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Obsessive-Compulsive Disorder

What Is Obsessive-Compulsive Disorder?

Obsessive-compulsive disorder (OCD) is an anxiety disorder in which time people have
recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do
something repetitively (compulsions). The repetitive behaviors, such as hand washing, checking
on things or cleaning, can significantly interfere with a person’s daily activities and social
interactions.

Many people have focused thoughts or repeated behaviors. But these do not disrupt daily life and
may add structure or make tasks easier. For people with OCD, thoughts are persistent and
unwanted routines and behaviors are rigid and not doing them causes great distress. Many people
with OCD know or suspect their obsessions are not true; others may think they could be true
(known as poor insight). Even if they know their obsessions are not true, people with OCD have
a hard time keeping their focus off the obsessions or stopping the compulsive actions.
A diagnosis of OCD requires the presence of obsession and/or compulsions that are time-
consuming (more than one hour a day), cause major distress, and impair work, social or other
important function. About 1.2 percent of Americans have OCD and among adults slightly more
women than man are affected. OCD often begins in childhood, adolescence or early adulthood;
the average age symptoms appear is 19 years old.

o Obsessions and Compulsions

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 mind and are excessive or
unreasonable. Yet these intrusive thoughts cannot be settled by logic or reasoning. Most
people with OCD try to ignore or suppress such obsessions or offset them with some
other thought or action. Typical obsessions include excessive concerns about
contamination or harm, the need for symmetry or exactness, or forbidden sexual or
religious thoughts.

Compulsions
Compulsions are repetitive behaviors or mental acts that a person feels driven to perform
in response to an obsession. The behaviors are aimed at preventing or reducing distress or
a feared situation. In the most severe cases, a constant repetition of rituals may fill the
day, making a normal routine impossible. Compounding the anguish these rituals cause is
the knowledge that the compulsions are irrational. Although the compulsion may bring
some relief to the worry, the obsession returns and the cycle repeats over and over.

Some examples of compulsions:

o Cleaning to reduce the fear that germs, dirt, or chemicals will "contaminate" them some
spend many hours washing themselves or cleaning their surroundings. Some people
spend many hours washing themselves or cleaning their surroundings.
o Repeating to dispel anxiety. Some people utter a name or phrase or repeat a behavior
several times. They know these repetitions won’t actually guard against injury but fear
harm will occur if the repetitions aren’t done.
o Checking to reduce the fear of harming oneself or others by, for example, forgetting to
lock the door or turn off the gas stove, some people develop checking rituals. Some
people repeatedly retrace driving routes to be sure they haven’t hit anyone.
 o Ordering and arranging to reduce discomfort. Some people like to put objects, such as
books in a certain order, or arrange household items “just so,” or in a symmetric
fashion.
o Mental compulsions to response to intrusive obsessive thoughts, some people silently
pray or say phrases to reduce anxiety or prevent a dreaded future event.

o Treatment

Related Conditions
Other conditions sharing some features of OCD occur more frequently in family members of
OCD patients. These include, for example, body dysmorphic disorder (preoccupation with
imagined ugliness), hypochondriasis (preoccupation with physical illness), trichotillomania (hair
pulling), some eating disorders such as binge eating disorder, and neurologically based disorders
such as Tourette’s syndrome.

o Body Dysmorphic Disorder

o Hoarding Disorder
o Hair-Pulling Disorder (Trichotillomania)
o Skin-Picking Disorder (Excoriation)

Physician Review By:

Tristan Gorrindo, M.D.

Ranna Parekh, M.D., M.P.H.
July 2017

Expert Q & A: Obsessive-Compulsive Disorder

Find answers to your questions about Obsessive-Compulsive Disorder written by leading

psychiatrists.

View More

Patient Stories: Obsessive-Compulsive Disorder

Read patient stories about Obsessive-Compulsive Disorder and learn how to share your story.

View More
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