OCD: A Hidden Occupational Risk for First Responders, Healthcare Workers, and Other Professionals
For many professionals, care and vigilance are part of what it means to do a good job. But high-pressure environments can also create conditions for mental health issues to arise.
As mental health awareness grows across professional industries, more first responders and other high-pressure professionals - such as paramedics, nurses, firefighters, and law enforcement officers - are opening up to the idea of therapy. In parts of Canada, the recognition that posttraumatic stress disorder (PTSD) can be presumed for first responders has improved access to needed mental health services (source). This shift reflects a broader understanding that PTSD is a common occupational risk in these professions.
However, PTSD is not the only mental health challenge faced by professionals, healthcare workers, and first responders in high-pressure environments. Failing to acknowledge other conditions may leave them unrecognized and untreated. One such condition is Obsessive-Compulsive Disorder (OCD), which affects approximately 1-3% of people worldwide. OCD is a debilitating mental health disorder that often goes undiagnosed for years, partly because it is under-recognized in the healthcare system (iocdf.org) and sometimes dismissed by individuals themselves as “just anxiety” or “part of the job.”
What Is OCD?
OCD involves two core features:
Obsessions: Intrusive, unwanted, and distressing thoughts or images that are repetitive and difficult to control. Obsessions are often described as “ego dystonic”, meaning they are usually incompatible with who we are as people (e.g. “I know this thought sounds excessive/illogical, but I just can’t help but worry….”)
Compulsions: Behaviours—either mental or physical—performed to neutralize the anxiety triggered by obsessions. Compulsions are time-consuming, stressful, and interfere with daily functioning.
Interestingly, certain personality traits associated with OCD - such as perfectionism - overlap with traits that drive individuals toward high-pressure careers. This overlap can make OCD harder to recognize because the behaviours may initially feel productive or aligned with professional norms.
Why OCD Can Go Unnoticed in High-Pressure Professions
Several aspects of professional environments can mask OCD symptoms:
High performance expectations: Pressure to appear competent and reliable can normalize OCD-related checking and reassurance-seeking.
Rigid protocols: Standard operating procedures may make repeated behaviors appear like diligence rather than compulsions.
Implicit moral codes: Professionals often hold themselves to high ethical standards, which can exacerbate obsessional doubt.
Co-occurring mental health issues: Anxiety, depression, and PTSD share some symptoms with OCD, complicating diagnosis and treatment.
Common OCD Experiences Among Professionals
Living with OCD often means adjusting to symptoms over time, making them feel “normal.” For professionals, symptoms may even feel reinforcing because they can temporarily prevent mistakes, or help one feel reassured. Some commonly reported experiences include:
Feeling pressure to be approved by colleagues or the public, followed by reassurance-seeking, double-checking work, or replaying past interactions.
Over-compliance with hygiene procedures at work (e.g., excessive handwashing or sanitization).
Persistent doubt about having made the “right” clinical or professional decision.
Repeatedly checking charts, documents, or other work-related materials.
Intrusive thoughts about causing - or being responsible for - harm to colleagues, clients, or patients.
Bizarre, violent, or shameful thoughts that create fear about one’s ability to perform professional duties.
Generally, if the thoughts themselves are alarming and incongruent with our values, or if the things we do to eliminate distress are only temporarily effective (i.e. they only work in the short term and tend to make things worse in the long term), this might be suggestive of OCD.
Even if all the evidence suggests we’re reasonably capable, OCD can make us doubt ourselves.
Getting Help: Exposure and Response Prevention (ERP)
OCD is highly treatable through a structured therapy called Exposure and Response Prevention (ERP). ERP involves gradually confronting feared situations or thoughts while resisting the compulsive responses that usually follow. Over time, this reduces OCD’s grip on daily life and improves confidence in handling professional pressures.
If you recognize these symptoms in yourself or a colleague, it’s important to seek support. A Registered Psychologist trained in ERP can help you navigate high-pressure environments with greater ease, and separate OCD-driven behaviors from professional competence.
Contact us today to see how we can help.
About the Author: Samantha Greenwood, M.C. is a registered psychologist practicing in Edmonton, Alberta. She specializes in supporting high-pressure professionals experiencing Obsessive Compulsive Disorder (OCD).
Disclaimer: The content on this blog is provided for informational and educational purposes only and is not intended as a substitute for professional psychological advice, diagnosis, or treatment. Reading this blog does not create a therapist–client relationship. If you are experiencing mental health concerns or distress, please seek support from a qualified mental health professional.
