Obsessive Compulsive Disorder

What Is Obsessive Compulsive Disorder?

Obsessive-Compulsive Disorder (OCD) is a neurobiological disorder characterized by recurrent, unwanted intrusive thoughts (obsessions) and repetitive behaviors (compulsions/rituals) such as counting, checking, praying, and cleaning. These compulsions are performed in an effort to relieve the anxiety and distress caused by the obsessions. OCD obsessions and compulsions can be extremely time-consuming, causing significant emotional distress and may greatly interfere with day-to-day functioning and interpersonal relationships. Individuals with OCD may go to great lengths to hide their obsessions and compulsions due to embarrassment and shame. It is estimated that one in every 40 adults, and one in every 100 children suffer with OCD. While some individuals may view their obsessive-compulsive patterns as helpful or protective, these behaviors ultimately reinforce the anxiety cycle and can contribute to ongoing psychological strain.

Obsessions

• Re-occurring thoughts, images, urges, feelings, or sensations that feel intrusive, disturbing, or out of character.

• Examples: Fear of germs, illness, or feeling unclean; Intrusive questions about life, death, or reality that feel impossible to answer; Repeated doubts about whether you did something wrong in the past; Fear of accidentally or intentionally harming yourself or others; A need for order, symmetry, or precision; Fear of violating religious, moral, or ethical beliefs.

Compulsions

• Repetitive physical or mental acts they feel driven to do in response to those thoughts or to prevent a feared outcome.

• Examples: checking, counting, cleaning, repeating, mentally reviewing, Reassurance-seeking from others, Confessing to possible wrongdoings, Repeatedly checking appliances, locks, or roads for evidence of harm, Repeating actions until the sensation feels complete, Performing rituals to “protect” others.

While OCD follows the same cycle for everyone, the themes of obsessions and compulsions can vary widely. These themes are often grouped into OCD subtypes. Below is a list of some of the most common types of OCD:

• Contamination OCD: Fear of germs, illness, or environmental toxins

• Harm OCD: Fear of causing harm to yourself or others

• Relationship OCD (ROCD): Intrusive doubts about your relationships—romantic or platonic

• Sexual Orientation OCD (SO-OCD): Significant distress over your sexual identity despite no desire to change it

• Scrupulosity OCD: Fears around morality, religion, or doing the “right” thing

What causes OCD?

Researchers and mental health professionals don’t know the exact cause of OCD, but the following factors may contribute:

• Genetics: OCD can run in families. Some studies estimate that 10-20% of people diagnosed with OCD have an immediate family member with OCD.

• Brain chemistry: Certain differences in brain structure or serotonin levels

• Environment: Stressful life events, trauma, or infections (e.g., PANDAS/PANS) may play a role

• Complex Trauma (C-PTSD): A history of chronic trauma or C-PTSD can increase an individual’s need for predictability, control, and safety. This heightened rigidity and hypervigilance can significantly influence the intensity and expression of OCD behaviors, often reinforcing the compulsion cycle as a way to manage perceived threats.

Treatment

It is generally recommended that individuals participate in both therapy and medication management. The following are some treatment options for OCD:

Therapy

• Individual Therapy

• Exposure and Response Prevention Therapy (ERP)

• Transcranial magnetic stimulation (TMS)

• Group therapy/support groups

• Family therapy

Medications

• Meeting with a psychiatrist can provide individualized information and support in determining whether medication is an appropriate part of treatment.

• Selective serotonin reuptake inhibitors (SSRIs)

• Clomipramine

Lifestyle Changes

• Mindfulness Strategies

• Regular physical exercise

• Regular, balanced meals

• A consistent sleep routine of at least seven to nine hours per night can help regulate mood and reduce the impact of symptoms

What Can Make OCD Worse?

1. Engaging in Compulsions

2. Trauma

3. Stress and Change

4. Co-Occurring Disorders

   • Two of the most common co-occurring mental health conditions are major depressive disorder (MDD) and generalized anxiety disorder (GAD), but there are several other conditions that can occur alongside OCD, such as:

     • Attention-deficit hyperactivity disorder (ADHD)

     • Eating disorders

     • Personality disorders

     • Substance use disorders

Relevant resources

Videos

Debunking the myths of OCD - Natascha M. Santos

Books

Obsessive-Compulsive Disorder Demystified: An Essential Guide for Understanding and Living with OCD

Getting Control: Overcoming Your Obsessions, Compulsions and OCD

Other Online Resources

OCD Challenge- A Free Online Program

International OCD Foundation

1. NOCD. (n.d.). What is OCD? NOCD. https://www.treatmyocd.com/what-is-ocd

2. NOCD. (n.d.). Different types of OCD. NOCD. https://www.treatmyocd.com/education/different-types-of-ocd

3. NOCD. (n.d.). What makes OCD symptoms get worse? NOCD. https://www.treatmyocd.com/blog/what-makes-ocd-symptoms-get-worse

4. International OCD Foundation. (n.d.). OCD treatment guide. https://iocdf.org/ocd-treatment-guide/