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Understanding obsessive-compulsive disorder (OCD)

Obsessive compulsive disorder

We all have thoughts or certain habits that we sometimes seem to frequently repeat. However some people have thoughts or compulsions that seem to obstinately take over their lives – this is obsessive-compulsive disorder (OCD).

OCD was originally classified as an anxiety disorder due to the intense anxiety linked to its symptoms. But the American Psychiatric Association decided it needed its own classification in 2013. 

One reason is that it is a mental health condition that has seen a significant rise in the number of sufferers. Presently, OCD affects more than two million Americans.

This is the harrowing statistic from the Anxiety & Depression Association of America (ADAA). It is equally common among the sexes, with the average age of onset being just 19 years of age.

Compulsions and obsessions

OCD is defined as having a pattern of unwanted fears and thoughts – known as obsessions – that lead someone to perform repetitive behaviors – compulsions. These compulsions and obsessions interfere with daily life and cause a great amount of suffering.

Many people with OCD have both compulsions and obsessions. Despite attempts to ignore, control or be rid of such urges and intrusive thoughts, sufferers feel powerless over them.

Trying to stop them or at least ignore them only normally leads to anxiety and distress. So to ease these overwhelming negative feelings, someone with OCD feels increasingly compelled to do the compulsions and pay attention to the obsessions – and they end up in a vicious cycle of OCD.

To mask or numb such negative feelings means it’s more likely that an addiction might develop to such as alcohol or a behavioral addiction. As well, people can become very depressed about their situation.

Compulsions include things like counting items, repeatedly checking to see if a window or door is locked, cleaning and excessive hand washing. Even though most people with OCD know their behaviors don’t make any real sense, they still feel compelled to do them.

When there are obsessive thoughts it can cause extreme anxiety, sorrow, or pain. This is due to the fact that when certain disconcerting thoughts keep coming into their mind they are not certain they will not actually act on them – and this can cause self-esteem problems or even lead the person to loathe themselves.

Obsessive compulsive disorder symptoms

What are OCD symptoms?

People suffering from OCD have obsessive thoughts or compulsive behaviors that:

  • Use up at least one hour every day.
  • Disturb daily living, such as social life, work, studies or parenting.
  • Are not pleasurable. People do them because they feel they cannot stop.
  • Feel totally out of control.


OCD presents in many different forms, but most cases will involve some sort of:

  • Ordering and symmetry.

This is the compulsive need to do things in a specific order or to have items lined up in a certain way. For example, perhaps all tins of food in a cupboard or bathroom items have to have their front label showing. Or it could be that all books must be in a certain order, or clothes hanging in a wardrobe in a very particular way.

If one is left out of place by another family member or a visitor it can lead the person with OCD to feel angry or even physically sick. Their heartbeat can quicken and they can develop a cold sweat. They may swiftly get up to put the item in the order they feel that it has to be, and this can be viewed as bizarre behavior by onlookers.

  • Checking.

This includes repeatedly checking that such as an alarm is set; an oven is turned off; that all light switches are not left on; that taps are not running; that doors and windows are locked; that an email or other message has been sent, or repeatedly checking personal items have not been stolen or lost from pockets and bags.

  • Contamination fear.

This is when someone has extreme fear and anxiety about germs. They can have an obsessive, almost frenzied at times, compulsion to clean – even if everyone else thinks somewhere looks clean.

Their fear of germs is much more intense than most people’s (that is a natural part of our survival instincts). It might be that they don’t want to sit down on a chair that someone else might have sat on at some point or they always feel an overwhelming need to keep windows open even if it’s cold. They may also avoid, for instance, using public toilets or shaking hands with anybody.

As well as the fear of germs, there can also be terrific anxiety about other health risks such as potentially fatal impairments that could be encountered. Contamination fear can be so extreme it means some people avoid going to places where there could be any other people.

  • Obsessive thoughts. 

This could be constantly thinking about and being aware of various body sensations such as blinking or breathing. There might be a constantly perturbing suspicion about a partner being unfaithful, with no actual evidence for it. For some people with OCD, there are thoughts that seem relentless that can be violent or disturbing, including sexual thoughts with intrusive images.

Some mental health conditions are similar to OCD. These involve obsessions with:

  • Collecting things (hoarding disorder).
  • Picking at skin (excoriation).
  • Pulling out and/or eating hair (trichotillomania).
  • How somebody looks (body dysmorphic disorder).
  • Abnormal body odors (olfactory reference syndrome).
  • Physical illness (hypochondriasis).


Mental health experts have no definitive reason as to why some people get this disorder. But it has been observed that many people diagnosed with OCD have experienced trauma, including physical or sexual abuse, that was frequently during childhood. It could be that they are attempting to create order on the outside as they battle their internal chaos.

People struggling with OCD are often reluctant to seek the help they need because they feel embarrassed or ashamed. But there are proven methods to successfully treat OCD.

Our experienced professional team has helped people with all mental health and emotional issues for many decades now. Get in touch with us today to discuss how we can help you or someone you know.

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David Hurst

David Hurst has four books published on mental health recovery, including 12 Steps To 1 Hero, The Anxiety Conversation and Words To Change Your Life. He has written for national newspapers and magazines around the world for 30 years including The Guardian, Psychologies, GQ, Esquire, Marie Claire and The Times. He has been in successful continual recovery since January 2002.

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