Obsessive Compulsive Disorder - OCD
What is obsessive-compulsive disorder (OCD)?
Have you ever heard someone casually refer to themselves as OCD because they like to do things in a precise and orderly way? ‘OCD’ is often misunderstood and the term is misused as a synonym for uptight, fussy, hard to please, overly neat, or too precise.1
However, OCD is a serious anxiety disorder characterised by uncontrollable, unwanted thoughts (obsessions) and ritual behaviours that sufferers feel the need to repeat over and over (compulsions).2, 3
Unlike someone who is particular about personal hygiene or safety and security, a person with OCD may repeatedly wash their hands on a daily basis until they are raw. Likewise, they might spend so much time checking and rechecking if their front door is locked that they may be late for work regularly.
OCD is about anxiety not logic
A typical OCD cycle = Obsessive thought - Anxiety - Compulsive behavior - Temporary Relief 2
People who have OCD likely know that their obsessive thoughts and compulsive behaviours are irrational – do not make sense.2 Even when trying to resist them, these obsessions (thoughts) and compulsions (urges) keep coming up and their brain gets ‘stuck’.1, 2 He or she cannot just snap out of it or get over it.1,2,4 Feeling powerless to resist or control them, they may carefully disguise or hide their obsessions and compulsions from others so as not to appear odd or crazy.5, 6
Someone with OCD may repeatedly wash their hands until the skin is red or raw, but they get no pleasure or satification from it. Repetitive scrubbing is a way to stop the anxiety that comes from what they think may happen if they do not wash their hands frequently.
People with OCD tend to fall into the following categories:
- Washers. Afraid of contamination (from objects or people they touch), for example from dirt, germs, diseases, they usually have cleaning or hand washing compulsions
- Checkers. They repeatedly check things (stove, taps, and light switches turned off, doors locked) they connect with harm or danger
- Doubters and sinners. They believe that if everything is not done perfectly or just right, something terrible will happen or they will be punished in some way
- Hoarders. Fearing something bad will happen if they throw anything away, compulsively collecting, keeping and storing things they do not need or use2, 7, 8
What causes OCD and who is at risk?
While no one knows for certain what causes OCD, researchers believe it may result from a combination of genetic, cognitive, and environmental factors.7,9,10
- Genetic. There is a tendency for OCD to run in families
- Cognitive. Cognitive function refers to the brain-based skills we use to perform simple and complex tasks – neuroimages (pictures of the brain) suggest that chemical, structural and functional differences in the brain may play a role
- Environmental. Behavioural conditioning (learned responses) help temporarily reduce or prevent the anxiety connected with the obsessive thought or compulsive behaviour9, 10
OCD occurs in males and females. While it can develop at any age, it tends to first appear between the age of 8 and 12 or between late teens and early adulthood.1
Signs and symptoms?
Signs and symptoms can be mild, moderate or severe, can come and go throughout a person’s life, and may ease over time or get worse.3,4 While most people with OCD have both obsessions and compulsions, it is possible for someone to have one or the other.2
Obsessive thoughts may include:
- Extreme fear of being contaminated by germs or dirt, or contaminating others
- Fear of losing control together with aggressive or horrific thoughts about harming yourself or others
- Disturbing, intrusive sexual or violent thoughts and images
- Excessive focus on religious or moral ideas
- Fear of losing or not having things you might need
- Excessive beliefs about perfection, order and symmetry – the idea that everything must line up perfectly
- Superstitious beliefs such as walking on cracks on a pathway will cause harm to yourself or others2,4,11
Signs and symptoms can also apply to other disorders such as ADHD, Autism and Tourette's Syndrome, so you will require a thorough medical and psychological examination to get a proper diagnosis
Compulsive behaviours may include:
- Following a strict daily routine
- Not touching objects touched by others
- Excessive checking and rechecking things, such as the stove, taps, light switches, locks
- Repeatedly checking in on loved ones to make sure they are safe
- Counting, tapping, repeating certain words, or doing other senseless things to reduce anxiety
- Spending a lot of time washing hands or cleaning
- Needing to arrange things symmetrically and precisely
- Praying excessively or engaging in rituals triggered by religious fear
- Accumulating everything you have ever owned, including items that should be thrown away such as old newspapers or empty food containers2, 4, 11
Diagnosis and treatment
Obsessive thoughts and compulsive behaviours can become all-consuming and overwhelming, causing serious distress, impacting work, school and relationships.2, 3, 4
While OCD is a chronic medical condition that cannot be cured, with the right treatment, it can be managed. If you suspect that you or someone you know, has obsessive-compulsive disorder, see your doctor. He or she will likely recommend anxiety-reducing medication and refer you to specialised healthcare professional, a psychologist or psychiatrist for cognitive behavioural therapy. Therapy will help you to better understand your obsessions (thoughts) and compulsions (urges), and will help you to change your thoughts and behavioural patterns.
Remember, your obsessions and compulsions are symptoms of your OCD and not a personal flaw. While there is no cure, with the correct medical treatment and self-care, you can get it under control.
Please note: This is educational information only and should not be used for diagnosis. For more information on OCD, consult your healthcare professional.
⦁ International OCD Foundation. 5 Things OCD is not. Available at: https://iocdf.org/blog/2013/03/01/5-things-ocd-is-not/. Accessed 13 May 2019.
⦁ Help Guide. Obsessive-Compulsive Disorder (OCD). Available at: https://www.helpguide.org/articles/anxiety/obssessive-compulsive-disorder-ocd.htm/. Accessed 13 May 2019.
⦁ National Institute of Mental Health. Obsessive-Compulsive Disorder. Available at:
https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml. Accessed 13 May 2019.
⦁ Mayo Clinic. Obsessive-compulsive disorder. Available at: https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/symptoms-causes/syc-20354432. Accessed 13 May 2019.
⦁ Better Health Channel. Obsessive compulsive disorder. Available at:
https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/obsessive-compulsive-disorder. Accessed 13 May 2019.
⦁ Health Central. 8 Things You Might Not Know About OCD. Available at: https://www.healthcentral.com/article/8-things-you-might-not-know-about-ocd. Accessed 13 May 2019.
⦁ The South African Depression and Anxiety Group. OCD Treatment & Referral Guide. Available at: ⦁ http://www.sadag.org/index.php?option=com_content⦁ &⦁ view=article⦁ &⦁ id=1831⦁ &⦁ Itemid=169. Accessed 13 May 2019.
⦁ Medical News Today. What is obsessive-compulsive disorder? Available at: https://www.medicalnewstoday.com/articles/178508.php. Accessed 13 May 2019.
⦁ Brain Blogger. Multifaceted Causes of Obsessive Compulsive Disorder. Available at: http://www.brainblogger.com/2013/07/13/multifaceted-causes-of-obsessive-compulsive-disorder/. Accessed 13 May 2019.
⦁ Beyond OCD. What causes OCD? Available at: Available at: http://beyondocd.org/ocd-facts/what-causes-ocd. Accessed 13 May 2019.
⦁ Psych Guides. Obsessive-Compulsive Disorder Symptoms, Causes and Effects. Available at: https://www.psychguides.com/ocd/symptoms-causes-and-effects/. Accessed 13 May 2019.