Obsessive-Compulsive Disorder (OCD)

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Obsessive-compulsive disorder (OCD) is a condition that many have heard of but few understand.

According to data from the National Institute of Mental Health, OCD isn’t uncommon: 2.3% of U.S. adults will develop it at some point. Children can also develop OCD.

The media often represents those with OCD as overly organized people who can’t stop washing their hands. While this might be partly accurate for some people with OCD, it’s far from the complete picture.

People with OCD tend to have distressing thoughts that won’t go away. They might act on their compulsions for temporary relief, even when they don’t really want to.

OCD can feel like a roadblock, and asking for help can be difficult. But therapy, medication, and self-care techniques can help you manage OCD and relieve unwanted symptoms.

Having questions about OCD is natural, but only a health professional can provide an accurate diagnosis.

There are two main parts of OCD:

• Obsessions: unwanted, intrusive, and persistent thoughts
• Compulsions: urges to do certain rituals or actions

Both obsessions and compulsions can cause distress and make day-to-day living harder.

There’s a difference between the occasional intrusive thought or good-luck ritual and OCD. Obsessions aren’t the same as having any unwanted thoughts. With OCD, these thoughts are distressing and persistent.

The rituals of people with OCD could look like being careful or superstitious. Many of us double-check locks before going out to feel safe or knock on wood for good luck. But if you live with OCD, you might feel as if you have to carry out a compulsion, even when you don’t want to.

Here’s our FAQ page on OCD.

Symptoms of OCD fall into the categories of obsessions and compulsions. They can show up in a variety of ways from person to person.

These symptoms can get in the way of daily life, especially because they can take up time.

For example, someone with a ritual of knocking on their door three times before leaving might do it even when it’s impractical — like if they’re late for work or in an emergency.

Obsessions

Obsessions are often compared to intrusive thoughts, but they’re also different from day-to-day anxieties.

If you have OCD, you might often try to suppress these thoughts or relieve the anxiety they cause with a different thought or a compulsion.

These obsessions, or thoughts, could include:

• images of hurting others
• thoughts you consider immoral, bad, or shameful
• urges to do something you don’t want to do

It’s common to have one specific thought (or type of thought) that comes to you over and over again. But the thought can also change over time.

Compulsions

Compulsions are repetitive behaviors you might feel a strong need to do to soothe anxiety related to an obsession.

Some examples of compulsions include:

• repeating words or phrases mentally
• hand-washing
• repeating an action
• checking locks, windows, or other objects

These compulsions might not seem directly connected to the obsession. For example, somebody might have intrusive thoughts about hurting someone, feel upset by these thoughts, and then feel a compulsion to shake their hands to relieve that distress.

Here’s a deeper dive into the symptoms of OCD if you’d like to learn more.

Living with OCD is a different experience for each person. Because these thoughts and compulsions can feel overwhelming, they can have a huge impact on your day-to-day life.

Obsessions and compulsions might affect your:

• relationships
• self-confidence
• social life
• school
• work
• ordinary tasks
• mood
• daily routine

For example, someone with an obsession-related thought during an exam might feel the need to act on a compulsion right there. If the compulsion is walking a certain number of steps or speaking out loud, they might walk out of the exam or feel anxious for the rest of it.

Some people with OCD isolate themselves because they’re afraid others will notice their compulsions. For example, someone might avoid going to social events because they’re afraid of acting on a compulsion.

The thoughts that come with OCD might also feel too shameful or scary to talk about. This shame, coupled with mental health stigma, can make OCD feel more isolating.

Here’s more about living with OCD.

The causes of OCD aren’t yet established. Many people with OCD have a genetic predisposition to it. But environmental factors could also be at play, as can your temperament.

A few things can also trigger OCD, such as:

• a traumatic brain injury (TBI)
• a bacterial or viral infection
• stress

Studies suggest these don’t cause OCD. Instead, they cause OCD to develop in people who already have a genetic tendency for it. Other people develop OCD without a clear cause.

Certain beliefs are strongly connected to OCD, and they’re thought to contribute to it or worsen symptoms. If you live with OCD, you might recognize some form of these beliefs in your own thought patterns:

• Inflated responsibility: Believing you can cause or prevent negative outcomes that aren’t really in your control
• Overimportance of thoughts: Feeling as if the thought of doing something bad (like hurting someone) is morally the same as doing it
• Control of thoughts: A belief that it’s necessary and possible to have total control over your own thoughts
• Overestimation of threat: The belief that catastrophic events are very likely
• Perfectionism: Believing that being imperfect is unacceptable
• Intolerance of uncertainty: A strong need to know what will happen (or to know that nothing bad will happen)

You can learn more about OCD causes and risk factors here.

It’s not always easy to tell if you have OCD. Professionals often use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a guideline for diagnosing OCD.

According to the DSM-5, you’ll fit the following criteria for an OCD diagnosis to apply:

• You experience obsessions, compulsions, or both.
• Your obsessions and compulsions cause a lot of distress or negatively impact your daily life.
• The obsessions and compulsions tend to take up an hour or more of your day.

If you’re having distressing thoughts and compulsions (regardless of whether you fit the above criteria), talking with a therapist could help.

If you want to learn more, you can check out How Do I Know If I Have Obsessive-Compulsive Disorder? for more info on getting a diagnosis.

Sometimes, people mistake OCD for other conditions (and vice versa). Many mental health conditions, including anxiety disorders, can involve intrusive thoughts and excessive worry.

OCD can also look like ADHD, autism, or Tourette syndrome.

According to the DSM-5, some conditions directly related to OCD include:

• body dysmorphic disorder
• hoarding disorder
• trichotillomania (hair-pulling)
• excoriation disorder (skin-picking)

No matter whether you fit the criteria for OCD, it can be important to talk with a therapist or someone you trust if you’re feeling stressed or bogged down by a particular thought or behavior.

While OCD can be difficult, it is treatable. There are a few ways to treat OCD, according to research.

Therapy

The most common treatment for OCD is a cognitive behavioral therapy (CBT) called exposure and response prevention (ERP). Numerous trials have concluded that this is an effective treatment for OCD.

You might feel as if something bad will happen if you don’t satisfy your compulsion. Guided by a therapist, you can learn to manage obsessions without engaging in compulsions. Over time, this can reduce the power of the obsessions.

Medication

Some people with OCD benefit from medication, especially selective serotonin reuptake inhibitors (SSRIs). You can get a prescription from a medical professional, such as a psychiatrist.

Self-care strategies

Certain self-care strategies could help people with OCD. Because stress can worsen OCD, stress management might help.

Stress management for OCD could look like engaging in relaxing activities — such as exercise, meditation, and creative hobbies — and processing your emotions through journaling and other expressive activities.

You could also use an OCD workbook, such as:

• Getting Over OCD: A 10- Step Workbook for Taking Back Your Life
• The Anti-Anxiety Workbook
• The Mindfulness Workbook for OCD

For more information on OCD treatment, you can check out this article.

Living with OCD isn’t always easy. But the good news is, OCD can be treated. Many people with OCD manage their condition and live happy, full lives.

If you suspect that you or a loved one has OCD, consider looking for a therapist who specializes in treating OCD. Talking with a professional is often the first step in learning to manage your OCD symptoms.