? “Overstimulation is a term for when any of your sensory systems are heightened to such a capacity that someone may need to stop what they’re doing and resettle,” says April Kilduff, a licensed therapist and OCD specialist at NOCD. These feelings can arise for a variety of reasons, such as too much sensory stimuli coming in—light, noise, smells, touch—to feeling so run down that you can’t deal with another thing.
When you’re overstimulated, you feel overwhelmed—and it may even be difficult to function. And while it’s difficult, not everyone who’s overstimulated would rank the experience as a 10/10 on the distress scale. “Overstimulation is a spectrum,” says Kilduff. Maybe you’re overstimulated, and as a result, you don’t feel well or can’t wait until you get out of the situation and can go seek some quiet. Other times, you may be extremely overstimulated and “need to leave the room to sit under a weighted blanket,” she says. Either way, it increases stress and anxiety.
Overstimulation doesn’t just happen in OCD. This feeling of “too much” can occur in a variety of neurodevelopmental conditions like ADHD as well as neurodivergent groups—overstimulation is commonly associated with autism in particular.
Really, though, it can happen to everyone. At some point, there’s so much going on—the lights are too bright, your child is crying, the TV is on loud—that everyone experiences overstimulation. Eventually we all feel it at some point: “On any given day, the average person can feel overstimulated by something,” Kilduff says.
The Relationship Between OCD and Overstimulation
For someone with OCD, it’s easier to reach a state of overwhelm due to the disturbing content that intrusive thoughts that occur in obsession can bring, Kilduff notes. These intrusive thoughts—which can include violence, sexual abuse, self-harm, among many others—trigger distress, which can build up quickly. As your mind continually gets peppered with intrusive thoughts, you can tip into overstimulation because there is just so much distressing stuff swirling in your mind.
We should be clear in pointing out that overstimulation on its own may not make symptoms of OCD worse, but it worsens the experience of OCD, says Kilduff. Here’s how:
Overstimulation can make you more prone to seeking isolation. OCD can be a lonely disorder. There are many reasons for this—you may feel shame about your compulsions around family and friends so you distance yourself to hide it, or you have depression alongside OCD, which is common—but the prospect of overstimulation might play into this, too. “OCD can shrink someone’s world to the point that they’re basically housebound,” says Kilduff. “Sometimes this can be seen as a response to overstimulation, because they’re avoiding the world to avoid triggers that stimulate anxiety and panic related to one’s OCD fears,” they explain.
Overstimulation may also play into panic attacks in OCD. “When I work with members, a lot of their anxiety comes out physically and physiologically—they can become overstimulated to the point where they have a panic attack,” Kilduff says.
Because a panic attack can be so uncomfortable, you can develop fear and anxiety about having another panic attack in the future. For example, while there’s actually not a real physical threat to your body, you might feel as if your pounding heart really does mean you’re going to have a heart attack, or as if your shortness of breath means you’re dying.
In some people with OCD, the fear of having a panic attack actually becomes the dominant theme of their fears. They can develop a debilitating fear of having a panic attack, to the point that their hypervigilance triggers intrusive thoughts and compulsions. In response, they seek to do things to stop a panic attack from occurring, ruminate about if one might be happening, and continually check their body for signs that they’re having one.
Overstimulation may also go hand-in-hand with body-focused repetitive behaviors (BFRBs). BFRBs are closely related to OCD, and they may also be triggered by overstimulation. These include hair pulling, skin picking, cheek or lip biting, scab picking, or teeth grinding, and many people perform these behaviors in secret due to shame and stigma that comes from them. It’s important to know that BFRBs are not the same as OCD—they are classified as two distinct conditions.
However, BFRBs and OCD are related to one another—BFRBs are classified in the DSM-V TR among “obsessive-compulsive and related disorders”—and they can often occur together at the same time. “You can be overstimulated due to being highly triggered with OCD. You may then see an increase in hair pulling or skin picking to manage that overstimulated feeling,” Kilduff says.
Overstimulation and Compulsions
We also need to explore the link between compulsions and overstimulation. What’s interesting about compulsions is that their purpose is to quickly relieve high distress and anxiety, says Kilduff. But that’s not always their main effect. “There’s often a point where compulsions become so complicated and severe that they prompt a lot of anxiety and overstimulation before they ever bring that temporary relief,” Kilduff says. In short, your compulsions might bring feelings of overstimulation before they even provide the illusory sense of relief. It’s truly a vicious cycle that’s difficult to break out of.
Here’s an example: You’re dealing with a bout of abdominal pain. Maybe it’s nothing more than bloating, but Dr. Google also tells you that you can have a number of gastrointestinal cancers, a tapeworm, or nightmare scenarios like a bowel perforation. Obviously, this is not the answer you wanted to find, and so you continue to search—maybe reading message boards or various health articles—in hopes of confirming with certainty that your symptoms are actually totally fine. The process might take hours.
This type of reassurance-seeking “can be overstimulating for a while, even though you’re trying to find an answer that you believe will ultimately make you feel better. You feel driven to keep seeking a sense of relief, and all the while you just feel more and more overstimulated,” Kilduff explains.
Coping Strategies for Managing Overstimulation in OCD
While OCD can feel so entrenched in who you are—after all, these feel like automatic thoughts and behaviors that you have no control over—there is real help that can get you over the hump of OCD and into the life you want to live, not the life OCD wants for you.
Interestingly enough, the gold standard treatment for OCD—exposure and response prevention, or ERP—turns feelings of overstimulation to your advantage, triggering these sensations in order to teach your brain to handle them without compulsions, which only make symptoms worse in the long run. “When we do ERP, we are often purposely putting people in a state of overstimulation by bringing on distress and anxiety intentionally,” says Kilduff.
With the guidance of a qualified therapist, you will be exposed to situations that trigger your obsessions. However, instead of performing a compulsion to get rid of the distress you feel, you will make a conscious choice not to engage in compulsions. Sitting with that discomfort and anxiety in a safe space and choosing to respond in a different way will ultimately free you from the OCD cycle.
The treatment is challenging and its purpose is to take you out of your comfort zone. Without doing so, you won’t move forward. “ERP definitely leads to high levels of stimulation. But however distressing or stimulating someone finds treatment, it’s nothing compared to what OCD is overstimulating and torturing you with,” says Kilduff. “ERP is the lesser of the two experiences and it’s the thing that will get you out of the OCD cycle. We call it productive discomfort,” they say.
What’s more, you’re tackling this with someone by your side: a trained therapist who specializes in ERP for OCD. “As a therapist, I like to ask clients, ‘what are you willing to do today to challenge your OCD?’” That shared decision making between you and your therapist can help you go into treatment knowing that you’re in a safe space so you can move through what scares you—and into your new life.
Conclusion
Overstimulation is an extreme feeling of overwhelm caused when your brain receives more inputs than you can process—and the relentless obsessions and compulsions of OCD provide these inputs in spades. While overstimulation may not cause symptoms of OCD or make them worse, it can make the experience of having OCD all the more stressful, playing a role in isolation, panic attacks, and/or body focused repetitive behaviors.
Coping with overstimulation in OCD means tackling OCD head-on with exposure and response prevention therapy, or ERP. ERP is the most effective and evidence-based treatment for OCD and involves intentionally exposing yourself to situations that trigger your obsessions so you can make the difficult but freeing choice to resist performing a compulsion in response.
ERP is the most effective way forward to get through your OCD. The clinicians at NOCD are specifically trained to deliver ERP through face-to-face video sessions that follow a personalized treatment plan. And if you’re feeling overstimulated in between treatment sessions, you can connect with your therapist, support groups, or member advocates at OCD for much-needed support. Book a free 15-minute call with the NOCD Care team if you’d like to learn more about reclaiming your life from OCD.