Each of us has, to some degree or another, a desire to maintain order, to control our circumstances, or to avoid illness. We may develop “quirks” about cleanliness, neatness, or perfectionism. We may even joke to others about our “OCD habits” as we rearrange the dishes in the dishwasher or go about our morning rituals in a specific order. These small nuances of personal preference, however, are not OCD. These individual differences are normal and don’t reflect the forces that compel a person who struggles with OCD to think and behave in the ways that they do. In its truest form, OCD is a condition that may significantly interfere with a person’s daily functioning, including school, work, and relationships. Left untreated, it can consume a person’s life. OCD is best managed through careful mental health treatment, likely including both psychotherapy and medication.
The symptoms of OCD usually begin gradually and vary in severity. Symptoms generally worsen during times of increased stress. Symptoms of OCD vary among individuals. Some people struggle more with obsessive thoughts. Others struggle more with compulsive behaviors. Many people with OCD exhibit symptoms in both areas.
Obsessions are persistent and intrusive thoughts, impulses, or images that create distress for the individual experiencing them. Examples include:
- Fear of germs, dirt, or being contaminated. Avoidance of touching others or touching objects that others have touched.
- Overconcern with order, neatness and exactness. Intense stress if objects are out of place, asymmetrical, or oriented improperly.
- Repeated thoughts of certain sounds, words or numbers.
- Preoccupation with counting things such as steps, or checking things such as locks.
- Intrusive thoughts, often with distressing content, such as:
- Being responsible for bad things happening to others, like hurting someone while driving.
- Shouting obscenities or insults.
- Violent, aggressive thoughts, often with horrific imagery.
- Forbidden or perverse sexual thoughts or images.
- Religious obsessions, known as scrupulosity, including fear of offending God and overconcern about morality.
- Marked fear and anxiety that one will act on obsessions.
Compulsions are repetitive behaviors that people feel drawn to perform. These repetitive behaviors, which may take the form of rules or rituals, are intended to prevent or reduce the anxiety related to obsessions. Examples include:
- Repeated hand washing and/or excessive bathing or grooming.
- Frequent cleaning, straightening, and ordering of certain objects.
- Repeated checking behaviors, such as:
- Checking doors to ensure they are locked.
- Checking appliances to be sure they are off.
- Retracing your path to be sure you did not hit a person or animal while driving.
- Counting in specific patterns.
- Completing religious rituals, including repeating prayers, developed to help avoid sin or repent for a real or imaginary sin.
- Repeated idiosyncratic behavioral rituals, such as:
- Closing and opening doors a certain number of times.
- Touching objects in a certain order.
- Performing routine behaviors a certain number of times that is “right” or “safe”
What to do if you think you have OCD
Most people with OCD are not surprised when they receive an official diagnosis. They recognize their difficulties suppressing obsessive thoughts and/or the unreasonable amount of time spent performing compulsive behaviors. Left untreated, OCD can become a disabling condition. So the best response is to seek treatment early. OCD doesn’t generally just go away with time, and efforts to “just stop it” usually make the obsessions and compulsions worse. Licensed mental health professionals can guide individuals with OCD through treatments that help.