What is OCD?
Obsessive-compulsive disorder (OCD) is described as an anxiety disorder.
The condition has two main parts: obsessions and compulsions.
Obsessions are unwelcome thoughts, images, urges or doubts that repeatedly appear in your mind; for example, thinking that you have been contaminated by dirt and germs or experiencing a sudden urge to hurt someone.
These obsessions are often frightening or seem so horrible that you can’t share them with others. The obsession interrupts your other thoughts and makes you feel very anxious.
“I get unwanted thoughts all through the day which is very distressing and affects my ability to interact with others and concentrate on my studies and work.”
Compulsions are repetitive activities that you feel you have to do. This could be something like repeatedly checking a door to make sure it is locked or repeating a specific phrase in your head to prevent harm coming to a loved one.
The aim of a compulsion is to try and deal with the distress caused by the obsessive thoughts and relieve the anxiety you are feeling. However, the process of repeating these compulsions is often distressing and any relief you feel is often short-lived.
“Getting ready for each day involves hand washing, mental rituals and doing things in the same order every day. Sometimes, I feel like staying in bed and avoiding the day.”
The OCD cycle
The diagram below shows how obsessions and compulsions are connected
in an OCD cycle.
Living with OCD
Although many people experience minor obsessions (e.g. worrying about leaving the gas on or if the door is locked) and compulsions (e.g. rituals like avoiding the cracks in the pavement), these don’t significantly interfere with their daily lives, or are short-lived.
If you experience OCD, your obsessions and compulsions will cause you considerable fear and distress. They will also take up a significant amount of time and disrupt your ability to carry on with your day-to-day to life including doing daily chores, going to work, or maintaining relationships with friends and family.
Many people with OCD experience feelings of shame and loneliness which often stop them from seeking help, particularly if they experience distressing thoughts about subjects such as religion, sex or violence.
This means that many people try to cope with OCD alone until the symptoms are so severe they can’t hide them anymore.
OCD is also known to have a close association with depression and some people find obsessions appear or get worse when they are depressed. (See Understanding depression.)
What are the common signs of OCD?
Although everyone will have their own experiences there are several
common obsessions and compulsions that occur as part of OCD.
The three most common themes are:
- unwanted thoughts about harm or aggression
- unwanted sexual thoughts
- unwanted blasphemous thoughts
Obsessions often appear closely linked to your individual situation. For example, if you are a loving parent, you may fear doing harm to a child and if you are religious you may have blasphemous thoughts.
“I have OCD harming thoughts and the compulsion to carry them out which is absolutely terrifying to say the least.”
Some examples of obsessions include:
• a fear of failing to prevent harm – e.g. worrying that you have left
the cooker on and might cause a fire
• imagining doing harm – e.g. thinking that you are going to push
someone in front of a train
• intrusive sexual thoughts – e.g. worrying about abusing a child
• religious or blasphemous thoughts – e.g. having thoughts that are
against your religious beliefs
• fear of contamination – e.g. from dirt and germs in a toilet
• an excessive concern with order or symmetry – e.g. worrying if objects
are not in order
• illness or physical symptoms – e.g. thinking that you have cancer
when you have no symptoms
Common compulsions include physical compulsions e.g. washing or checking, or mental compulsions, e.g. repeating a specific word or phrase.
“I have to keep checking things three times and have to have certain items on me to help me feel safe.”
Some examples might be:
- repeating actions – e.g. touching every light switch in the house every time you leave or enter the house
- touching – e.g. only buying things in the supermarket that you have touched with both hands
- focusing on a number – e.g. having to buy three of everything
- washing or cleaning – e.g. having to wash your hands very frequently in order to feel clean
- checking – e.g. reading through an email ten times before sending it
- ordering or arranging – e.g. keeping food organised by colour in the fridge
- repeating a specific word or phrase – e.g. repeating someone’s name in order to prevent something bad happening to them
- praying – e.g. repeating a prayer again and again whenever you hear about an accident
- counteracting or neutralising a negative thought with a positive one – e.g. replacing a bad word with a good one.
You might find that some objects or experiences make your obsessions or
compulsions worse and you try to avoid them as a result. For example,
if you fear contamination you might avoid eating and drinking anywhere
except in your own home. Avoiding things can have a major impact on
“OCD means that I miss out on things because I stay in to try to protect myself from the stress. It’s sunny outside and I want to go out but I know I probably won’t.”