Obsessive-compulsive disorder (OCD) is a disorder in which people have persistent, unwanted thoughts, ideas, or sensations that make them feel driven to do something repetitively. People with OCD may realize their seemingly uncontrollable behavior is irrational, but may feel unable to stop it. In addition to performing complicated rituals, some people with OCD live in fear that they will accidentally do something wrong or harm someone.
We all have daily habits and routines, but someone with OCD may spend hours performing complicated rituals involving hand-washing, counting, or checking. These rituals can be extremely time-consuming, exhausting, and even disruptive. For a person with OCD, their thoughts can be overwhelming and consuming, causing distress, and sometimes anxiety.
People with OCD may experience unwanted and intrusive thoughts, which causes them to repeatedly perform ritualistic behaviors and routines. These unwanted and persistent thoughts are called obsessions and the rituals are called compulsions. Both obsessions and compulsions can significantly interfere with regular routines and obligations, like work, school, family, or social activities.
Obsessions are recurrent and persistent thoughts, impulses, or images that cause distress or anxiety. Many people with OCD recognize that their obsessions are excessive, unreasonable, and untrue, but are also unable to ignore them or settle the thoughts with logic and reasoning. Typical obsessions may include:
- Constant irrational worry about dirt, germs, or contamination
- Excessive concern with order, arrangement, or symmetry
- Fear that negative or blasphemous thoughts will cause personal harm or harm to a loved one
- Preoccupation with losing or throwing away objects with little or no value
- Distasteful religious and sexual thoughts and images
Compulsions are repetitive behaviors or mental acts that a person feels compelled to perform in response to an obsession. These behaviors are aimed at preventing or reducing stress. In some cases, the constant repetition of rituals may fill the day, making a normal routine impossible.
Many people with OCD recognize their compulsions as irrational. Although the compulsion may bring some relief to the worry, the obsession returns and the cycle continues to repeat. Compulsions may include:
- Repetitive or excessive cleaning, such as repeatedly washing hands, bathing, or cleaning household items
- Checking and re-checking several to hundreds of times a day that doors are locked, stove is turned off, hairdryer is unplugged, etc.
- Repeating a name, phrase, or activity without being able to stop
- Touching and rearranging
- Mental rituals, including the endless review of conversations, counting, or praying to neutralize obsessions
There’s a difference between being a perfectionist and having OCD. People with OCD may go to great lengths to hide their behavior, even from friends and loved ones. For some, their symptoms may prohibit them from a daily routine outside of obsessions and compulsions. For others, they may disrupt their work, academic performance, or family and social relationships. The symptoms can also change or progress over time.
While the exact cause of obsessive-compulsive disorder is unknown, biological, genetic, and environmental factors may play a role. Having a family member, especially a parent or sibling, with OCD can increase your risk of development. Also, experiencing a traumatic or stressful event may trigger intrusive thoughts, rituals, and emotional distress. OCD may also be related to another behavioral or mental health condition, such as anxiety disorders, depression, or substance use.
OCD typically begins in the teen or young adult years. Symptoms usually begin gradually and tend to vary in severity throughout life. The symptoms will generally be worse when a person experiences greater stress. OCD is considered a lifelong disorder, the symptoms can be mild to moderate, or, at times, so severe and time-consuming that it becomes disabling.