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What is OCD?

Obsessive compulsive disorder (OCD) is an anxiety disorder. It has two main parts: obsessions and compulsions.

"It's not about being tidy, it's about having no control over your negative thoughts. It's about being afraid not doing things a certain way will cause harm."

You might find that sometimes your obsessions and compulsions are manageable and other times they are impossible to live with. They may be more severe when you are stressed about other things like work, university or relationships.

If you experience OCD during pregnancy or after birth, you might get diagnosed with antenatal or postnatal OCD.

What's it like to live with OCD?

Although many people experience minor obsessions (such as worrying about leaving the gas on, or if the door is locked) and compulsions (such as avoiding the cracks in the pavement), these don’t significantly interfere with daily life, or are short-lived.

If you experience OCD, it's likely that your obsessions and compulsions will have a big impact on how you live your life:

“I knew it was irrational...but tapping certain objects would ease the effect of the terrible intrusive thoughts. It would be time consuming but at least then I could feel like I wasn't a bad person.”

Related disorders

There are some other mental health problems that are similar to OCD because they involve repetitive thoughts, behaviours or urges. They are sometimes called habit disorders.

Comorbidity (having more than one diagnosis at the same time) with OCD is common, but it can sometimes make OCD difficult to diagnose and treat. For example, if you experience OCD you might be living with other mental health problems as well, such as anxiety or depression.

Experiences of facing stigma

Lots of people have misconceptions about OCD. Some people think it just means you wash your hands a lot or you like things to be tidy. They might even make jokes about it. This can be frustrating and upsetting, especially if people who think this are friends or family, colleagues or even healthcare professionals. Stigma can make OCD feel difficult to talk about but it's important to remember you are not alone.

“One of the most difficult things about OCD is how people perceive it. Intrusive thoughts and compulsions take a greater toll, yet people don't seem to understand that.”

What are the symptoms of OCD?

Obsessions

Obsessions are persistent thoughts, pictures, urges or doubts that appear in your mind again and again. They interrupt your thoughts against your control and can be really frightening, graphic and disturbing. They may make you feel anxious, disgusted or 'mentally uncomfortable'.

You might feel you can't share them with others or that there is something wrong with you that you have to hide. You do not choose to have obsessions - but you might feel upset that you are 'capable' of having such thoughts.

Remember: Obsessions are not a reflection of your personality. People with OCD are very unlikely to act on their thoughts because they find them so distressing and repugnant. There are no recorded cases of a person with OCD carrying out their obsession.

“I get unwanted thoughts all through the day, which is very distressing and affects my ability to interact with others and concentrate on my studies.”

Type of obsession

Examples include


Fear of causing or failing to prevent harm

 

  • Worrying you've already harmed someone by not being careful enough. For example, that you have knocked someone over in your car.
  • Worrying you're going to harm someone because you will lose control. For example, that you will push someone in front of a train or stab them.


Intrusive thoughts, images and impulses

 

 

 

  • Violent intrusive thoughts or images of yourself doing something violent or abusive. These thoughts might make you worry that you are a dangerous person.
  • Religious or blasphemous thoughts that are against your religious beliefs.
  • Relationship intrusive thoughts often appear as doubts about whether a relationship is right or whether you or your partner's feelings are strong enough. They might lead you to end your relationship to get rid of the doubt and anxiety.
  • Sexual intrusive thoughts or images. These could be related to children, family members or to sexually aggressive behaviour. You might worry that you could be a paedophile or a rapist, or that you are sexually attracted someone in your family.


Fear of contamination

 

  • Contamination (for example by dirt, germs or faeces). You might worry that you have been contaminated and that you - or other people - are spreading the contamination. You might worry that you have or might get a disease.
  • Mental contamination. You might experience uncomfortable feelings of 'internal uncleanliness'.


Fears and worries related to order or symmetry

  • You might have a fear that something bad will happen if everything isn't 'right' - for example if things are not clean, in order or symmetrical.

Intrusive sexual thoughts may lead you to constantly monitor and check your genitals. This attention and the anxiety you are feeling may actually increase blood flow and physical arousal. This can make you feel as if you are aroused by the intrusive thoughts when in fact the opposite is true. Many people with this type of OCD call this 'groinal response'.

You might experience more than one type of obsession. They are often linked together. For example you might experience a fear of contamination and a fear of doing someone harm by accidentally making them ill. You can read more about the different types of obsessions on OCD UK's website.

“I would seek medical reassurance online and for a day or so I could breathe a sigh of relief... but then the doubt would set in and I started the process again.”

Compulsions

Compulsions are repetitive activities that you feel you have to do. The aim of a compulsion is to try and deal with the distress caused by obsessive thoughts. You might have to continue doing the compulsion until the anxiety goes away and things feel right again. You might know that it doesn't make sense to carry out a compulsion - but it can still feel too scary not to. Repeating compulsions is often very time consuming and the relief they give you doesn't usually last very long.

Compulsions can:

Type of compulsion

Examples include


Rituals

 

 

  • Washing your hands, body or things around you a lot
  • Touching things in a particular order or at a certain time
  • Arranging objects in a particular way


Checking

 

 

  • Doors and windows to make sure they are locked
  • Your body or clothes for contamination
  • Your body to see how it responds to intrusive thoughts
  • Your memory to make sure an intrusive thought didn't actually happen
  • Your route to work to make sure you didn't cause an accident


Correcting thoughts

 

  • Repeating a word, name or phrase in your head or out loud
  • Counting to a certain number
  • Replacing an intrusive thought with a different image


Reassurance

  • Repeatedly asking other people to tell you that everything is alright

Avoidance

You might find that some activities, objects or experiences make your obsessions or compulsions worse. For example if you are worried that you might stab someone then you might avoid the kitchen because you know there are knives there. Sometimes it might feel easier to avoid situations that mean you have to do a compulsion. For example if you have to do a long and time consuming ritual every time you leave the house, you might just decide it's easier to stay indoors. But avoiding things can have a major impact on your life. Getting ready involves so much hand washing and so many mental rituals. Sometimes, I feel like staying in bed and avoiding the day.

What is 'Pure O'?

Pure O stands for 'purely obsessional'. People sometimes use this phrase to describe a type of OCD where they experience distressing intrusive thoughts but there are no external signs of compulsions (for example checking or washing). The name is slightly misleading as it suggests that there are no compulsions at all.

If you have 'Pure O' you will still experience mental compulsions - but you might not be aware of them. Because they are not as obvious as physical compulsions it can sometimes be difficult to define exactly what these compulsions are.

Here are some examples of internal compulsions:

What treatment is there?

The sort of treatment you're offered for depression will depend on:

The main treatments for OCD are:

How do I receive support?

Please click here to refer yourself to our service.

 

** Information in this section is kindly provided by the mental health charity MIND **