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People with Obsessive Compulsive Disorder (OCD) in the workplace face an unusual kind of stigma. Unlike other mental health conditions, where friends and managers might walk on eggshells to accommodate the impact that poor mental health is having on someone’s life and work, the tendency is to underestimate how hard OCD is to live with. Though hand washing and light switches have become a shorthand for OCD ‘quirks’ in soap operas, OCD is a scary, and sometimes debilitating, mental health condition.
😓 It takes people with OCD a painful 12 years on average to get treatment.
The first step towards managing, supporting or working with someone with OCD is to understand a bit more about their personal experience.
What is OCD?
OCD is a mental disorder which affects about 1-2% of the UK population. Originally considered an anxiety disorder in the DSM (a big book used to classify psychiatric conditions), it has been grouped under a slightly different category (Obsessive-Compulsive and Related Conditions) since 2013.
How does OCD affect someone's life?
Someone who experiences OCD is caught in an urgent loop between thinking a particular thought and feeling compelled to act on it out of fear. The severity of symptoms varies, but OCD is a distressing cycle of obsessions (intrusive thoughts) and compulsions (behaviours used to ease the anxiety caused by obsessions). This cycle of trigger and response can make simple tasks feel impossible.
OCD’s intrusive thoughts are usually hypothetical, and strongly connected to feelings of fear, doubt or danger. Someone with OCD may become preoccupied with the worst possible ‘what if’ scenarios, feeling like they’re responsible for fixing them or preventing them from happening.
Though most people with OCD know logically that their concerns are irrational, the smallest glimmer of doubt causes anxiety, which overrides a logical reaction and causes compulsive behaviours. For this reason, Obsessive Compulsive Disorder is often described as “a fight with your own brain” by people who experience it.
These are the rituals that someone undertakes to relieve the anxiety caused by their intrusive thoughts and obsessions. They stem from the belief that a particular behaviour can stop that big ‘what if’ fear from happening. A compulsion is an uncontrollable urge which can result in repeating actions (sometimes a set number of times) until the anxiety temporarily resolves or it ‘feels right’, potentially hours later.
Compulsions are often the most visible aspect of OCD – behaviours like checking the door’s locked, washing hands, cleaning or arranging things on repeat are common. But mental rituals, like repeating thoughts or phrases over and over, ‘neutralising’ a bad thought with a good one, checking bodily sensations or avoiding situations that provoke obsessions altogether are also a kind of compulsion, albeit a less visible one.
These compulsions end up giving more power to the obsessive thought, because the relief someone feels when they complete a ritual reinforces the whole anxiety cycle for next time.
Can you have OCD without compulsions?
The cycle between obsessions and compulsions is a key characteristic of OCD. People sometimes use the phrase “Pure O” to describe someone with OCD who experiences obsessive thoughts without compulsions. This is a common misconception; if you have Pure O you’ll still experience mental compulsions, you just may not be aware of them, because rituals like checking whether you still have a thought are less obvious. This can stop some people with OCD from recognising their own symptoms and seeking treatment.
What is high-functioning OCD?
‘High functioning’ and ‘low functioning’ have become shorthand for describing the severity of someone’s OCD – usually from an outside perspective. This terminology isn’t recognised in the DSM. A person with high functioning OCD still experiences distressing obsessive thoughts, but their compulsions might be less noticeably disruptive to their everyday life.
Plenty of people with OCD are highly intelligent, focused and productive at work. But the condition can still lead to misunderstandings between coworkers. A colleague with OCD might need to check and recheck their camera settings before joining an online meeting, for example, and this can lead to people thinking they’re late, or underprepared. Usually, the opposite is true.
Download our OCD support guide for managers
What does OCD in the workplace look like?
Recognising the symptoms of OCD at work
Lots of obsessions and compulsions are invisible, so as a manager or coworker, you might rely on your colleague telling you that they experience OCD before you can make any adjustments to help them feel comfortable.
With other anxiety disorders, you can look out for changes in everyday behaviour to spot when someone’s struggling, but given the length of time it takes people with OCD to seek treatment, it’s possible, if not likely, that they’ve experienced OCD the whole time you’ve worked together. It might only become obvious if their symptoms get worse.
🗓 People with OCD lose 46 working days per year to the condition, on average
Signs of OCD in the workplace might include:
- Arriving to work consistently late or distressed
- Being more irritable than usual
- Seeming distracted or having trouble focussing on their work
- Performing repetitive actions or rituals
- Missing deadlines for no reason
- Getting frustrated or disruptive if meetings don’t stick to an outlined agenda
- Avoiding specific objects, spaces or situations, like conference rooms or toilets (this is common if somebody’s obsessive about contamination or germs)
- Asking how others perceive them repeatedly, seeking more reassurance than normal or mentioning the same specific worry or concern multiple times
Naturally, in isolation these signs don’t mean that someone has OCD. But it’s still worth asking them if everything’s okay, and giving them an opportunity to open up to you about their mental health, if they like.
Remember, as a manager or colleague, it’s not up to you to diagnose anybody with OCD, or any other mental health disorder. But you might be able to point them towards professional help, if your workplace offers mental health support or therapy, like Spill.
Support employees who are struggling with any aspect of their mental health by giving them access to Spill.
Supporting a colleague with OCD
If somebody you work with tells you that they have OCD, the best thing you can do is listen to how it affects them. Your professional relationship with them also makes a difference to how you might react.
👉 Working with someone with OCD: tips for coworkers
- If your colleague has rituals at work, be patient. Remember that the fear driving this behaviour is very real to that person, no matter how irrational it might sound, or how safe you personally feel in your surroundings.
- If they share their intrusive thoughts with you, don’t show shock or judgement. Obsessive thoughts usually revolve around taboo or extreme subjects. Bear in mind they don’t reflect someone’s morals or true beliefs (they’re more likely to reflect somebody’s worst fears).
- Try not to help them carry out their compulsions to speed things along or placate them; it can reinforce the intrusive thought and be more damaging in the long term.
- Encourage them to disclose their OCD to a direct manager, if they’re comfortable doing so. The only situation that means your colleague is legally obliged to disclose their OCD to a manager is if their symptoms are likely to put themselves or others at risk.
👉 Managing someone with OCD: tips for team leaders
- Be as open as you can when someone discloses they have OCD. Listen to them and ask open questions about how it affects their workday. Try not to ask about how OCD affects their personal life unless they volunteer that information to you. Keeping some professional boundaries as ‘boss’ at this stage can save you both some emotional stress later.
- Remind your colleague about any mental health support that’s available in your company. Remember that getting treatment is a very personal choice, and you shouldn’t expect anyone to seek out therapy or medication if they’re not ready for it.
OCD discrimination in the workplace
People with OCD sometimes experience discrimination in the workplace due to a lack of understanding around the condition itself, and assumptions around how certain behaviours or rituals (like handwashing) could impact their work.
Long-term OCD (which lasts, or is likely to last longer than 12 months) is classed as a disability in the Equality Act 2010. That’s a legal framework designed to prevent discrimination at work. It means your workplace must make ‘reasonable adjustments’ so that a colleague with OCD isn’t at a disadvantage compared to everyone else.
Making reasonable adjustments for people with OCD at work
You’ll need to talk to your colleague about any changes they’d like to make to their working day or environment. OCD workplace adjustments might include:
- Flexible hours. Compulsive behaviours can make leaving the house on time very difficult.
- Giving some duties to another person. This might be necessary if somebody’s OCD affects their safety or productivity at a specific task. Make sure to ask which duties they are finding challenging, and how much they’d like to be communicated with any team members who you might be subbing-in.
- Home working. Depending on the theme of your colleague’s obsessive thoughts, getting on public transport might feel impossible at times.
- Giving more notice of project deadlines. Someone with OCD might lose more time to completing rituals some days than others.
- Building downtime into work schedules and rotas. To allow for therapy or medical appointments, if needed.
- A dedicated desk space. Giving someone control over their own workspace can be helpful if you share an office.
👉 Working with someone with OCD: tips for HR or People leaders
There are some things you can do at a business level to support people with OCD at work. Remember that your colleague might prefer to stay anonymous, so any company-wide initiatives should be launched sensitively.
- Consider any performance-related pay arrangements and see whether they are still fair and achievable for everyone.
- Symptoms of OCD at work might be exacerbated by social situations. Don’t make any team socials (in-person or otherwise) compulsory.
- Challenge any mental health stigma that exists in your business.
- Investigate mental health training for your managers.
- Make sure your Mental Health Policy a) exists b) is up to date, and c) is kept somewhere accessible.
- Remind employees that saying they’re “a bit OCD” about their spreadsheets isn’t that helpful or supportive.
- Prepare a return-to-work plan to make sure everything's in place to welcome employees back after a period of rest or recovery for poor mental health.
Treatment for OCD
The two main treatments for OCD are psychological therapy and medication. CBT (cognitive behavioural therapy), which teaches people to identify and alter their negative thought patterns, or Exposure and Response Prevention (ERP) therapy, which encourages someone to let the obsessive thoughts happen without ‘correcting’ them with compulsions can both have a positive impact quite quickly.
NHS England estimates that just 10 hours of therapist treatment is enough to resolve mild OCD. While some aspects of work might be challenging even for those with high functioning OCD, people living with the disorder often find that the structure of working full or part time actually helps their recovery. With a bit of understanding from coworkers and managers, they could still be your team’s star player.
Download our OCD support guide for managers
Spill works with fully qualified BACP- or NCS-registered counsellors with 80+ areas of expertise, including specialists in supporting OCD.