Written by Colter Bloxom, LPC
Colter is a licensed psychotherapist and the owner and founder of Thrive Therapy. He specializes in the treatment of anxiety, OCD, pornography addiction, identity issues, and more.
Avoiding your triggers by not leaving your house is actually a compulsion behavior, and makes OCD worse in the long run. But when symptoms are severe, you’re in fight-or-flight mode – and the fear might feel so paralyzing that you’re simply not able to challenge yourself.
But there is a way out, and you deserve a better life than the prison that OCD has constructed around you. Here, we’ll talk about what to do when you have severe OCD and are afraid to leave your home.
How can severe OCD lead to a fear of leaving the house?
A fear of leaving the house isn’t a recognized symptom of OCD, but for some people, their symptoms can get so severe that their home becomes their only “safe” space. If you live with OCD, you probably try to avoid anything that triggers your obsessions – and if your symptoms are severe, then it could feel like everything is triggering.
Avoiding triggers only makes OCD worse, which I’ll talk about later – but it’s an understandable reaction.
Any type of OCD obsession could cause you to be scared of leaving the house. Some examples include:
- Contamination: “Every surface is covered in germs. I can’t control who touches what outside of my home, so what if I get infected?”
- Harm OCD: “What if I go out I lose my mind, causing me to go on a killing spree?”
- Just-right OCD: “I can’t leave until I touch the doorway enough times until it feels ‘right’ – but no matter how many times I do it, I just can’t seem to get it right.”
- Checking: “Did I turn off the stove? I can’t remember. Let me go back and check. I know I just checked a minute ago, but I need to be 100% sure. I can’t get out the door until I’m sure.”
- Pedophile OCD: “Every time I see a child, I am consumed with fears that I am secretly a pedophile without knowing it. I need to stay in to avoid seeing any children because it makes me so uncomfortable.”
- Religious scrupulosity: “The outside world is filled with temptations of sin. I better stay at home and avoid those temptations.”
- Hit-and-run OCD: “If I drive anywhere, I could run some over and kill them. I’m not willing to take that ‘risk’.”
OCD and agoraphobia: similarities and differences
You might be familiar with another mental health condition called agoraphobia, which also leads to a fear of public places. Agoraphobia is classified as an anxiety disorder , and its key symptoms include:
- Fear of public transportation: Feeling anxious about taking buses, trains, or any form of public transit.
- Avoidance of open spaces: Staying away from places like parking lots, bridges, or large open areas.
- Fear of enclosed spaces: Getting nervous or anxious in places like shops, theaters, or small rooms.
- Avoidance of crowds: Avoiding crowded places like concerts, malls, or busy streets.
- Fear of being outside the home alone: Feeling scared when you’re out by yourself, worried something bad might happen.
- Needing to escape: Constant worry that if anxiety hits, you won’t be able to get out or get help easily.
If you have such severe OCD that you stop being able to leave your house, you might wonder if it really is OCD or if it’s agoraphobia. Only a licensed mental health provider can help you tell the difference, and our therapists can support you through grappling with this question.
But one of the key differences is that someone with OCD will experience more intrusive thoughts. Those with agoraphobia might be terrified of leaving their home, but that fear might not be linked to specific thoughts or images. For example, if you have OCD-related fear of leaving the home, you might have intrusive thoughts like “What if I leave the house and immediately get infected with HIV?” or “What if my pet dies because I’ve left the home?”
People with agoraphobia have a more general underlying fear of public places, which may not be related to specific thoughts.
On top of that, compulsions are a key component of OCD. Everyone with this condition performs compulsive, repetitive, or ritualistic behaviors to try to ease the anxiety about their fears and obsessions. Avoiding your triggers by refusing to go outside can be one type of compulsion, but you probably have others, like checking things, seeking reassurance from others, or performing mental rituals.
People with agoraphobia, on the other hand, don’t tend to experience compulsions.
Can you have both agoraphobia and OCD?
It’s also possible that you have both conditions. One study found that a significant number of people with OCD – around 20% – also live with either agoraphobia or panic disorder. If you live with both of these conditions, it’s important to tease them apart and work on addressing both. Treatments for each of these are similar in that they both require you to face your fears, but OCD needs to be addressed differently when you also live with agoraphobia.
How to leave the house when you have OCD anxiety
If anxiety and fears are keeping you from leaving your house, then you might feel like OCD is ruining your life. You’re a prisoner in your own home, but it doesn’t have to be this way forever. There are ways to manage your symptoms, break out of this prison, and live the life you long for and deserve.
Like I hinted at earlier, avoiding your fears by refusing to go outside actually keeps you stuck in an OCD loop. Avoidance of triggers is a compulsion, and compulsions give strength to your obsessional fears. They teach your brain that there is, in fact, something to be afraid of – that your obsessions are “real” enough to take seriously.
You might see advice online about how to leave your house when you have OCD anxiety, like taking pictures of everything so you don’t have to double-check it, carrying hand sanitizer with you, or leaving a camera on so you can periodically check that everything is okay. But these are compulsions, and eventually, they will make your symptoms worse. For example, you might start second-guessing that your camera is actually recording, or worry that things have changed since you took the photos.
Compulsions don’t work in the long run.
The only way to get out of an OCD loop is to stop doing compulsions – including avoiding your triggers. Obviously, it’s easier said than done to “just go out” when you’re afraid of leaving your home. With the support of a therapist, you can take it one step at a time and approach your fears in a way that feels challenging, but safe.
How to treat severe OCD
Most people need the support of professional treatment to get a handle on OCD. Luckily, treatment for OCD – even its most severe forms – has been shown to be very effective. The first-choice OCD treatment, a type of cognitive-behavioral therapy called ERP (exposure and response prevention), helps you confront your obsessions and intentionally resist the urge to perform compulsions.
For example, your therapist might help you slowly take small steps toward overcoming your fear. You might start out with just imagining yourself leaving the house and coming across triggers or writing a story about it. You’ll be guided to just sit through the fear and anxiety this brings without resorting to compulsions. Eventually, you’ll go outside and face triggers in real life.
In some cases for severe OCD, we might recommend medication. In these cases, we’ll refer you to a psychiatric provider who can help.
Mental health IOP for OCD in Arizona
Severe OCD often requires intensive treatment – once-a-week therapy might not feel like enough. Thrive Therapy’s mental health IOP (intensive outpatient program) in Phoenix, AZ is specifically designed to help people like you who live with OCD and other mental health conditions like anxiety, depression, and PTSD. We meet 9 hours a week for 12 weeks, which provides you with an intensive treatment option that still fits into your busy schedule.
Are you ready to break out of the prison that OCD has held you in? Get in touch with us today to ask how we can help.
