Honestly, my OCD symptoms absolutely ruled my life, regardless of medication, right up until I started smoking cannabis daily. The dissociative effect of the THC along with the relaxing effect of the CBD made for a lot of nights smoking a bowl then staring at my ceiling fan, music on, quietly unpacking the magical thinking, the superstitions and intrusive thoughts, the way my brain invented all these "rules" for me.
Like if I stepped over a different number of sidewalk cracks with each foot, I would be preoccupied with worry I was gonna kill my mom and everybody would know I did it and hate me. I managed to pull all this guilt and sensation of responsibility onto my own shoulders with my intrusive thoughts. Years later, my therapist explained it's common for folks with severe anxiety, especially associated with PTSD (childhood trauma in particular,) to feel guilty about stuff that they can't actually control because, at least to use a personal example from when my OCD was at it's worst, it was easier and more comfortable for me to feel guilty for months about having killed David Bowie by not going to karaoke night the night before (I do a wicked Bowie voice, he's the artist whose parts I practiced the most early in my transition when my voice broke from its original soprano into a pretty flexible baritone,) then to admit to myself that sometimes people who have terminal lung cancer die and that he was probably gonna croak no matter how much I personally regarded him as a great artist. My mom had a bad back before I was born, stepping on a crack that one time in fifth grade or whatever didn't change anything. Losing sleep at night over the starving kids in Uganda, institutionalized racism, the fact that Hitler didn't make it into art school, whatever, doesn't change that these issues exist. There are things I cannot control. Wow, what a mindfuck.
My therapist explained it in a way which almost made me facepalm because I didn't think of it when I was back in college working on my degree in psychology and sociology. The scariest thing is losing control of a situation. Admitting something bad can happen and it have nothing to do with me is a pretty scary moment of radical acceptance for someone who had scary things happen to them before they were big enough to do anything about it. Turns out a lot of my OCD symptoms came from an abusive childhood, a very early sexual assault and a ton of gaslighting. If I felt guilty or devoted a lot of energy to rumination and compulsive behaviors, I could maybe prevent something bad from happening to me or someone I love again.
It's so hard for me to "let go" of anything, but that seems to be the trick for OCD. Accept that you cannot control everything in your life, and life will get even scarier for a little bit, but then it'll sort of "click" and you'll realize it means a lot of freedom as well.