Obsessive-compulsive disorder (OCD) is defined by the National Institute of Mental Health, as a chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (“obsessions”) and/or behaviors (“compulsions”) that they feel the urge to repeat. People with OCD suffer from consistent intrusive thoughts (obsessions), coupled with chronic feelings of danger or doubt, and these feelings often drive them to commit repetitive or specific behaviors (compulsions). Individuals experiencing symptoms of obsessions and compulsions can experience an interference with all aspects of life, such as work, school, and relationships.
Examples of obsessions and compulsions:
Obsessions are repeated thoughts, urges, or mental images that cause anxiety. Common obsessions could include:
- Fear of germs or contamination
- Unwanted or forbidden thoughts about religion, sex, or harm
- Aggressive thoughts toward self or others
- Uncontrollable need to have things in order
Compulsions are repetitive behaviors that a person with OCD feels the urge to do in response to an obsessive thought. Common compulsions include:
- Excessive cleaning
- Compulsive research or avoiding
- Ordering and arranging things in a particular and precise way
- Repeatedly checking on things
- Compulsive counting
Other common symptoms of OCD include:
- Unsuccessful attempts to control thoughts or behaviors, even when those thoughts or behaviors are recognized as excessive
- Spending an excessive amount of time or energy on thoughts or behaviors
- No longer finds fulfillment, pleasure, or satisfaction when performing the behaviors or rituals, but may feel brief relief from the anxiety the thoughts cause
- Experiencing significant problems in daily life due to these thoughts or behaviors
OCD is typically treated with medication, psychotherapy, or a combination of the two. Although most patients with OCD respond to treatment, some patients continue to experience symptoms. Serotonin reuptake inhibitors (SRIs) have been found to help reduce OCD symptoms.
Other medications have been used to treat OCD, but more research is needed to show the benefit of these options. For basic information about these medications, you can visit the NIMH Mental Health Medications webpage. For the most up-to-date information on medications, side effects, and warnings, visit the FDA website.
Myth: OCD is always about cleanliness
While many cases of OCD are related to cleanliness or neatness, OCD is more complex than someone who frequently washes their hands in attempt to rid of germs. People with OCD can experience obsessions and compulsions that vary in context and nature. Some common OCD obsessions include:
- Contamination: dirt, bodily fluids, germs and disease, household chemicals, or environmental contaminants
- Religious obsessions: excessive concern with morality or offending God
- Harm: fear of harming others or being responsible for a terrible event
- Unwanted sexual thoughts: perverse or forbidden sexual thoughts and images, thoughts about aggressive sexual behavior toward others
- Perfectionism: fear of losing or forgetting important information, concern with exactness or evenness, superstitious ideas about lucky or unlucky numbers
- Losing control: fear of harming oneself or others on impulse, fear of blurting out insults or obscenities, fear of violent images in one’s mind
Similarly, common compulsions fall into respective categories:
- Cleaning: excessively washing hands, showering, brushing one’s teeth, or cleaning objects
- Repeating: rewriting or rereading, repeating body movements, repeating activities in specific multiples
- Checking: checking certain body parts, checking that nothing terrible has happened, checking that you didn’t make a mistake or harm yourself or others
- Mental compulsions: praying to prevent harm, counting while performing tasks in order to end on a certain number, mentally reviewing events to prevent harm
- Other compulsions: avoiding situations that trigger obsessions, asking for reassurance, arranging or putting things in order until it “feels right”
Myth: People with OCD just need to relax
People with OCD have a diagnoseable condition and cannot simply “turn it off”. In order to treat intrusive thoughts and learn to live a more productive and satisfactory life, people with OCD dedicate time and energy to therapy and treatment. Similar to other mental health diagnoses, it cannot be easily overcome by “trying harder”. Growth, healing, and change is a lifelong process.
Myth: All particular or “picky” people have OCD
Being excessively focused on tidiness, organization, or orderly does not equate to OCD. Many people like neatness and put effort into making their lives orderly and planned out. Individuals with personality traits such as these are normal, healthy, and do not correlate to having obsessive compulsive disorder. Some OCD obsessions can be related to being clean or tidy, but the disorder criteria are more complex than this one attribute. OCD obsessions refer to severe intrusive thoughts, images, or impulses that feel to be outside of the individual’s control and interfere with important aspects of the person’s life. Obsessions paired with intense negative feelings create an experience of disturbance and unwanted repetitive behaviors called compulsions. Similarly, not every routine or ritual is an OCD compulsion. Compulsions are actions that people do to help relieve consistent or frequent negative thoughts and emotions.
Myth: You can be “a little OCD”
The term “OCD” has be frequently misinterpreted and misused in popular culture, using phrases such as “I’m just a little OCD” or “stop being so OCD”. These common phrases are used to reference someone being overly concerned with neatness or organization. Obsessive compulsive disorder is not a personality trait or chosen quirk; it is a mental disorder that causes significant impairment, distress, and debilitation. People who have OCD are not just excessively focused on certain things occasionally, they suffer from consistent intrusive thoughts (obsessions) paired with chronic feelings of danger or doubt, driving them to participate in repetitive behaviors (compulsions).