Obsessive Compulsive Disorder
Learn more about OCD and find professional help.
Obsessive compulsive disorder (OCD) is understood as an anxiety disorder, recognised by obsessive thoughts and compulsive behaviours. While anxiety can be harnessed positively as a survival instinct, many individuals suffer with debilitating anxiety problems. Obsessive thoughts, urges, or images can often be unwanted yet feel uncontrollable. Compulsive behaviours alleviate anxieties caused by the particular obsession by behaving in a certain way.
For example, an individual may wish to wash their hands, becoming anxious that it must be done. The compulsion involves washing their hands in order to alleviate the anxiety they feel. For this behaviour to constitute as part of OCD, it must be disruptive to everyday functioning and an inability to mentally control the obsession, such as washing for very long periods of time so that the skin becomes irritated, ensuring that hands are washed before touching anything, or washing so much that appointments are missed.
What are the signs and symptoms of OCD?
The severity of OCD has great scope. It can be slight and not interfere too much with everyday life, but can also be extremely severe and thus take over everyday life. Sufferers may try to resist or ignore an obsession, but this can lead to high levels of anxiety and stress until the obsession is acted upon.
Some examples of obsessions are:
● Excessive doubts
● Fearing contamination
● Superstitious thoughts
● Imagining doing harm
● A fear of failing to prevent harm
● ‘Forbidden’ thoughts
Some examples of compulsions are:
● Ordering items
● Arranging items
● Repeating actions
● Focusing on the number of times to conduct behaviours
● Throwing things away
How common is OCD?
OCD can affect individuals of all genders, backgrounds, ethnicities, and ages. It is estimated that between 1-3% of the population have OCD. The common onset of OCD is early adulthood before the age of 25 years-old. It is less common for OCD symptoms to emerge after this point.
What are the causes of OCD?
There are many known causes of OCD and a range of models that can be used to understand its development. In many cases of OCD, there are a number of contributing factors that can lead to its development.
Negative life experiences may contribute to the development of OCD, including physical illness, loss of a loved one, war experience, over protection, physical, sexual, and emotional abuse, and other traumas. If these experiences are left emotionally unresolved, this can often lead to mental ill health. In such traumatic experiences, the individual may have felt a sense of having limited or no control. OCD may then develop as a complex result of the individual attempting to regain control over their life, body, or environment.
OCD can also be linked with other mental health issues, including depression, other anxiety disorders, eating disorders, body dysmorphic disorder, and substance misuse. This supports the idea that OCD can be connected to underlying issues and past experiences. Environmental factors may also enhance an existing anxiety problem such as poor social support and stress.
Many individuals may not be able to identify a specific cause of their OCD, with research suggesting that these individuals may have suppressed memories into their subconscious mind and therefore do not consciously know why their anxiety disorder has developed.
Find a counsellor or psychologist specialising in OCD here
Misunderstandings and stigma surrounding OCD
Most individuals will have experience slighter variations of the symptoms of OCD, such as unwanted thoughts or a sense of order and organisation. However, this does not become obsessive or compulsive for many.
Despite this link existing between sufferers and non-sufferers, there are many misunderstandings about OCD among the general public. Some people may find compulsions to be unnecessary, such as checking a door is locked 5 times. However, it is important to understand that without checking the door is locked 5 times, the individual with OCD may feel extremely anxious.
Criticisms, impatience, and generally negative comments will not be helpful to those with OCD. It is important to remember that the individual has OCD for a reason and that it is a mental health problem. Individuals do not choose to develop OCD and many cannot imagine life without their anxiety disorder.
It is also important to not normalise compulsions by helping an OCD sufferer in their rituals or routines. Encouraging the individual to seek treatment is often the most effective way to help a person with OCD.
People with OCD may also feel ashamed and embarrassed about their condition and thus find it difficult to discuss with others.
What are the diagnostic criteria for OCD?
The UK diagnostic system (ICD-10) suggest for a diagnosis, ‘obsessive symptoms and/or compulsive acts must be present on most days for at least 2 successive weeks and be a source of distress or interference with activities'.
The obsessive symptoms should have the following characteristics:
● They must be recognised as the individual's own thoughts or impulses.
● There must be at least one thought or act that is still resisted unsuccessfully, even though others may be present which the sufferer no longer resists.
● The thought of carrying out the act must not in itself be pleasurable (simple relief of tension or anxiety is not regarded as pleasure in this sense.)
● The thoughts, images, or impulses must be unpleasantly repetitive.
Discussions have also focused on whether behaviours such as nail biting, hair pulling (Trichotillomania), or scab picking (Dermatillomania) should be classified as OCD.
What is the risk if OCD is left untreated?
If OCD is left untreated, symptoms of the condition may worsen and other mental health problems may develop. OCD can lead to significant difficulties in relation to an individual’s interpersonal relationships, occupation, and everyday functioning. OCD can become more severe over time without treatment, with more rituals and routines developing. Individuals suffering with symptoms should seek help and not delay treatment.
Treatment for OCD has a high success rate. Research, experiments, and clinical practice have led to the development of many evidence-based treatments that can result in an alleviation of symptoms and improvement in mental health.
Recommended intervention for OCD
Research suggests that the best approach to treatment for OCD is almost always psychology based. Anti-anxiety medication can ease symptoms in some cases, but some suggest that they do not alleviate the problem and are therefore not an effective treatment exclusively. Because OCD often impacts on families and carers, interventions may be more effective when involving families and carers in the recovery process.
Evidence-based treatment for OCD
There are many evidence based treatments available for individuals with OCD. Many people benefit from one or a combination of these approaches:
Cognitive behavioural therapy explores your thoughts, feelings, and behaviours around obsessions and compulsions. Practical solutions to effectively deal with the anxiety disorder are developed.
Exposure response therapy involves exposing the individual to the obsession and asking them to gradually refrain from the compulsive behaviour that usually follows. With time, the individual will come to learn that their anxiety can be controlled without needing to carry out the compulsion. This can seem daunting to many individuals, and a therapist will work with a client to work on exposure at their own pace.
Mindfulness and learning relaxation techniques can also be helpful. These can boost personal awareness and allow individuals to develop calming coping styles. Family therapy can also be beneficial, with many sufferers finding that OCD can cause problems within their family. If those surrounding you better understand your anxiety disorder, this can positively impact your recovery and allow families to support each other and feel involved in your journey to recovery.
Pharmacological approaches can also be used to alleviate symptoms of OCD, such as anti-anxiety medication.
Advice for breaking the cycle
Individuals with OCD can try self-control methods to help ease their anxieties. Test yourself so that when you experience obsessions or urges, you can shift your behaviour to something other than the desired compulsion.
Examples of self-control methods include:
● Playing a game
● Playing an instrument
● Making a phone call
Carry out the method of self-control for as long as possible. Practising these self-control methods to distract yourself and delay or avoid the compulsion may be a helpful step to take.
Resources for OCD
When you feel ready to seek help, there are many ways in which to access support and advice.
It may be worthwhile reading a self-help book. Some titles include:
● The OCD Workbook: Your Guide to Breaking Free from Obsessive-Compulsive Disorder Bruce Hyman and Cherlene Pedrick (2010).
● Helen Kennerley, Overcoming Anxiety - A Self-Help Guide (1997).
● Emma Fletcher and Martha Langley. Free Yourself from Anxiety: A self-help guide to overcoming anxiety disorders (2008).
NHS help website:
NHS telephone number:
NHS Direct- 0845 4647
There are now many counselling and therapeutic services and organisations available. Trained professionals will be able to support you, including psychotherapists, psychiatrists, counsellors, and psychologists.
Here are details of available services:
The NHS - visiting your GP and requesting a referral to meet with a specialist.
Charities - (including MIND, Young Minds, the Mental Health Foundation, and Rethink) these organisations can provide access to therapy, support groups, and advice within your local area. See their websites for more details and information.
Counselling and psychotherapy clinics and services - search online directories like this one or contact your local council for a list of organisations that can provide therapeutic help.
A healthcare professional may invite you to undertake an initial assessment. This will include asking a few questions to identify any problems, issues, and causes you may be experiencing. It helps to be open and honest when giving your answers. The person asking you questions wants to understand your situation and help in any way they can.