Obsessive compulsive

About the Condition

Obsessive-compulsive disorder (OCD) features a pattern of unreasonable thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). These obsessions and compulsions interfere with daily activities and cause significant distress.

You may try to ignore or stop your obsessions, but that only increases your distress and anxiety. Ultimately, you feel driven to perform compulsive acts to try to ease your stress. Despite efforts to ignore or get rid of bothersome thoughts or urges, they keep coming back. This leads to more ritualistic behavior — the vicious cycle of OCD.

OCD often centers around certain themes — for example, a fear of getting contaminated by germs. To ease your contamination fears, you may compulsively wash your hands until they’re sore and chapped.

If you have OCD, you may be ashamed and embarrassed about the condition, but treatment can be effective.

Symptoms

Obsessive-compulsive disorder usually includes both obsessions and compulsions. But it’s also possible to have only obsession symptoms or only compulsion symptoms. You may or may not realize that your obsessions and compulsions are excessive or unreasonable, but they take up a great deal of time and interfere with your daily routine and social or work functioning.

Obsession symptoms

OCD obsessions are repeated, persistent and unwanted thoughts, urges or images that are intrusive and cause distress or anxiety. You might try to ignore them or get rid of them by performing a compulsive behavior or ritual. These obsessions typically intrude when you’re trying to think of or do other things.

Compulsion symptoms

OCD compulsions are repetitive behaviors that you feel driven to perform. These repetitive behaviors or mental acts are meant to prevent or reduce anxiety related to your obsessions or prevent something bad from happening. However, engaging in the compulsions brings no pleasure and may offer only a temporary relief from anxiety.

OCD usually begins in the teen or young adult years. Symptoms usually begin gradually and tend to vary in severity throughout life. Symptoms generally worsen when you experience greater stress. OCD, usually considered a lifelong disorder, can have mild to moderate symptoms or be so severe and time-consuming that it becomes disabling.

Questions and Answers

OCD

Do people with OCD really believe their thoughts?

Most people with OCD are well aware that their obsessions and compulsions are irrational. Indeed, this is part of the torment of OCD – their insight does little to weaken the obsessional distress or to make compulsive behaviors easier to resist, and the understanding that these thoughts and behaviors are irrational heightens the distress. This can lead to a high degree of shame, embarrassment, and isolation.

The emotional areas of the brain are making the person feel as if, for example, their hands are contaminated with deadly germs, or that they may have accidentally hit someone with their car, or that they left the iron on and their house might burn down as a result. The distress that arises doesn’t stop until they perform their compulsive behaviors of (respectively) perhaps scrubbing their hands with soap and hot water, or retracing the entire route they just drove checking for a struck pedestrian, or driving back home to check that the iron is off.