We have the answers to some common questions about OCD, from what it is to how you can manage it.
Do you have intrusive thoughts throughout the day that can only be managed by performing a specific action? If you’ve had these thoughts for a long time, you may find that giving in to this compulsion just feels easier than trying to fight it.
You may even suspect you have OCD but feel overwhelmed and embarrassed by it — especially since your friends are always saying they’re “obsessed” with this or that.
With the right diagnosis and a treatment plan that fits your needs, OCD is manageable. It could take some hard, uncomfortable work, but it is possible to reduce symptoms related to OCD.
Obsessive-compulsive disorder (OCD) is a chronic condition where obsessions can lead to compulsive behaviors.
“Obsessive” refers to recurring, often distressing thoughts that are out of your control. Meanwhile, “compulsive” means you feel an urge to repeat something over and over to minimize the distress caused by the obsession. It can be hard to control these impulses.
It’s common for people to call themselves “OCD” in reference to organization habits or a need to double-check that the stove is off before leaving the house. This use of “OCD” is not only inaccurate but also adds to stigma and misunderstanding for people who live with OCD.
Real OCD often causes people to think or act out certain rituals even when it may be distressing, unwanted, or inconvenient. The behavior required for an OCD diagnosis is more significant than something like a strong preference for tidiness.
In the United States, OCD affects 1.2% of people over age 18 each year, or around 1 in 100 people. At any given time, it affects 2.3% of the population, or about 1 in 50 people.
On average, people with symptoms will receive an OCD diagnosis in their late teens, around age 18.
OCD is a mental health condition that involves obsessive thoughts and repetitive compulsions. It can look similar to obsessive-compulsive personality disorder (OCPD). But OCPD is broader and impacts more areas of your life and personality.
If you have OCPD, you can have an intense desire for control, perfection, and order that also greatly affects your relationships with others. You might not even be aware of its effect on your relationships, even when other people notice.
You may have obsessions, compulsions, or both. You may try hard to ignore the obsessions, but this only increases your anxiety. As a result, you engage in compulsive behavior to help relieve that anxiety.
Let’s break down what types of thoughts and behaviors you might experience with each.
- thoughts or fears of harming other people or yourself
- unwanted and upsetting thoughts about topics like sex or religion
- fear of germs or contamination
- worry that you’ll say inappropriate things while out in public
- washing your hands or cleaning over and over
- repeatedly returning to check on things, like whether you turned off the lights or locked the door
- repeatedly counting things, such as money
- rereading or rewriting
- constantly checking that nothing bad has happened
When researchers look at images of the brains of people with OCD, they might be able to see differences in certain areas. These differences tend to be in the frontal cortex and subcortical structures. It’s not clear what the link is, but people with these changes can have symptoms of OCD.
Genetic factors might play a role in causing OCD.
Of course, research is still looking at the role your family history plays in causing OCD.
While there could be a genetic component to OCD, genes aren’t entirely responsible for causing it. There can be other factors involved as well.
Some evidence suggests childhood trauma and maltreatment could play a role in the development of OCD symptoms.
Medications like clomipramine and sertraline (antidepressants) seem to work well in managing symptoms of OCD. This is because they help increase serotonin — a type of chemical messenger — in the brain.
Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a condition that causes inflammation in the brain, resulting in OCD-like symptoms in children. It comes on quickly and severely, unlike true OCD symptoms.
You can visit this page if you’re looking for a deeper dive into what causes OCD.
Because OCD can include anxiety, increased stress can worsen the symptom of OCD, as one study indicated. You might even find that the good kind of stress, like the feeling before an upcoming vacation, can make your symptoms worse.
Fatigue and lack of sleep can also affect OCD symptoms. On top of that, living with OCD can cause you to feel exhausted from trying to control your symptoms in the first place.
If you suddenly stop taking your medication for OCD, you might find that your symptoms get worse. It’s important to talk with your doctor before making any changes to your medication.
Everyone’s OCD is unique, and symptoms can vary in what they are and how intense they can be.
For example, you might feel persistent guilt and shame over sexual thoughts you’re having. These thoughts might arise frequently throughout the day, and you can’t seem to stop them from coming.
Maybe your friends make fun of you because you need to line up the pencils on your desk just right. But if you don’t do this, you can’t stop thinking about the crooked pencils.
You may wash your hands constantly. You’re always thinking about germs and feeling unclean. Sometimes you wash your hands over and over, even though you know objectively that they’re already clean.
When you live with OCD, these symptoms can have a dramatic effect on how you live your life. You might find that even when you try hard to control them, your anxiety just gets worse.
There’s no single “cure” for OCD, but there are many effective treatments for it.
Two popular treatments for OCD are cognitive behavioral therapy (CBT) and medication. Doing CBT while taking medication is one common starting point for treatment. Research has found that this combined therapy approach might be the most effective strategy for helping people reduce OCD symptoms.
A type of CBT called exposure and response prevention (ERP) seems to be
ERP is exposure therapy. In a controlled environment, you’re exposed to whatever it is that’s causing you anxiety. During this exposure, you practice managing the compulsions. When confronting the anxiety and obsessions, you choose to respond by not performing the compulsions that normally decrease your anxiety. Over time, this helps some people feel less anxious.
Selective serotonin reuptake inhibitors, or SSRIs, are some of the most effective medications for OCD. Because people living with OCD may not have high enough serotonin levels, medications that boost this brain chemical can help reduce your symptoms.
Examples of SSRIs for OCD include:
Your doctor or mental health professional can diagnose OCD. They might want to first rule out the following with a physical exam or some blood work:
- another medical condition
- medication-related causes
- a different mental health condition
- substance use
To receive a diagnosis, you’ll have either obsessions, compulsions, or both. These must impact and cause difficulty in areas of your life like work or relationships. Your symptoms usually last for at least an hour each day.
Your doctor might ask you questions about your symptoms, such as:
- How long have you had your symptoms?
- How do the symptoms make you feel? (Stressed? Anxious? Overwhelmed?)
- What kinds of thoughts are you having?
An accurate diagnosis is important, since OCD can mimic other mental health conditions like generalized anxiety disorder, certain phobias, and hoarding disorder.
OCD is a long-term mental health condition that can affect nearly every area of your life. The symptoms can be difficult to deal with, but many effective treatment options can help you manage your symptoms.
If you think you might have OCD, consider bringing it up with your doctor. They can listen to your concerns and discuss next steps you can take to care for your mental health and reduce the impact of OCD on your life.