OCD is an anxiety disorder. People living with OCD are troubled by recurring unwanted thoughts, images, or impulses, as well as obsessions and repetitive rituals. People with OCD are usually aware that their symptoms are irrational and excessive, but they find the obsessions uncontrollable and the compulsions almost impossible to resist.
OCD is an easily misunderstood condition, and can be highly distressing for both the person affected and their family and friends.
OCD facts
- There is no ‘typical’ OCD behaviour. The symptoms and features of OCD can vary greatly.
- Obsessive or compulsive thoughts and behaviours often appear in childhood or adolescence. More people are diagnosed by their late teens.
- People living with OCD have a higher risk of having another mental health issue, most commonly anxiety disorders and depressive disorders.
- The causes of OCD are not fully understood, but are likely to be a combination of genetic and biological factors.
OCD myths
- Myth: 'I like to be clean and tidy. I must have OCD’
- Reality: Obsessions and compulsions are more than just a need for cleanliness. They can be exhausting, take up a lot of time, and can significantly reduce a person's quality of life.
- Myth: ‘People with OCD cannot get better.’
- Reality: With good treatment and support, people with OCD can recover well.
- Myth: ‘People with OCD just need to get over it.’
- Reality: Obsessive and compulsive behaviours are not just a character trait. A person with OCD cannot easily control their repetitive thoughts and behaviour.
Related: Tim Hillier on living with OCD – What I wish people knew about OCD - Busting the myths about OCD
OCD symptoms
People with OCD typically experience some, but not necessarily all, of these symptoms. A mental health professional will be able to give you a proper diagnosis. Compulsions and obsessions can take up hours of a person’s day and can interfere with relationships. They can also impact on education and employment.
Obsessions
The nature and severity of obsessions can change over time. They are often exaggerated or more intense versions of concerns and worries that many people have at some time. Common obsessions include:
- Fear of contamination from germs, dirt, toxins and other substances
- Fears of harm to self or others
- Intrusive sexual or violent thoughts
- Concerns with symmetry, order and routine
- Concerns about illness or religious issues
- An intense, irrational fear of everyday objects and situations (phobia).
Compulsions
Compulsions can involve both actions and thoughts. They occur in response to an obsession. Engaging in compulsions may reduce feelings of anxiety or fear that result from an obsession. Sometimes a compulsion is clearly and logically linked to an obsession, but other times the link may be unclear to an outsider. Common compulsions include:
- Excessive handwashing or cleaning the body
- Repeated counting and ordering of objects
- Excessive checking of locks, electrical appliances, and other things associated with safety
- Touching, tapping, counting or moving in a certain way or a certain number of times
- Mentally repeating words or numbers a certain number of times.
‘I felt I had to keep my family safe,’ says Julie, ‘but I didn't know why. If I made a mistake at school I had to rip the pages out and start again, or I felt something terrible would happen to someone I loved.’
Related: What is trichotillomania? - Five tips to help someone who hoards – The anxiety continuum
Help for people with OCD
Treatments for OCD can help people manage their obsessions and compulsions, and reduce or eliminate their symptoms.
Psychological therapy
A doctor, psychologist or other health professional talks with the person about their symptoms, and discusses alternative ways of thinking about and coping with them. This may involve anxiety management techniques such as mindfulness and breathing training. Specific treatments have been designed and tested to help people manage symptoms of OCD, such as exposure and response prevention (ERP) and cognitive restructuring (Rosa-Alcazar et al., 2008).
Medication
Certain medications assist the brain to restore its usual chemical balance and help control obsessions and compulsions. Sometimes medications are prescribed alone, or alongside psychological therapies.
Community support programs
Support groups provide an environment where people with OCD and their families can meet to give and receive support. Information is provided, along with self-help and coping strategies. Understanding and acceptance by the community is also very important.
Related: Support for young people and children - Busting the myths on anxiety
SANE factsheets provide brief, introductory information about mental health.