OCD in Veterans: A Step-by-Step Guide

A former infantry sergeant checks the front door, the back door, and every window before bed. Always in the same order. If his wife speaks to him halfway through, he starts again from the front door. Some nights it takes an hour and a half.

His VA chart says PTSD, and he does have PTSD. But nobody has asked why the order matters, or why starting over feels like the only option. Keeping watch is one thing. A ritual that has to feel “right” is another, and it may be OCD.

OCD in veterans is real, treatable, and badly under-counted. In a national review of Veterans Health Administration (VHA) records, only 0.31% of patients had an OCD diagnosis Barrera et al., Psychol Serv, 2019. When researchers sat down and interviewed 854 veterans in VA primary care, 1.9% had OCD Gros et al., Gen Hosp Psychiatry, 2013. That’s about six times more.

This guide is for veterans and service members who think OCD may be part of the picture, and for the partners and families beside them. It covers how OCD differs from PTSD, from military habits, and from moral injury, how family can help without feeding OCD, where to get care, and a 7-step plan.

Start here: the short version

• OCD is common in veterans and often missed. Interviews find it far more often than medical records do.
• OCD and PTSD are different conditions, and many veterans have both. PTSD looks back at something that happened. OCD asks “what if?” and demands a ritual.
• Training is not a disorder. Checking your gear or your locks once is a habit. Checking until it “feels right,” for an hour a day, is something else.
• The best-studied treatment for OCD is ERP therapy, and very few veterans get it. In one VHA study, 4 in 100 did. You may have to ask for it by name.
• If you’re in crisis: in the US, dial 988 then press 1 or text 838255 (Veterans Crisis Line). In the UK, call 999, or the Combat Stress helpline on 0800 138 1619. More help lines are below.

In this guide: What it looks like · How common, and why it’s missed · OCD, PTSD, or both? · Habit or OCD? · Moral injury or moral OCD? · 7 steps · For partners and family · Treatment · Where to get help · FAQ

What does OCD in veterans look like?

The diagnosis is the same in or out of uniform: unwanted thoughts, images, or urges (obsessions), and repeated actions or mental rituals done to feel safe or “sure” (compulsions) (NIMH). What changes is the content. OCD uses whatever matters most to you, and for many veterans that is safety, responsibility, and doing the right thing.

In daily life it can look like this:

• Checking locks, windows, the stove, the car, or a firearm safe, in a fixed order, again and again. Driving back home to check. See our guide to checking OCD.
• Fear of harming someone: sudden, unwanted images of hurting your partner or kids, followed by hiding knives, avoiding being alone with them, or testing yourself. These thoughts are the opposite of what you want, which is why they frighten you. Read the fear of acting on intrusive thoughts.
• Going over the past: replaying a decision from service for hours to prove, once and for all, whether you did something wrong.
• Contamination: long washing or cleaning routines, sometimes tied to a place, a smell, or something you handled on deployment.
• Order and “just right”: gear, tools, or the house must be arranged exactly, and it’s hard to move on until it feels right.
• Asking for reassurance: “Are you sure I locked it?” “Do you think I’m a bad person?” The answer helps for minutes.
• Avoidance: not driving, not cooking, not being alone with the kids, so that nothing can go wrong.

Two more things often travel with OCD in veterans:

• Alcohol and drugs. Among 38,157 veterans with an OCD diagnosis in VHA records, 36.7% also had a substance use disorder. Alcohol was the most common after tobacco Ecker et al., J Cogn Psychother, 2019.
• Feeling like a burden. In two studies of US veterans, OCD symptoms were linked with feeling like a burden and feeling cut off from other people, even after the researchers accounted for trauma and depression. Both feelings are known risk factors for suicide Patel et al., J Clin Psychol, 2024. If that’s where you are today, please reach out now.

How common is OCD in veterans, and why is it missed?

Nobody has an exact number. A systematic review of 19 studies of US veterans and active-duty personnel found a clear pattern, though: OCD shows up less in medical records than in studies that actually assess people for it, which points to OCD being overlooked in clinics. It also found lower rates in active-duty personnel than in veterans McIngvale et al., J Cogn Psychother, 2019.

Some of the figures:

• In VHA records: 0.31% of patients seen in 2010 and 2011 Barrera et al., 2019.
• In VA primary care, by interview: 1.9% of 854 veterans. Those with OCD were younger and had worse physical health, mental health, and social functioning than those without Gros et al., 2013.
• For comparison: about 1.2% of US adults have OCD in a given year Ruscio et al., Mol Psychiatry, 2010.

Why is it missed? The research points to four reasons.

• PTSD takes the spotlight. VA psychologists told researchers that a lack of training and time got in the way of assessing OCD in veterans with PTSD. Across the clinics in the study, providers held some mistaken ideas about how OCD is diagnosed and treated Ponzini et al., Psychol Serv, 2026.
• Stigma. Veterans with both conditions said they feared the stigma of OCD, and that their providers didn’t understand OCD or focus on it Ponzini et al., Psychol Serv, 2026. That study spoke with 11 veterans, so it’s a small window, but it matches what many people report.
• It looks like discipline. Order, checking, and high standards are praised in the military. A ritual can hide in plain sight for years.
• Even a diagnosis doesn’t mean treatment. In the year after a new OCD diagnosis, veterans in VHA had an average of 3.9 individual therapy visits Barrera et al., 2019. A standard course of OCD therapy is longer than that.

Is it OCD, PTSD, or both?

About 7 in 100 veterans will have PTSD at some point in their lives. Among veterans of the Iraq and Afghanistan era, the figure is 29 in 100 (VA National Center for PTSD). So when a veteran has intrusive thoughts and avoids things, PTSD is the first thing clinicians think of. Often they’re right. But OCD and PTSD overlap a lot:

• A review of the research found that people with OCD also have PTSD nearly 25% of the time, and that OCD is even more common among people being treated for PTSD Pinciotti et al., J Cogn Psychother, 2022.
• In a clinic for combat-related and terror-related PTSD, 41% of 44 patients also had OCD Nacasch et al., Eur Neuropsychopharmacol, 2011.
• In a VA PTSD program, 125 of 318 veterans reported obsessive-compulsive tendencies. Their PTSD symptoms were also more severe Aldea et al., J Cogn Psychother, 2019.

The two conditions feel similar from the inside, but they work differently.

	PTSD	OCD
Where the thoughts point	Back, to something that happened: memories, flashbacks, nightmares	Forward or sideways, to “what if?”: what if the door is open, what if I hurt someone, what if I did something unforgivable
What you do about it	Avoid reminders, stay on guard, scan for threat	Rituals with rules: a set order, a set number, repeat until it feels right or sure
Does the behavior make sense for the threat?	Usually connected to the trauma (sitting facing the door)	Often more than the situation calls for, and you usually know it
What relief feels like	Safer once the reminder is gone	Relief for minutes, then the doubt returns and asks for more
What treatment focuses on	Processing the trauma memory (for example, prolonged exposure)	Facing the fear without doing the ritual (ERP)

The definitions come from the US National Institute of Mental Health (OCD, PTSD). A real assessment is more careful than any table, and telling the two apart can be hard even for professionals Pinciotti et al., 2022.

Can trauma start OCD? Sometimes it seems to. Israeli doctors described five veterans of the 2006 Lebanon War whose OCD appeared within months of combat. At first the obsessions were about the trauma. Later they spread to other things and took on a life of their own Fostick et al., World J Biol Psychiatry, 2012. An earlier report described 13 veterans whose OCD clearly began with a trauma Sasson et al., Psychiatry Res, 2005. These are small case series, not proof of cause. But they explain something veterans say themselves: in interviews, most veterans with both conditions believed their OCD and PTSD symptoms were connected Ponzini et al., 2026.

Why it matters to name both. In four patients with both conditions, clinicians noticed a seesaw: when OCD symptoms went down, PTSD symptoms went up, and the other way around Gershuny et al., Behav Res Ther, 2003. That’s only four people. Still, it’s a good reason to make sure your treatment plan knows about both. Our article on OCD and PTSD together has more.

Military habit, or OCD?

The military teaches you to check. Weapon clear. Gear accounted for. Doors locked, perimeter secure. Those habits kept people alive, and keeping some of them at home doesn’t mean anything is wrong with you.

OCD is different in kind, not just in amount.

Training and habit	OCD
You check once, and it’s done	You check until it “feels right,” and the feeling doesn’t last
The routine has a purpose you can name	The routine has rules that don’t make practical sense (a fixed order, a certain number, starting over if interrupted)
You can skip it if you’re in a hurry	Skipping it brings strong anxiety or a sense that something terrible will happen
It takes a few minutes	It takes more than about an hour a day, or gets in the way of work, sleep, or family (APA)
Checking makes you more confident	Checking makes you less sure

That last row is backed by experiments. People who checked something again and again remembered it just as accurately, but their memory became less vivid and they trusted it less van den Hout & Kindt, Behav Res Ther, 2003. More checking, more doubt.

Moral injury, or moral OCD?

Many veterans carry things they did, saw, or couldn’t stop. Researchers call the lasting harm from events that violate your deepest values moral injury Litz et al., Clin Psychol Rev, 2009. In a national survey of 3,002 US veterans, 5.9% met the study’s criteria for moral injury Litz et al., J Psychiatr Res, 2025. The VA’s National Center for PTSD lists guilt, shame, betrayal, disgust, and anger as its hallmark reactions, and notes that it overlaps with PTSD but can exist without it (VA).

OCD can also fix on morality. This is sometimes called scrupulosity or moral OCD. The feelings are similar. The pattern isn’t.

Moral injury	Moral OCD
About a real event, and you know what happened	About doubt: did I, might I, what if I did and don’t remember?
The pain is grief, guilt, shame, or anger about it	The pain is uncertainty, and an urgent need to be sure
You may avoid talking about it	You may confess it again and again, or ask others to judge it
Going over it brings sorrow	Going over it is a ritual: review, check, get a verdict, repeat
Helped by approaches that work with meaning, grief, and repair	Helped by ERP: facing the doubt without reviewing or asking

They can also show up together, and OCD can attach itself to a real event (see real-event OCD). A 2026 paper from OCD researchers goes further and suggests that for some people, OCD itself can be understood partly as a moral injury, because the obsession feels like a moral failing Giraldo-O’Meara et al., Behav Cogn Psychother, 2026. That’s a theory paper, not a trial. The practical point: tell your clinician about the event and about the loop. They may need different kinds of help.

A 7-step plan for veterans with OCD

Each step is small. If you’re reading this for a partner or family member, go through the steps together.

Step 1: Recon the pattern

For one week, keep a short log: what the doubt was, what you did about it, how long it took. “Back door. Checked 8 times. 35 minutes.” Don’t try to change anything yet.

Why it helps: OCD hides behind good reasons (“I’m just squared away”). A written week shows you and your clinician its real size, and the pattern that defines it: the relief never lasts.

Example: a Navy veteran logs every time he walks back to the car to check it’s locked. By Friday he has 31 entries.

Step 2: Take a short screen

A screen is not a diagnosis, but a score on paper makes the next conversation easier. You can take the 4-question OCI-4 screening test or the longer Y-BOCS self-report on our site. Save or print the result.

Why it helps: VA researchers used the same family of questionnaires (the OCI-R and the Y-BOCS) to track veterans’ progress in OCD treatment Fletcher et al., Mil Psychol, 2022.

Step 3: Tell one person

Pick the person you trust most: a partner, a battle buddy, a chaplain, a peer at a Vet Center. You don’t have to describe the content of the thoughts. “I think I have OCD, and I spend about an hour a day checking” is enough.

Why it helps: veterans in interviews named fear of stigma as a main barrier to OCD care Ponzini et al., 2026. Saying it once, to one person, makes it easier to say to a clinician.

Example: “You know how I do the doors every night? It’s not about security anymore. I can’t stop. I want to get it looked at.”

Step 4: Ask for an OCD assessment, by name

Start where you already get care: your VA primary care team or mental health clinic, a Vet Center, your unit’s medical or behavioral health provider, or your GP. If you’re already in PTSD treatment, raise it there.

What to say:

“I have thoughts I can’t shake about [the house not being secure / hurting someone / something I did], and I [check, wash, go over it, ask my wife] for about [time] a day. I know it’s more than makes sense, but I can’t stop. I don’t think this is only PTSD. I’d like to be assessed for OCD, and if I have it, I’d like exposure and response prevention therapy.”

Why it helps: it names OCD, which providers may not be looking for, and it names the treatment. In VA interviews, psychologists themselves said OCD often gets less attention when PTSD is the focus Ponzini et al., 2026.

Step 5: Ask for ERP, and ask about video sessions

Exposure and response prevention (ERP) is the best-studied therapy for OCD. You face a feared situation in small steps without doing the ritual, until your brain learns the alarm passes on its own. Our complete guide to ERP explains how.

Here’s the hard truth: of 554 veterans newly diagnosed with OCD in VHA, only 22 (4%) received any ERP. Most of it was delivered in urban facilities on the East and West coasts Hertz et al., J Behav Health Serv Res, 2023. So you may need to ask more than once, and ask about telehealth.

Why it helps: in a small VA pilot, 11 rural veterans had ERP by video. The 9 who finished had significantly lower OCD symptoms, and lower PTSD symptoms too. Veterans said they felt more comfortable doing exposures at home than in a clinic Fletcher et al., 2022.

Example: the sergeant from the top of this page agrees a first step with his therapist: lock each door once, in a different order every night, and go to bed without a second round.

Step 6: Make one plan for OCD and PTSD

If you have both, tell every clinician about both. Ask: “Which do we treat first, or can we treat them together?” There isn’t one proven answer yet, and a good clinician will say so.

Why it helps: a team that treats veterans tried four ways of combining ERP with prolonged exposure for PTSD. In their case studies, the plans that taught about OCD and started cutting back rituals before the trauma work reduced both sets of symptoms Haft et al., J Trauma Stress, 2026. Those are single cases, so treat them as a starting point for a conversation, not a rule.

Step 7: Bring your people in, and plan for setbacks

OCD pulls in whoever is closest: the partner who does a second round of the doors, the buddy who answers the same 2 a.m. text. See the section for partners and family below.

OCD also flares with stress: anniversaries, a move, a new baby, leaving the service. A flare is not failure. Go back to the steps that worked, and book a top-up session if you can. Small daily practice keeps the gains. Our list of ERP exercises has ideas.

Why it helps: in a small trial, relatives of adults with OCD had just two sessions on how to step back from rituals. Their family members’ OCD improved faster than with ERP alone Thompson-Hollands et al., Behav Ther, 2015.

For partners and family: how to support without feeding OCD

It’s 11 p.m. He’s done the doors twice. He asks you to walk the house with him one more time, “just so I can sleep.” You’re tired, you love him, and it takes five minutes. So you go. A month later it’s the rule: he can’t sleep unless you’ve walked it too.

Nothing about that makes you a bad partner. But here is what OCD learns from it: “That really was dangerous, and I couldn’t have handled it alone.” The next doubt comes back stronger.

Researchers call this family accommodation. It was first measured with the Family Accommodation Scale Calvocoressi et al., Am J Psychiatry, 1995. What the studies show:

• It’s the norm. Among 141 relatives living with an adult with OCD, 47% gave reassurance every day and 35% took part in rituals every day Albert et al., Psychiatry Res, 2010.
• More accommodation goes with more severe OCD. That was the result across 14 studies Strauss et al., J Anxiety Disord, 2015, and it’s linked with poorer treatment outcomes Lebowitz et al., Expert Rev Neurother, 2016. In children, families who cut back on it during therapy saw the most improvement Merlo et al., J Consult Clin Psychol, 2009.
• Military partners do it for PTSD too. Partners change their own behavior around PTSD symptoms, for example by helping the service member avoid uncomfortable situations or by keeping their own feelings to themselves. More of it goes with more distress and less satisfaction in the relationship for both people Fredman et al., J Anxiety Disord, 2014. In 274 military couples followed for about 18 months, a rise in PTSD symptoms came before a rise in partner accommodation, not the other way around Allen et al., J Trauma Stress, 2021. In other words, partners are reacting to the symptoms. They are not causing them.

There’s no research yet on family accommodation of OCD in veteran families specifically, so the advice below is adapted from studies of adults with OCD and their relatives.

One thing is different when PTSD is in the house: some needs are real. A veteran who sits facing the door in a restaurant, or who needs warning before fireworks, is managing trauma. That’s for the PTSD treatment plan, not something for you to challenge at home. The question to ask is: Is this about a memory, or about a doubt that needs a ritual? If you can’t tell, ask their therapist, and change nothing until you have.

Test yourself: do you enable your loved one’s OCD?

About this self-test

• What it measures: how much OCD has pulled you into its routines. Experts call this family accommodation. It does not test anyone for OCD or PTSD, and it does not grade you as a partner or parent.
• Who it’s for: partners, parents, adult children, and close friends of a veteran or service member with OCD. The questions use general wording, so read “your loved one” as your partner or family member.
• How it works: 8 questions about everyday situations. Each one asks: in the past 7 days, on how many days did this happen? Choose from “Not at all this week” to “Every day this week.” It takes about 2 minutes.
• Your result: a score from 0 to 32, with one of three levels (little, some, or a lot of accommodation) and a suggested next step. A high score is common, comes from love, and is something you can change.
• Based on: the topics of the Family Accommodation Scale, a tool clinicians use. This short version is a self-check, not a clinical assessment. It doesn’t cover PTSD. Share your result with your loved one’s therapist.

What OCD asks of family, and what to try instead

OCD asks you to…	Try this instead	What you can say
Walk the house and check the doors and windows with them, again	Agree in advance: one round by them, none by you	“I know the doubt is loud tonight. We agreed I don’t do rounds. I’m right here while it passes.”
Answer “Are you sure it’s locked?” for the fifth time	Answer once. After that, name the pattern	“I answered that already. This sounds like OCD asking. I’m not going to feed it.”
Say, again, that they’re a good person and did nothing wrong back then	Listen with warmth, but don’t deliver a verdict	“I can hear how much this hurts. I’m not going to rule on it, because OCD would only ask again. I love you either way.”
Hide the knives, or never leave them alone with the kids, because of an unwanted thought	Keep family life normal, at a pace agreed with the therapist	“I trust you with the kids. The thought is OCD, not you. I’m going to the store for 20 minutes.”
Do the driving, the cooking, or the locking up so they don’t have to face the doubt	Hand tasks back one at a time	“You lock up tonight, once. I’ll be on the couch.”
Follow their rules for where things go, or wait while they redo it	Do your part the normal way and don’t wait for the ritual	“I’ve put it away my way. Dinner’s on the table in five minutes.”
Text or call several times a day to confirm everyone is safe	Agree one check-in a day	“I’ll text when I get to work, once. If OCD wants more, we let it be uncomfortable.”
Wash, change, or clean beyond normal when you come home	Normal hygiene, nothing extra	“I’ve washed my hands the usual way. I’m coming in for a hug.”

If the request is about trauma (crowds, loud noise, a nightmare), it doesn’t belong in this table. Follow the PTSD treatment plan.

Emotional support that doesn’t feed OCD

Stepping back from rituals doesn’t mean stepping back from the person. A simple rule: comfort the feeling, not the fear.

• Reassurance answers the worry: “Yes, it’s locked. I’m sure.” It works for a few minutes, and then the doubt comes back, often bigger. Our article on reassurance seeking explains why.
• Support speaks to the person: “That doubt is hammering you tonight. You’ve ridden it out before. I’m staying right here.” It doesn’t answer the worry, so OCD gets nothing to hold on to, but your loved one still feels cared for.

This idea comes from the SPACE program at Yale, which teaches supportive statements: accept how hard it feels, and show confidence that the person can cope. In a trial with 124 children with anxiety disorders, this approach, delivered only through parents, worked as well as therapy for the child Lebowitz et al., JAACAP, 2020. That research was with parents and children, not adult couples. But the two parts, acceptance plus confidence, fit any age. They matter a lot with someone who was trained never to show weakness, and who may hear “I won’t check with you” as “you’re on your own.”

Five phrases to have ready:

• “I know this feels awful, and I know you can get through it.”
• “That’s OCD talking. It’s not who you are.”
• “You don’t have to feel sure to go to bed.”
• “One round and you walked away. That took guts.”
• “I’ve got your back. I’m just not backing up the OCD.”

Other ways to help:

• Be there without fixing. Sit on the porch, go for a walk, hit the gym together. Being there isn’t a ritual. Doing what OCD asks is.
• Name the feeling. “You look wound up tonight” helps more than a debate about the lock.
• Praise effort, not outcome. Locking the door once while terrified is courage, even if it “didn’t feel right.”
• Make time that isn’t about OCD or the service. A meal, a game, the kids’ news.
• Repair after hard moments. If you snap, say so later: “I got frustrated. I’m sorry. We keep going.”

Try to avoid “just stop,” “you’re home now, get over it,” “man up,” and “it’s definitely locked.” The first three add shame to something they can’t yet control. The last is reassurance.

Ground rules for the household

1. Blame the OCD, not the person. It’s the two of you against OCD.
2. Change one thing at a time. Stopping every kind of help at once usually leads to a blow-up, then giving in, which teaches OCD that pushing harder works.
3. Agree changes in advance. No surprises. Plan the next step together, ideally with the therapist.
4. Don’t argue with the content. You can’t logic someone out of an OCD fear, and long explanations turn into reassurance.
5. Same plan for everyone. If you stop answering but a parent or buddy keeps going, OCD calls them instead.
6. Expect a spike, and hold steady. Anxiety often gets worse for a few days when you step back. That’s usually a sign it’s working.

Safety first: none of this applies in a crisis. If your loved one talks about suicide, or you’re worried about anyone’s safety, call the Veterans Crisis Line or emergency services right away (see Where to get help). Don’t change how you respond to PTSD symptoms without advice from their clinician. And look after yourself: your stress counts too. For more, read our guide to family accommodation in OCD.

What helps: treatment for OCD in veterans

CBT with ERP is the best-studied treatment for OCD. A meta-analysis of randomized trials found large effects compared with waiting-list and placebo conditions Öst et al., Clin Psychol Rev, 2015, and the UK guideline recommends it as a first-line treatment (NICE CG31).

What about veterans in particular? The honest answer: the research is thin, and it’s finally being done.

• When researchers reviewed the field in 2019, they found only two case studies of ERP in veterans. Both showed OCD symptoms going down McIngvale et al., 2019.
• The VA video pilot described above followed, with good results in 9 veterans Fletcher et al., 2022.
• The first randomized trial is under way: 160 veterans with OCD, half of them with PTSD too, get up to 16 video sessions of ERP or a stress management program Ponzini et al., Contemp Clin Trials, 2024. Results haven’t been published yet.

Does PTSD make OCD treatment work less well? The studies disagree. In a residential program, 8 patients with both conditions didn’t improve significantly with ERP, while 7 without PTSD did Gershuny et al., Am J Psychiatry, 2002. But in a larger study of 219 outpatients, people with OCD and PTSD responded at least as well as those with OCD alone Shavitt et al., Eur Arch Psychiatry Clin Neurosci, 2010.

Can both be treated at once? Early evidence says it’s possible. In 181 adults (not specifically veterans) who had ERP and prolonged exposure together by video, 64% had a clinically significant drop in OCD symptoms, 67% in PTSD symptoms, and 49% in both Farrell et al., J Clin Psychiatry, 2026. There was no comparison group, and the study came from the therapy provider itself, so read it as encouraging, not final.

Medication. Medication, usually an SSRI, is also a standard treatment for OCD. NICE says adults with moderate OCD should be offered a choice of an SSRI or more intensive CBT with ERP (NICE CG31). Many veterans already take medication for PTSD, depression, pain, or sleep, so bring a full list to the appointment. Don’t start, stop, or change any medication without talking to your prescriber.

Practice between sessions. Some people use an app to keep up small daily exercises between sessions. ocd.app, for example, has short guided practice you can do in a few minutes a day. It’s a support for treatment, not a replacement, and it is not a crisis service.

Where to get help

If you’re in crisis, or you’re worried about a veteran or service member, get help now.

• US: Veterans Crisis Line. Dial 988, then press 1. Or text 838255, or chat online. It’s free and confidential, 24 hours a day, every day. It serves veterans, service members, National Guard and Reserve members, and the people who support them. You don’t have to be enrolled in VA benefits or health care (Veterans Crisis Line). In an emergency, call 911.
• UK: call 999 or go to A&E in an emergency. The Combat Stress helpline is 0800 138 1619, free for veterans, family members, and carers, 24 hours a day (NHS). Samaritans are free on 116 123, day or night (Samaritans).

For OCD assessment and treatment:

• US, veterans: start with your VA primary care team or the mental health clinic at your VA medical center (VA mental health). Ask for an OCD assessment and for ERP, and ask whether it’s available by video.
• US, Vet Centers: free, confidential counseling for eligible veterans, service members (including Guard and Reserve), and their families, in a non-medical setting. The Vet Center Call Center is 1-877-927-8387, around the clock (Vet Centers).
• US, active duty and families: Military OneSource is available 24/7 on 800-342-9647 (Military OneSource). For diagnosis and treatment, see your unit’s medical or behavioral health provider.
• US, caregivers: the VA Caregiver Support Line is 1-855-260-3274, Monday to Friday, 8am to 8pm ET (VA Caregiver Support).
• US, outside VA: the IOCDF directory lists therapists who treat OCD. Ask whether they’ve worked with veterans and with PTSD.
• UK, veterans in England: Op COURAGE is the NHS mental health service for veterans, reservists, and service leavers. You can contact it yourself, ask your GP to refer you, or ask a charity to refer you. You need to live in England, be registered with a GP there (or willing to register), and have served at least one day in the UK armed forces (NHS). Tell them you’d like an OCD assessment.

Not sure where you stand? Try the OCI-4 screening test or read our guide to what online OCD tests can and can’t tell you. Our other audience guides cover OCD in teens, OCD in children, pregnancy and postpartum OCD, and OCD in older adults.

Frequently asked questions

Can military service cause OCD? There’s no proof that service itself causes OCD, and studies have found lower rates in active-duty personnel than in veterans McIngvale et al., 2019. But case reports describe OCD that began within months of combat trauma Fostick et al., 2012, and stress can make existing OCD worse.

Is OCD common in veterans with PTSD? Yes. In one clinic for combat-related and terror-related PTSD, 41% of patients also had OCD Nacasch et al., 2011. The numbers vary between studies, but OCD is clearly more common in people with PTSD than in the general population Pinciotti et al., 2022.

How do I know if it’s OCD or PTSD? PTSD symptoms point back to something that happened: memories, nightmares, staying on guard. OCD asks “what if?” and demands a ritual with rules, and the relief lasts minutes. Many veterans have both. Only an assessment can sort it out, so ask for OCD to be assessed by name.

Is checking the locks every night OCD or just training? One round that takes a few minutes is a habit. Checking in a fixed order, starting over if interrupted, feeling intense anxiety if you skip it, or spending around an hour a day on it points to OCD (APA).

Does the VA treat OCD? Yes, but ERP, the main therapy for OCD, has been hard to get. In one study, 4% of veterans newly diagnosed with OCD in VHA received any ERP Hertz et al., 2023. Ask for ERP by name, and ask about video sessions.

Can OCD and PTSD be treated at the same time? Early studies suggest they can. In 181 adults who received ERP and prolonged exposure together, about half improved significantly on both Farrell et al., 2026. A randomized trial in veterans is under way.

How do I stop enabling my partner’s OCD? Notice what OCD asks you to do, then cut back one thing at a time, ideally with your partner’s therapist. Agree each change in advance, comfort the feeling but don’t answer the fear, and leave PTSD-related needs to the treatment plan. Take the family accommodation self-test to see where to start.

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This article is for educational purposes and is not a substitute for professional diagnosis or treatment. If you’re in crisis, contact your local emergency services or a crisis line.