Obsessive-Compulsive Disorder (OCD) is an anxiety disorder that has two parts:

  • Obsessions are unwanted thoughts, images, urges or worries that constantly appear in your mind, no matter how much you try and ignore them. They can cause feelings of anxiety.
  • Compulsions are repetitive activities you do to reduce the anxiety that has been caused by the obsession.


For example, someone with an obsessive fear of catching germs and diseases may start to wash their hands compulsively to cope with the anxiety. 

Now, a lot of people experience minor obsessions (such as worrying about if the door is locked) and compulsions (such as going back to double-check that the door is locked), but these don’t significantly interfere with their daily lives and are short-lived. If you have OCD however, your obsessions and compulsions will begin to disrupt your day-to-day life. 

Constantly repeating compulsions can take up a lot of time and you might start to avoid any situations that could trigger your OCD, meaning that you withdraw from family and loved ones, avoid work and probably won’t even go outside. Obsessions can even make it hard to concentrate and can leave you feeling exhausted.

A very common myth is that OCD is just when you wash your hands a lot or like for things to be tidy. Remember that this isn’t true! As we have explained, there is a lot more to it.

Symptoms

Type of obsession:

  • Fear of causing/failing to prevent harm – worrying you’ve harmed someone because you haven’t been careful or that you will harm someone because you will lose control (e.g. that you will stab someone)
  • Intrusive thoughts/images – violent intrusive thoughts or images of you doing something violent or abusive, blasphemous thoughts that are against your religion, sexual intrusive thoughts (these could be about family members or children)
  • Fear of contamination – worrying that you have been contaminated and that you and/or other people are spreading the disease.
  • Fears related to order/symmetry – worrying that something bad will happen if everything isn’t ‘right’ (e.g. if things aren’t clean or they aren’t symmetrical)


Type of compulsion:

  • Rituals – washing your hands/body a lot, arranging things in a particular way or touching things in a specific order or at a certain time
  • Checking – checking doors and windows to make sure they’re locked, checking your body to see how it responds to intrusive thoughts, checking your body for contamination, checking your memory of events for intrusive thoughts
  • Reassurance – constantly asking other people to tell you that everything is okay
  • Correcting thoughts – counting to a certain number, replacing your intrusive thought with a ‘neutral’ thought, repeating something in your head or out loud (such as a word, name or phrase)

Causes

The causes of OCD are unclear, but these factors might lead to its development:

  • Inability to neutralise intrusive thoughts – we all get intrusive thoughts but most people dismiss it and carry on with life. If you feel that you may act on an intrusive thought, you may develop a compulsion to stop the anxiety that has been caused, creating an OCD cycle.
  • Learned behaviour – if your parents/guardians had similar anxieties and showed similar compulsive behaviour, you may have learned that compulsions are way to cope
  • Stressful life events – OCD may be more common if you experienced physical, emotional or sexual abuse or neglect in your childhood. Stressful events may also trigger anxiety and then the development of OCD (e.g. childbirth or a car accident)
  • Biology – if you have low levels of a brain chemical called serotonin or if you have unusually high levels of activity in some areas of the brain

How can I help myself?

  • Talking to someone you trust – being able to talk about your experiences may help you feel better as OCD can often cause you to isolate yourself due to feelings of embarrassment or fears of being misunderstood. 
  • Manage your stress – OCD can become worse if you are stressed out, try to identify triggers so that you can anticipate stressful events and manage them better
  • Look after yourself – get some more sleep, choose a healthier diet and do some exercise!

Treatment

  • The treatment usually offered for OCD is Cognitive Behavioural Therapy (CBT) which is a talking therapy that focuses on your thoughts, feelings and behaviour. Exposure and Response Prevention (ERP) is a type of CBT recommended for OCD. It works by exposing you to situations that would usually cause anxiety, and encouraging you to tolerate the anxiety instead of acting out your compulsions. This teaches you that the feelings soon go away and the compulsions aren’t necessary. You may also be offered medication with CBT to help you manage your symptoms of anxiety. This is something that you should discuss with your doctor.