Obsessive Compulsive Disorder, commonly called OCD, is a mental health condition that can cause persistent unwanted thoughts and repetitive behaviors that interfere with everyday life. OCD is more than simply liking things organized, worrying about germs, or double-checking that a door is locked. For people living with Obsessive Compulsive Disorder, intrusive thoughts and compulsive behaviors can become difficult to control and may interfere with work, school, relationships, sleep, and overall quality of life.
Fortunately, OCD is treatable. Recognizing the signs and symptoms and seeking an appropriate evaluation are important first steps toward managing the condition.
What Is Obsessive Compulsive Disorder?
Obsessive Compulsive Disorder (OCD) is a mental health disorder characterized by obsessions, compulsions, or both.
Obsessions are recurrent, unwanted thoughts, images, fears, or urges that can cause significant anxiety or distress. A person may recognize that these thoughts are excessive or unwanted but still have difficulty stopping them.
Compulsions are repetitive behaviors or mental acts that a person feels driven to perform, often in an attempt to reduce the anxiety created by an obsession or prevent something bad from happening.
Completing a compulsion may temporarily reduce anxiety. However, that relief can reinforce the cycle of obsession, anxiety, and compulsive behavior, causing the pattern to repeat.
What Are Common Signs and Symptoms of OCD?
OCD does not look the same in everyone. Some people primarily experience intrusive thoughts, while others have more noticeable repetitive behaviors. Many people experience both.
Common Obsessions
Obsessive thoughts or fears may include:
- Fear of germs, contamination, or illness
- Fear of harming yourself or another person
- Persistent doubts about whether something was done correctly
- Fear of making a serious mistake
- Excessive concern about safety
- Unwanted thoughts involving sex, religion, morality, or harm
- Fear of losing control
- A strong need for symmetry, exactness, or order
- Fear of losing or misplacing important objects
- Repeated thoughts about whether doors were locked or appliances were turned off
Having an intrusive thought does not mean that someone wants to act on it. Intrusive thoughts can be particularly distressing because they are unwanted and may conflict with a person’s values or beliefs.
Common Compulsions
Compulsive behaviors may include:
- Excessive handwashing or cleaning
- Repeatedly checking locks, appliances, messages, or other items
- Arranging objects in a particular order
- Repeating certain actions until they feel “right”
- Counting objects or actions
- Repeatedly seeking reassurance from others
- Mentally reviewing conversations or events
- Repeating words, phrases, or prayers
- Avoiding people, places, objects, or situations that trigger obsessive thoughts
Many people occasionally double-check something or have an unwanted thought. This alone does not mean someone has OCD.
With OCD, the obsessions or compulsions are typically difficult to control, cause significant distress, take considerable time, or interfere with normal daily activities.
How Can OCD Affect Everyday Life?
When OCD symptoms become severe, they can consume a significant amount of a person’s day.
Someone who fears contamination, for example, may spend excessive time washing, cleaning, or avoiding certain objects. Someone with checking compulsions may repeatedly return home to make sure a door is locked or an appliance is turned off. Other people may experience primarily mental compulsions that are less visible to family and friends.
OCD can affect:
- Work or school performance
- Relationships
- Sleep
- Social activities
- Concentration
- Daily routines
- Emotional well-being
Some people also begin avoiding situations that trigger their obsessions. Over time, this avoidance can further restrict daily activities and quality of life.
How Is Obsessive Compulsive Disorder Diagnosed?
There is no single blood test, laboratory test, or imaging study that diagnoses OCD.
An OCD evaluation typically includes a detailed discussion of your symptoms, medical history, mental health history, medications, and how your thoughts or behaviors affect your daily life.
A healthcare professional may ask about:
- The types of intrusive thoughts you experience
- Repetitive behaviors or mental rituals
- How much time these symptoms consume
- Whether you can resist the behaviors
- How much distress the symptoms cause
- Whether symptoms interfere with work, school, relationships, or other activities
- Other symptoms such as anxiety or depression
A healthcare provider may also evaluate whether another medical condition, medication, substance, or mental health disorder could better explain the symptoms.
People sometimes hesitate to discuss intrusive thoughts because they are embarrassed or afraid of being judged. Being open with your healthcare provider is important because these symptoms can be part of OCD and can help your provider determine the most appropriate next steps.
What Is the Treatment for OCD?
Treatment is individualized based on the severity of symptoms, medical history, other mental health conditions, previous treatments, and personal preferences.
Common OCD treatment options include psychotherapy, medication, or a combination of the two.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is a form of psychotherapy used to treat many mental health conditions. CBT helps people recognize patterns involving thoughts, emotions, and behaviors and develop healthier ways of responding to them.
For OCD, a specialized form of CBT called Exposure and Response Prevention (ERP) is particularly important.
Exposure and Response Prevention
Exposure and Response Prevention therapy, or ERP, gradually and safely exposes a person to situations that trigger obsessive thoughts while helping the person resist performing the associated compulsion.
For example, someone with contamination-related OCD may gradually encounter a feared situation and then practice tolerating the anxiety without immediately washing or cleaning.
Over time, ERP can help reduce the power of the obsession-compulsion cycle and improve a person’s ability to tolerate uncertainty and anxiety without relying on compulsive behaviors.
Medication for OCD
Medication may also be recommended as part of an OCD treatment plan.
Selective serotonin reuptake inhibitors, commonly known as SSRIs, are frequently used to treat OCD. These medications affect serotonin signaling in the brain and may help reduce the frequency and intensity of obsessive thoughts and compulsive behaviors.
Treatment response varies from person to person. Medication for OCD may also take several weeks to produce meaningful improvement. A healthcare provider should monitor effectiveness, side effects, medication interactions, and dosage.
Medication should not be started, stopped, or changed without discussing it with a qualified healthcare professional.
Combining Therapy and Medication
For some people, psychotherapy alone may be effective. Others benefit from medication, and some achieve better symptom control through a combination of ERP or CBT and medication management.
Treatment should be individualized rather than taking a one-size-fits-all approach.
When Should You Seek Help for OCD Symptoms?
Consider speaking with a healthcare professional if intrusive thoughts or repetitive behaviors:
- Consume a significant amount of your day
- Are difficult to control
- Cause significant anxiety or distress
- Interfere with work or school
- Affect your relationships
- Cause you to avoid normal activities
- Interfere with sleep or daily routines
- Are becoming more frequent or severe
You do not need to wait until symptoms become overwhelming before asking for help. An earlier evaluation can help identify what is happening and determine appropriate treatment options.
Virtual Mental Health Care and Medication Management
Accessing mental health care can sometimes be challenging because of work schedules, family responsibilities, transportation, or the discomfort some people experience discussing sensitive concerns in a traditional office environment.
Telehealth mental health services can provide a convenient and private way to discuss symptoms and receive ongoing behavioral health care.
Seidell Health & Wellness dba Connecticut Telehealth provides virtual behavioral health support and medication management through secure telehealth visits. The goal is to provide personalized, patient-centered care while making mental health services easier to access from the privacy and comfort of home.
If you are experiencing obsessive thoughts, compulsive behaviors, anxiety, depression, or other mental health concerns, an evaluation can help determine appropriate next steps.
Take the Next Step Toward Better Mental Health
Living with intrusive thoughts and repetitive behaviors can be exhausting, but Obsessive Compulsive Disorder is treatable. Therapy, medication, or a combination of treatments can help many people reduce symptoms and regain greater control over their daily lives.
If mental health symptoms are interfering with your quality of life, consider discussing them with a qualified healthcare professional.
Christine Seidell, APRN, FNP-BC
Seidell Health & Wellness dba Connecticut Telehealth
This article is intended for educational purposes only and does not replace individualized medical advice, diagnosis, or treatment. If you are experiencing a medical or mental health emergency, seek immediate medical attention. If you are having thoughts of suicide or self-harm, call or text 988 to reach the Suicide & Crisis Lifeline.
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