Obsessive-Compulsive Disorder: When Unwanted Thoughts or Repetitive Behaviors Take Over

Obsessive-compulsive disorder (OCD) is a common, long-lasting disorder characterized by uncontrollable, recurring thoughts (obsessions) that can lead people to engage in repetitive behaviors (compulsions). While everyone worries or double-checks things occasionally, the symptoms of OCD are severe, persistent, and can interfere with daily life, work, and relationships.

Signs and Symptoms

People with OCD may have symptoms of obsessions, compulsions, or both.

Obsessions (Recurring Thoughts)

Obsessions are repeated thoughts, urges, or mental images that cause anxiety. Common symptoms include:

• Fear of germs or contamination
• Unwanted, forbidden, or taboo thoughts involving sex, religion, or harm
• Aggressive thoughts towards others or self
• Having things symmetrical or in perfect order

Compulsions (Repetitive Behaviors)

Compulsions are repetitive behaviors that a person with OCD feels the urge to do in response to an obsessive thought. Common compulsions include:

• Excessive cleaning and/or handwashing
• Ordering and arranging things in a particular, precise way
• Repeatedly checking on things, such as seeing if the door is locked or the oven is off
• Compulsive counting

Risk Factors

OCD is a common disorder that affects adults, adolescents, and children worldwide. Most people are diagnosed by about age 19, typically with an earlier age of onset in boys than in girls. The exact cause of OCD is unknown, but risk factors include:

• Genetics: Study of family history shows that people with first-degree relatives (such as a parent or sibling) who have OCD are at a higher risk.
• Brain Structure and Functioning: Imaging studies have shown differences in the frontal cortex and subcortical structures of the brain in patients with OCD.
• Environment: An association between childhood trauma and obsessive-compulsive symptoms has been reported in some studies.

Treatments and Therapies

The first steps are usually talking with your doctor or a mental health professional about your symptoms. Treatments for OCD generally include medication, psychotherapy, or a combination of the two.

Psychotherapy

Psychotherapy can be an effective treatment for adults and children with OCD. Research shows that certain types of psychotherapy, including Cognitive Behavioral Therapy (CBT) and other related therapies (such as exposure and response prevention), are as effective as medication for many people.

Medication

Serotonin reuptake inhibitors (SRIs) and selective serotonin reuptake inhibitors (SSRIs) are used to help reduce OCD symptoms. Examples include fluoxetine, fluvoxamine, and sertraline. If symptoms do not improve with these types of medications, research suggests that some patients may respond well to antipsychotic medication.

Beyond Treatment: Things You Can Do

• Education: Learn about the disorder to understand symptoms and treatment options.
• Stress Management: Practice relaxation techniques and meditation.
• Support Groups: Connecting with others who have OCD can provide support and reduce feelings of isolation.
• Healthy Lifestyle: Proper sleep, exercise, and diet can support overall mental health.

Finding Help

If you or someone you know has symptoms of OCD, talk to a health care provider. You can also use the following resources:

• NIMH website: www.nimh.nih.gov
• MedlinePlus: https://medlineplus.gov
• Crisis Text Line: Text HOME to 741741
• 988 Suicide & Crisis Lifeline: Call or text 988

Note: This document is for informational purposes and is not a substitute for professional medical advice, diagnosis, or treatment.