What Does Relationship OCD (ROCD) Look Like?

Fleeting moments of doubt about your relationship or wavering levels of attraction to your partner are ordinary experiences. However, if you feel consumed by relationship-focused uncertainty and anxiety—and these feelings are frequent and pervasive—you may have relationship obsessive-compulsive disorder (ROCD).

ROCD can be overwhelming for both partners in the relationship as it shares many symptoms with obsessive-compulsive disorder (OCD). However, unlike OCD, ROCD isn't a diagnosis that you can find in the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-5-TR). Here's what you need to know, including what to look for and treatment options for ROCD.

What Is Relationship OCD?

Relationship OCD is a common type of OCD, Kristin Bianchi, PhD, a licensed clinical psychologist who specializes in treating anxiety disorders and OCD, told Health. People with this disorder, said Bianchi, have unwanted, intrusive, and upsetting doubts about their romantic partners.

Additionally, there are two common types of ROCD: relationship-centered and partner-focused. Relationship-centered symptoms relate to how suitable the relationship is for the person, while partner-focused ROCD manifests in doubts about a partner's characteristics.

Relationship OCD Symptoms

The symptoms of ROCD are similar to those of OCD. The main difference is that ROCD symptoms are only based on a person's relationship. They can consist of obsessions and compulsions.

Obsessions

People with ROCD may have obsessions in the form of images, thoughts, and urges related to their relationships. For example, they wonder if their partner is right for them or have the desire to leave a partner. Also, they may have feelings of love for a partner but question different qualities of the partner such as:

• How they look
• How smart they are
• How well they can connect with others
• What their morals are

Compulsions

You may also respond to doubts with compulsive behavior—like you would if you were diagnosed with obsessive-compulsive disorder. "In an attempt to feel relief from the anxiety associated with these intrusive thoughts, people with ROCD often engage in rituals or repetitive behaviors known as compulsions," Misti Nicholson, PsyD, director and clinical psychologist at Austin Anxiety and OCD Specialists, told Health.

Here are some common compulsions in relationship OCD:

• Seeking reassurance: Compulsively consulting with others about your relationship is a common indicator of ROCD, said Nicholson. Sometimes this takes the form of seeking reassurance from a partner, added Bianchi.
• Scanning for evidence: Like emotional detectives, people with ROCD seek evidence—for a partner's being a good match, for attraction levels, to quantify a partner's love—to affirm the relationship, said Bianchi.
• Making comparisons: Another indicator of ROCD is compulsively comparing your relationship with other people's relationships—from friends and families to fictional characters on TV, said Nicholson. The comparisons can also be between your current and previous relationships, added Bianchi.
• Mental rituals: People with ROCD can spend hours monitoring their thoughts and feelings around the relationship, said Nicholson.
  

How to Spot Relationship OCD

Relationship-based obsessions and compulsions can be linked to any anxious feelings, so one way to spot ROCD is to look for evidence of distress. The symptoms of ROCD have been associated with different types of personal and relationship distress such as:

• General OCD symptoms
  
• A lack of security regarding attachment
• Low self-esteem or relationship satisfaction
• Negative affect
  
• Sexual functioning issues
  

The distress can result in unhealthy or unsatisfying relationships—though people may fail to realize there's a disorder involved. "People will dismiss their symptoms and label themselves as 'too picky' or a 'worrywart,' or 'bad at relationships,'" said Bianchi.

Nicholson said that time could be another factor in spotting ROCD. For example, a person could track if obsessive thoughts or compulsions consume more than an hour daily. Ultimately, the thoughts and compulsions also have to cause you significant distress or impair your relationships, your work, or other areas of your life, added Nicholson.

Examples of ROCD

A person with ROCD may have the following thoughts or voice them:

• "I'm not sure if I care that much about my partner."
• "I love my partner, but how do I know they love me back?"
• "Is this relationship right for me?"
• "My partner doesn't share all the same morals as me, so they can't be the person I should be with."
  
• "What does my partner think about me?"

Potential Triggers

There's not a lot of research about the causes or triggers of ROCD. However, some researchers suggested that abandonment fears and relying on self-worth related to the relationship or partner may impact a person's development of ROCD.

Treatments Options

Mental health professionals may use cognitive behavioral therapy (CBT) as a treatment option. One research article suggested that CBT may be helpful for a person to:

• Explore contingencies of the link between self-worth and relationship aspects, and worries and anxieties about attachment
• Help challenge negative relationship-related beliefs
  

One small randomized controlled trial with college students showed that an app may be helpful in ROCD treatment. Researchers had students with subclinical ROCD—they had the obsessions and/or compulsions of ROCD without functional impairment—use an app with cognitive interventions.

The results showed improvement in ROCD symptoms and increased self-esteem after 15 days of using the app. However, due to the small sample size of 50, researchers said more research needs to be done with larger clinical populations.

With severe symptoms, said Nicholson, the most helpful treatment is typically a combination of medication and therapy. Selective serotonin reuptake inhibitors (SSRIs) are commonly used medications to treat OCD.

Another possible adjunct FDA-approved treatment for OCD is transcranial magnetic stimulation (TMS). Originally approved for the treatment of major depression and later for certain types of migraine pain, TMS uses magnetic fields to stimulate nerve cells in the brain.

How to Cope as a Partner

A relationship with someone who has ROCD can be hard on your emotions. However, there are different ways to cope as a partner. The following coping strategies can be helpful—whether your partner has ROCD or not:

• Be an open communicator about your and your partner's feelings.
• Focus on ways to show love.
• Recognize what may be stressing your partner out.
• Seek help from a mental health professional, like a psychologist or marriage and family therapist, before any relationship-related situations get worse.
  

When to See a Healthcare Provider

Talk with a healthcare provider if you feel like you have any of the symptoms of ROCD or OCD symptoms in general. This is essential when the symptoms interfere with your personal or work life. The provider can refer you to the appropriate specialists for further treatment.

A Quick Review

Relationship OCD, or ROCD, is the experience of having relationship-related uncertainty and anxiety. Signs that someone has ROCD can include seeking reassurance that the relationship or partner is right for them or making comparisons between their relationship and that of others. The symptoms also may be partner-focused, relationship-focused, or both.

However, treatments for OCD (e.g., cognitive-behavioral therapy or medications) can be used for those with ROCD. Engaging in treatment may be helpful for improving how individuals with ROCD feel about their relationships.