What is Psychosis/Mental Health OCD?

 – by Madison Di Silvio



Psychosis/Mental Health OCD is a subtype of Obsessive Compulsive Disorder, that consists of intrusive thoughts and ritualistic behavior in attempt to reduce the level of distress these thoughts cause. Psychosis/Mental health OCD is when the sufferer fears they are developing psychosis or another mental health condition that they deem as “worse”. Both could be recognized as different themes as Psychosis OCD could be the fear of just experiencing Psychosis while mental health OCD could be the fear of developing Schizophrenia, Bipolar, a personality disorder, or any other mental health condition the sufferer sees as “worse” however for this blog post we will discuss them together. 

Symptoms of Psychosis/Mental Health OCD 

Symptoms of Psychosis/Mental Health OCD can range from intrusive thoughts to physical sensations that can cause extreme distress. This is due to the brain being highly creative leading the sufferer to feel they have already developed or are in the beginning stages of developing the illness they fear most. For example:

  • Thoughts such as:
    • What If I am in the beginning stages of schizophrenia?”
    • “What if I’m manic?”
    • “What if I’m delusional?”
    • “Am I experiencing a flat affect?”
    • “What if I have Antisocial Personality Disorder?”
  • Physical experience based on the 5 senses:
    • hypervigilance or derealization
    • questioning whether you are seeing/hearing things that are not really there
    • doubting your own sense of reality


Compulsions in Psychosis/Mental Health OCD 

As we know compulsions are used to create short-term relief but cause long-term problems. Due to the constant 5 senses component of psychosis/mental health, OCD intrusive thoughts/sensations are often automatically linked to compulsions. While the sufferer may feel these compulsions are keeping them aware of a possible “developing” mental health condition it’s actually keeping them stuck.

A few examples of compulsions in Psychosis/Mental health OCD are: 

  • Researching the signs and symptoms of the feared mental health conditions 
  • Asking for reassurance from loved ones and mental health professionals.
  • Rewinding/reviewing something to see if you experience the sound, smell, or image again. 
  • Mentally checking if they feel the same way they used to about activities and loved ones. 
  • Checking for personality or cognitive changes.
  • Trying to rehear the same thing in your head/trying to stop your internal monologue to prove it’s not a voice.


How is this different than having Psychosis? 

Those who suffer from this subtype are not actually experiencing psychosis. The fear they experience from this subtype teaches their brain that they need to always “be on guard” for any changes in the 5 senses or cognitive changes. In doing so sounds, sights, touch, taste, and smells are heightened making the sufferer believe they are developing their feared mental illness. When in reality the brain is on hyperdrive causing them to hear, see, smell, and feel things that are there but they otherwise wouldn’t notice if they weren’t suffering with this subtype. 

The brain is wired to detect things we fear and if the sufferer has labeled the senses as something to fear the brain will pay more attention to it than someone who isn’t suffering with this subtype. 

However, a person can have both OCD and experience psychosis or another mental health condition so it’s important to learn to distinguish between actual symptoms of psychosis and this subtype in order to best help the sufferer. 


If you suspect you or someone you love is suffering from this subtype of OCD know there is effective treatment. 

  • Exposure and Response Prevention (ERP): ERP is the gold standard treatment for OCD. It involves exposing yourself to your fears and not responding with compulsions. This idea ultimately teaches your brain that your fears are not as valid as originally thought. When we start to respond differently our brain learns to fear the stimuli less without doing anything to solve it.
  • Acceptance and Commitment Therapy (ACT): ACT is another form of treatment for OCD in which the sufferer learns to lean more into their values and uncover how those values don’t align with their feared subtype. ACT encourages the sufferer to engage in values-based behavior to get more in touch with who they are instead of who OCD says they are. 
  • Inference-based Cognitive Behavioral Therapy (ICBT): ICBT is a newer approach to the US and is more of a cognitive approach to help the suffering slow down and understand the inferences they made to get them to do the compulsion. When the sufferer learns the reasoning behind why they continue to engage in compulsions it becomes easier to recognize their faulty reasoning ultimately limiting their need to do compulsive behavior. 
  • Medication: SSRIs and other mental health medications prescribed by your psychiatrist or primary physician have been known to reduce the symptomology of both the physical and mental components of OCD. Research has shown when used in conjunction with therapy medication has had great effects. 


Seeking Mental Health Support

No matter how much OCD tries to convince you that you are alone in your thoughts this subtype like many others is more common than you’d think. It is important to seek therapy from a therapist who specializes in OCD. Consider scheduling an appointment with Chicago Counseling Center. Our therapists can provide guidance, support, and strategies tailored to your specific needs. Meet our team to learn more!

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