Indecision in obsessive-compulsive disorder (OCD) may be linked to the frequency and intensity of intrusive thoughts and the high levels of anxiety these cause.

Living with obsessive-compulsive disorder (OCD) means more than engaging in rituals or repetitive behaviors. The main symptom of OCD is rumination or obsessive thoughts. These could lead you to have difficulting making up your mind when trying to decide.

OCD is a mental health condition with two main symptoms: obsessions and compulsions. Obsessions are unwanted intrusive thoughts that cause a great deal of distress, and compulsions are rituals you engage in to try to decrease said distress.

Due to the nature of cycling intrusive thoughts, some people with OCD may also find themselves constantly fixating on finding every possible option for each situation before making a decision.

OCD indecision is common. This difficulty can make you question if you’re picking the correct choice or lead you to worry about all the possible consequences that may be at stake.

Rumination, fear of uncertainty, and doubt may be causes of indecision in OCD.

OCD indecision isn’t well understood but may be linked to the formal symptoms of OCD and the tendency to engage in rumination.

“OCD is also known as the ‘doubting disorder,’” explains Dr. Holly Schiff, a licensed clinical psychologist from Greenwich, Connecticut. “The cause for this doubt comes from the fact that OCD makes you obsess over certain thoughts and in the case of making decisions, may cause indecision.”

A 2016 paper about indecision in people with OCD suggests that doubt, uncertainty, and lack of confidence may have neurological underpinnings.

This means that how you process information and arrive at any decision may be already hardwired into your brain. These unique thought paths in your brain can make certain decision-making processes take longer.

Doubt

Doubt may play an important role in OCD indecision.

A 2018 study found that fear of guilt was prominent among people living with OCD and was directly related to feelings of doubt about making a choice.

In 2020, researchers found that people living with OCD often doubt the validity of their past experiences. So, even if they’ve already successfully made a decision in the past, a similar decision may require thought and evaluation each time.

Lack of clarity

If you can’t clearly foresee or anticipate the results of your actions, your brain may not be as quick to make a decision.

In a small 2015 study, researchers noted that indecision in OCD was most prevalent when decision outcomes were vague or unclear to the person making the decision. Not having a clear vision of what’s to come was linked to less choice consistency, and a lower value placed on the decision itself.

Maximization

A two-study comparison from 2018 found people living with OCD have a drive to maximize when making decisions.

Maximize refers to getting the most out of the decision. This push can ultimately keep you from making a decision, as you weigh each pro and con of your choices against one another and may constantly find a “but” or “what if.”

There are many signs of OCD indecision. You might find yourself:

  • asking endless questions
  • constantly checking up on someone to make sure your decision didn’t negatively affect them
  • changing your mind once you’ve reached a decision
  • avoiding having to make choices
  • doing lots of researching and becoming less productive
  • constantly reviewing every angle, every possibility
  • feeling intense fear of causing harm or negative consequences
  • not completing tasks
  • persistently apologizing to those involved in the decision

Example of OCD indecision

You’re hungry and want to go out to a restaurant. Your partner asks you where you want to go and you can’t make up your mind because “better options” keep coming up in your head. In the end, you ask your partner to make the decision even if you don’t like any of their choices.

Even though indecision may be a part of living with OCD for some people, there are ways you can work toward limiting its impact on your life.

Radical acceptance

Schiff recommends developing a skill called “radical acceptance” to help cope with indecision in OCD.

Radical acceptance is the process of acknowledging — but not fighting — challenges in life. It means working toward eliminating avoidance behaviors and approaching situations proactively.

Schiff explains this process often starts by acknowledging what you can’t control and focusing on what you can.

“Make peace with your decisions and practice radical acceptance,” she says. “Change the narrative and write your own story. You are in control of how you feel and perceive yourself.”

Turning “what if” into “then what”

Dr. Paul DePompo, an ABPP board verified behavioral and cognitive therapist in Newport Beach, California, suggests turning vague piles of possibilities into concrete plans.

This can also include a plan for what happens if you do make a less than an optimal decision. “Come up with a detailed constructive plan for if you make a wrong decision how you could cope,” he says.

Doing your research

It’s OK to want to have all the information. It’s valid to thrive on clarity.

“As an exposure, ask yourself: ‘what else do I need to know to make this decision?’ If there is nothing left to know, then you’re able to make a decision work,” DePompo says. “Make sure your goal is to make the best choice based on the information at hand, not by fortunetelling the future.”

You can treat decisions equally by creating defined criteria for each choice.

Making a list, for example, with questions like “does this choice meet my needs?” and “how much does this choice cost?” can help you compare your options objectively.

Living with indecision is often a part of living with OCD. It may mean asking too many questions, changing your mind after making a decision, and living with doubt about the impact of your choices.

OCD indecision is not something you can turn on and off and may be linked to neurological pathways and formal symptoms of OCD.

Focusing on what you can control, creating a plan, and establishing clear outcomes may help you limit how OCD indecision impacts your life.