Obsessions and compulsions can take up a great deal of time

Obsessive-compulsive disorder (OCD) is a mental health condition that involves experiencing recurring thoughts (obsessions) that may then lead to repetitive behaviors (compulsions). These obsessions and compulsions can take up a great deal of time, interfere with a person’s ability to function in their daily life and create significant distress. While the exact causes are not known, genetic, biological, and stress-related factors may play a role. Effective treatments are available and include medications and psychotherapy techniques such as cognitive behavioral therapy (CBT) and exposure and response prevention (ERP) therapy.

Many people without OCD have distressing thoughts or repetitive behaviors. However, these thoughts and behaviors do not typically disrupt daily life. For people with OCD, thoughts are persistent, and behaviors are rigid. Not performing the behaviors commonly causes great distress. Many people with OCD know or suspect their obsessions are not realistic; others may think they could be true (known as limited insight). Even if they know their obsessions are not realistic, people with OCD have difficulty disengaging from the obsessive thoughts or stopping the compulsive actions.

Typical OCD Thoughts:

Each person with OCD will have a different experience with obsessions, but common thoughts or thought patterns include:

• Aggressive or disturbing ideas (e.g. thoughts of murdering a spouse or child)
• Concerns about unwittingly causing injury (e.g. hitting a pedestrian while driving)
• Constant worry about catching a deadly disease and/or contaminating others with your germs
• Disturbing sexual and/or religious imagery that might include sexual assault or inappropriate sexual acts
• Fears about contamination with environmental toxins (e.g. lead or radioactivity)
• Fear of harming inanimate objects
• Fears of forgetting or losing something
• Intense fear that something terrible will happen to a loved one
• Profound worry about doing something extremely embarrassing (e.g. screaming out an obscenity at a funeral)
• Strong need to reorder things until they feel “just right”

Obsessions:

Obsessions are recurrent and persistent thoughts, impulses, or images that cause distressing emotions such as anxiety or disgust. Many people with OCD recognize that the thoughts, impulses, or images are a product of their minds and are excessive or unreasonable. However, the distress caused by these intrusive thoughts cannot be resolved by logic or reasoning. Most people with OCD try to ease the distress of the obsessions with compulsions, ignore or suppress the obsessions, or distract themselves with other activities.

Typical obsessions:

• Fear of getting contaminated by people or the environment
• Disturbing sexual thoughts or images
• Fear of blurting out obscenities or insults
• Extreme concern with order, symmetry, or precision
• Recurrent intrusive thoughts of sounds, images, words, or numbers
• Fear of losing or discarding something important

Compulsions:

Compulsions are repetitive behaviors or mental acts that a person feels driven to perform in response to an obsession. The behaviors typically prevent or reduce a person’s distress related to an obsession. Compulsions may be excessive responses that are directly related to an obsession (such as excessive hand washing due to the fear of contamination) or actions that are completely unrelated to the obsession. In the most severe cases, a constant repetition of rituals may fill the day, making a normal routine impossible.

Typical compulsions:

• Excessive or ritualized hand washing, showering, brushing teeth, or toileting
• Repeated cleaning of household objects
• Ordering or arranging things in a particular way
• Repeatedly checking locks, switches, or appliances
• Constantly seeking approval or reassurance
• Repeated counting to a certain number