It’s normal, on occasion, to go back and double-check that the iron is unplugged or your car is locked. But if you suffer from obsessive-compulsive disorder (OCD), obsessive thoughts and compulsive behaviors become so excessive they interfere with your daily life. No matter what you do, you can’t seem to shake them. But help is available. With treatment and self-help strategies, you can break free of the unwanted thoughts and irrational urges and take back control of your life.
What is obsessive-compulsive disorder (OCD)?
Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by uncontrollable, unwanted thoughts and repetitive, ritualized behaviors you feel compelled to perform. If you have OCD, you probably recognize that your obsessive thoughts and compulsive behaviors are irrational – but even so, you feel unable to resist them and break free.
Like a needle getting stuck on an old record, obsessive-compulsive disorder (OCD) causes the brain to get stuck on a particular thought or urge. For example, you may check the stove twenty times to make sure it’s really turned off, wash your hands until they’re scrubbed raw, or drive around for hours to make sure that the bump you heard while driving wasn’t a person you ran over.
Understanding OCD obsessions and compulsions
Obsessions are involuntary, seemingly uncontrollable thoughts, images, or impulses that occur over and over again in your mind. You don’t want to have these ideas but you can’t stop them. Unfortunately, these obsessive thoughts are often disturbing and distracting.
Compulsions are behaviors or rituals that you feel driven to act out again and again. Usually, compulsions are performed in an attempt to make obsessions go away. For example, if you’re afraid of contamination, you might develop elaborate cleaning rituals. However, the relief never lasts. In fact, the obsessive thoughts usually come back stronger. And the compulsive behaviors often end up causing anxiety themselves as they become more demanding and time-consuming.
Most people with obsessive-compulsive disorder (OCD) fall into one of the following categories:
- Washers are afraid of contamination. They usually have cleaning or hand-washing compulsions.
- Checkers repeatedly check things (oven turned off, door locked, etc.) that they associate with harm or danger.
- Doubters and sinners are afraid that if everything isn’t perfect or done just right something terrible will happen or they will be punished.
- Counters and arrangers are obsessed with order and symmetry. They may have superstitions about certain numbers, colors, or arrangements.
- Hoarders fear that something bad will happen if they throw anything away. They compulsively hoard things that they don’t need or use.
- Just because you have obsessive thoughts or perform compulsive behaviors does NOT mean that you have obsessive-compulsive disorder. With OCD, these thoughts and behaviors cause tremendous distress, take up a lot of time, and interfere with your daily life and relationships.
Signs and symptoms of obsessive-compulsive disorder (OCD)
Most people with obsessive-compulsive disorder (OCD) have both obsessions and compulsions, but some people experience just one or the other.
OCD signs and symptoms: Obsessive thoughts
Common obsessive thoughts in obsessive-compulsive disorder (OCD) include:
- Fear of being contaminated by germs or dirt or contaminating others.
- Fear of causing harm to yourself or others.
- Intrusive sexually explicit or violent thoughts and images.
- Excessive focus on religious or moral ideas.
- Fear of losing or not having things you might need.
- Order and symmetry: the idea that everything must line up “just right.”
- Superstitions; excessive attention to something considered lucky or unlucky.
- OCD signs and symptoms: Compulsive behaviors
Common compulsive behaviors in obsessive-compulsive disorder (OCD) include:
- Excessive double-checking of things, such as locks, appliances, and switches.
- Repeatedly checking in on loved ones to make sure they’re safe.
- Counting, tapping, repeating certain words, or doing other senseless things to reduce anxiety.
- Spending a lot of time washing or cleaning.
- Ordering or arranging things “just so.”
- Praying excessively or engaging in rituals triggered by religious fear.
- Accumulating “junk” such as old newspapers or empty food containers.
- Living With
“I couldn’t do anything without rituals. They invaded every aspect of my life. Counting really bogged me down. I would wash my hair three times as opposed to once because three was a good luck number and one wasn’t. It took me longer to read because I’d count the lines in a paragraph. When I set my alarm at night, I had to set it to a number that wouldn’t add up to a ‘bad’ number.”
“Getting dressed in the morning was tough, because I had a routine, and if I didn’t follow the routine, I’d get anxious and would have to get dressed again. I always worried that if I didn’t do something, my parents were going to die. I’d have these terrible thoughts of harming my parents. I knew that was completely irrational, but the thoughts triggered more anxiety and more senseless behavior. Because of the time I spent on rituals, I was unable to do a lot of things that were important to me.”
“I knew the rituals didn’t make sense, and I was deeply ashamed of them, but I couldn’t seem to overcome them until I got treatment.” (from Obsessive-Compulsive Disorder: When Unwanted Thoughts Take Over: What is it like having OCD? )