Obsessive-Compulsive Disorder (OCD)
What is obsessive-compulsive disorder (OCD)?
Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by uncontrollable, unwanted thoughts and ritualized, repetitive behaviors you feel compelled to perform. If you have OCD, you probably recognize that your obsessive thoughts and compulsive behaviors are irrational—but even so, you feel unable to resist them and break free.
Like a needle getting stuck on an old record, OCD causes the brain to get stuck on a particular thought or urge. For example, you may check the stove 20 times to make sure it’s really turned off, or wash your hands until they’re scrubbed raw. While you don’t derive any sense of pleasure from performing these repetitive behaviors, they may offer some passing relief for the anxiety generated by the obsessive thoughts. You may try to avoid situations that trigger or worsen your symptoms or self-medicate with alcohol or drugs. But while it can seem like there’s no escaping your obsessions and compulsions, there are plenty of things you can do to help yourself and regain control of your thoughts and actions.
OCD obsessions and compulsions
Obsessions are involuntary thoughts, images, or impulses that occur over and over again in your mind. You don’t want to have these ideas, but you can’t stop them. Unfortunately, these obsessive thoughts are often disturbing and distracting.
Compulsions are behaviors or rituals that you feel driven to act out again and again. Usually, compulsions are performed in an attempt to make obsessions go away.
For example, if you’re afraid of contamination, you might develop elaborate cleaning rituals. However, the relief never lasts. In fact, the obsessive thoughts usually come back stronger. And the compulsive rituals and behaviors often end up causing anxiety themselves as they become more demanding and time-consuming. This is the vicious cycle of OCD.
Most people with OCD fall into one of the following categories:
- Washers are afraid of contamination. They usually have cleaning or hand-washing compulsions.
- Checkers repeatedly check things (oven turned off, door locked, etc.) that they associate with harm or danger.
- Doubters and sinners are afraid that if everything isn’t perfect or done just right something terrible will happen, or they will be punished.
- Counters and arrangers are obsessed with order and symmetry. They may have superstitions about certain numbers, colors, or arrangements.
- Hoarders fear that something bad will happen if they throw anything away. They compulsively hoard things that they don’t need or use. They may also suffer from other disorders, such as depression, PTSD, compulsive buying, kleptomania, ADHD, skin picking, or tic disorders.
OCD signs and symptoms
Just because you have obsessive thoughts or perform compulsive behaviors does NOT mean that you have obsessive-compulsive disorder. With OCD, these thoughts and behaviors cause tremendous distress, take up a lot of time (at least one hour per day), and interfere with your daily life and relationships.
Most people with obsessive-compulsive disorder have both obsessions and compulsions, but some people experience just one or the other.
Common obsessive thoughts in OCD include:
- Fear of being contaminated by germs or dirt or contaminating others
- Fear of losing control and harming yourself or others
- Intrusive sexually explicit or violent thoughts and images
- Excessive focus on religious or moral ideas
- Fear of losing or not having things you might need
- Order and symmetry: the idea that everything must line up “just right”
- Superstitions; excessive attention to something considered lucky or unlucky
Common compulsive behaviors in OCD include:
- Excessive double-checking of things, such as locks, appliances, and switches
- Repeatedly checking in on loved ones to make sure they’re safe
- Counting, tapping, repeating certain words, or doing other senseless things to reduce anxiety
- Spending a lot of time washing or cleaning
- Ordering or arranging things “just so”
- Praying excessively or engaging in rituals triggered by religious fear
- Accumulating “junk” such as old newspapers or empty food containers
OCD symptoms in children
While the onset of obsessive-compulsive disorder usually occurs during adolescence or young adulthood, younger children sometimes have symptoms that look like OCD. However, the symptoms of other disorders, such as ADHD, autism, and Tourette’s syndrome, can also look like obsessive-compulsive disorder, so a thorough medical and psychological exam is essential before any diagnosis is made.