OCD

Have you ever double-checked whether you locked the door? Or maybe you have felt uneasy until your phone was placed just right on the table.

Obsessive-Compulsive Disorder (OCD) is one of the most misunderstood mental health conditions out there. Many people casually say, “I’m so OCD about my desk” or “I need my room clean—it’s my OCD”. And it is more than just organizing things or typical worrying.

What is OCD?

Obsessive-compulsive disorder (OCD) features a pattern of unwanted thoughts (obsessions) and repetitive behaviors (compulsion). It affect everyone - men, women, children, people from all cultures and races [1].

Obsessions: Lasting and unwanted thoughts or urges that won’t go away causing anxiety. Obsessions feel intrusive, often bizarre.

Compulsions: Repetitive behaviors people feel forced to perform to reduce the anxiety caused by obsessions. At first, these behaviors feel like they offer relief, but soon they become exhausting, time-consuming, and impossible to control.

The OCD Cycle

First, an obsession pops into the mind suddenly which is hard to control. It triggers overwhelming anxiety causing distress. The discomfort increases as one tries to ignore the thought. To ease this, a behavior or ritual is performed which reduces anxiety for a little while. This relief reinforces the cycle, making it more likely the person will repeat the obsession → anxiety → compulsion pattern the next time they face a trigger.

For example, being overly fearful of getting contaminated by germs (obsession). To ease contamination fears, you may wash your hands over and over again until they're sore and chapped (compulsion). [2]

Symptoms

OCD symptoms vary from person to person, but they usually include both obsessions and compulsions.

    Obsessions:

• Fear of being contaminated by touch or touching objects others have touched. [2]
• Fear of causing harm to yourself or someone else. [3]
• Constant doubts like have you locked the door or turned off the stove.
• Intense stress when objects aren't orderly or facing a certain way. [2]
• Excessive concerns with morality. [3]
• Unpleasant sexual images. [2]
• Need for constant reassurance. [3]

These repetitive behaviors or mental acts are meant to reduce anxiety related to your obsessions or prevent something bad from happening. 

    Compulsions:

• Excessive hand-washing
• Repeated checking of locks, stoves, or appliances
• Counting or tapping in specific patterns
• Silent prayers or phrases to neutralize "bad" thoughts
• Arranging your canned goods to face the same way. [2]
• Avoiding situations that may trigger obsessions

OCD is usually a life-long (chronic) condition, but symptoms can come and go over time. They generally get worse when you are under greater stress, including times of transition and change. [2]

Causes

Obsessive-Compulsive Disorder doesn’t have a single, clear cause. Instead, it often results from a combination of factors—ranging from brain chemistry to life experiences.

Cognitive factors

• Brain imaging studies show differences in certain areas of the brain—especially the frontal cortex and subcortical regions—which are involved in decision-making, impulse control, and habit formation.
• OCD tends to overlap with other mental health conditions like anxiety disorders (such as generalized anxiety or social anxiety) and mood disorders like depression and bipolar disorder.
• Some individuals develop OCD after traumatic brain injuries. Studies have shown that a sudden onset of OCD symptoms can occur within days or months after such injuries.
• People with OCD often struggle with dysfunctional thinking patterns, such as extreme perfectionism, excessive doubt, or the need for certainty which can both trigger and maintain the cycle of obsessions and compulsions.

Genetics

• People with a family history of OCD (especially a parent or sibling) are at a higher risk of developing it.
• However, genetics alone don’t determine whether someone will have OCD—environmental factors and learned behaviors are important too.

Learned Behavior

• Someone repeatedly using compulsive actions to reduce anxiety or distress, creates a reinforcement loop i.e. the temporary relief, making it more likely that they’ll repeat the behavior again.
• Watching family members with OCD can also play a role. For example, a child may observe a parent constantly checking locks or washing hands, and gradually begin to adopt those same behaviors, thinking they are “normal” or necessary.

Stressful event

• Experiencing childhood trauma, such as abuse, neglect, or bullying, may increase the risk of developing OCD later in life.
• Shame-inducing situations, including overly critical parenting or repeated experiences of embarrassment, may also set the stage for obsessive-compulsive tendencies.
• OCD symptoms have even been linked to physical conditions like stroke, brain tumors, and Parkinson’s Disease in some cases.

Effects:

OCD doesn’t just affect thoughts—it can impact almost every part of life. Here are some of the most common effects people experience due to OCD:

• Excessive time spent on compulsions and rituals, often taking hours out of the day (Example: Repeated handwashing, checking locks, or counting routines). This can also lead to health problems. (Example: Contact dermatitis from frequent hand-washing).
• Difficulty attending school, college, or work. We all find it hard to focus at times. But OCD can amplify this, causing productivity rates to drop and making the simplest of tasks far more challenging. [4]
• Loved ones may not fully understand OCD, leading to conflicts or distancing. Constant reassurance-seeking can strain family, friendships, or romantic relationships. Also, parents with OCD may find it difficult to give their full attention to children.
• Reduced quality of life as OCD can interfere with hobbies, leisure activities, and social life. Many people report feeling “trapped” in their compulsions and are unable to fully enjoy everyday moments.
• OCD can lead to depression, emotional burnout, and even suicidal thoughts or behaviors in severe cases.
• OCD can also cause related disorders such as trichotillomania (compulsive hair-pulling, often from the scalp, eyebrows, or other body areas) and excoriation (compulsive skin-picking, sometimes causing bleeding or scarring). These behaviors are often used to cope with stress or anxiety.

How to treat OCD?

OCD isn’t something you have to face alone. There are effective treatments available — many people with OCD see significant improvements through therapy, self-care, and community support.

Psychotherapy (Talk Therapy):

Psychotherapy involves working with a trained mental health professional to help identify and change harmful thoughts, emotions, and behaviors. The most common approaches for OCD include:

Cognitive Behavioral Therapy (CBT):

CBT helps you recognize the patterns of your thoughts and behaviors. Over time, it teaches you how to break out of negative thinking cycles and replace them with healthier coping strategies.

Exposure and Response Prevention (ERP):

ERP is a specialized form of CBT. Here, a therapist will gently guide you to face your feared thoughts or situations without performing compulsions.
For example: You might be asked to touch something “contaminated” but then avoid washing your hands afterward. This helps retrain your brain to realize that the fear isn’t as dangerous as it feels [3].

Acceptance and Commitment Therapy (ACT):

ACT focuses on helping you accept your intrusive thoughts instead of fighting them. The goal is to reduce their power over your actions, allowing you to live a fulfilling life despite them.

Resources:

[1] What is OCD? | APA

[2] Obsessive-compulsive disorder (OCD) - Symptoms and causes - Mayo Clinic

[3] Obsessive-Compulsive Disorder (OCD) - Types, Symptoms, Treatment and Prevention

[4] What to Know About OCD: Symptoms, Causes, Treatment | Psych Central