Social OCD refers to experiencing obsessions and compulsions around the fear of being rejected, judged, or humiliated by others. It may also refer to overlapping symptoms of OCD and social anxiety.
Obsessive-compulsive disorder (OCD) is a mental health condition characterized by two primary symptoms: persistent intrusive thoughts (obsessions) and repetitive behaviors or rituals (compulsions).
Social OCD isn’t an established clinical term or a formal diagnosis. It may refer to overlapping symptoms of OCD and social anxiety.
Social anxiety is one of many anxiety disorders characterized by fear or panic of social interactions and of being criticized and rejected socially.
For people with social OCD, obsessions may be about social interactions or social performance. When this is the case, you may experience uncontrollable thoughts and intrusive images about people making fun of you, rejecting you even without knowing you, or humiliating you.
When this fear of social humiliation and rejection is a persistent symptom and impacts your daily routine, a mental health professional may diagnose both OCD and social anxiety.
It’s possible for symptoms of OCD and social anxiety to occur together, though. This would mean that you live with two separate conditions. In fact,
But it’s also possible for someone with OCD to experience obsessions about social rejection for a period of time without receiving a social anxiety diagnosis.
To receive both diagnoses, you would need to meet the diagnostic criteria for both conditions. Diagnostic criteria are established by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR), a reference handbook used by most U.S. mental health professionals.
Diagnostic criteria for OCD
According to the DSM-5-TR, two main criteria must be met for you to receive an OCD diagnosis:
- You experience repetitive and persistent obsessions and compulsions.
- These obsessions and compulsions take considerable time from your daily routine (more than 1 hour per day) or they cause you significant distress that translates into impairment or inability to function.
Diagnostic criteria for social anxiety
According to the DSM-5-TR, the criteria to receive a social anxiety diagnosis are:
- Significant fear about social events where you may be exposed to other people’s judgment and criticism.
- Persistent fear that others may recognize social anxiety symptoms in you that may lead you to be humiliated or embarrassed in public. It may also be fear that you won’t know how to act and offend others.
- Consistent fear about the same social situations.
- Tendency to avoid social situations or experience impairing levels of fear when exposed to those.
- Your fear of these social interactions isn’t proportionate to the threat you face.
- These symptoms last for at least 6 months but typically more than that.
- Your fear of social situations impairs the way you function at work, school, and in relationships.
- These symptoms cannot be explained by an injury, disease, or substance use.
- These symptoms cannot be explained by any other anxiety disorder or mental health condition.
- If you live with any injury, disease, or condition, your fear is unrelated to those or impairing.
A person with both OCD and social anxiety may be more likely to experience obsessions with social themes. This may lead to symptoms commonly seen in people with “responsibility OCD,” also known as “social scrupulosity OCD.”
Responsibility OCD involves feeling an extreme fear of harming someone else’s feelings. For instance, you might worry excessively that you’ll say something in front of your friends that may remind them of a traumatic experience they lived. You experience intrusive images and thoughts about saying what you fear. This may lead you to repeatedly shrug your shoulders when you’re in front of your friends.
Social scrupulosity is a theme in OCD and doesn’t mean you also live with social anxiety, unless you meet all the criteria for this condition.
OCD is not a social disorder nor is it a social disability.
Even though OCD symptoms can be debilitating and highly distressing, many people with the disorder can navigate different aspects of life, including employment, romantic relationships, and social interactions.
OCD doesn’t cause social anxiety disorder, and social anxiety doesn’t cause OCD. However, it’s possible that one may be a contributing factor to the other in some instances. In fact, they often co-occur.
In one study, social anxiety disorder was seen in about
Both OCD and social anxiety disorder can be managed with the support of a mental health professional.
Cognitive behavioral therapy (CBT) is one of the most effective treatments for both conditions.
CBT for the management of social anxiety disorder may include techniques like exposure therapy, which involves gradually exposing you to your social fears until your anxiety is reduced or gone.
CBT for the management of OCD typically involves exposure and response prevention (ERP) therapy. ERP also gradually exposes you to your fears while helping you not to engage in a compulsion to relieve the anxiety they cause you. In time, you learn that you don’t need to engage in compulsions to decrease anxiety.
Social anxiety disorder and OCD are two separate mental health diagnoses. In some instances, someone can live with both conditions.
It’s also possible for someone with OCD to have obsessions around a fear of social interactions without meeting the criteria for social anxiety.
Only a mental health professional can provide an accurate diagnosis and a management plan for both conditions.