Obsessive-compulsive disorder is a mental disorder whose main symptoms include obsessions and compulsions, driving the person to engage in unwanted, oftentimes distress behaviors or thoughts. It is treated through a combination of psychiatric medications and psychotherapy.
Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by recurrent and disturbing thoughts (called obsessions) and/or repetitive, ritualized behaviors that the person feels driven to perform (called compulsions). Obsessions can also take the form of intrusive images or unwanted impulses. The majority of people with OCD have both obsessions and compulsions, but a minority (about 20 percent) have obsessions alone or compulsions alone (about 10 percent).
The person with OCD usually tries to actively dismiss the obsessions or neutralize them by engaging in compulsions or avoiding situations that trigger them. In most cases, compulsions serve to alleviate anxiety. However, it is not uncommon for the compulsions themselves to cause anxiety — especially when they become very demanding.
A hallmark of OCD is that the person recognizes that their thoughts or behaviors are senseless or excessive.
However, the drive can be so powerful that the person caves in to the compulsion even though they know it makes no sense. One woman spent hours each evening sifting through the household trash to ensure that nothing valuable was being discarded. When asked what she was looking for, she nervously admitted, “I have no idea, I don’t own anything valuable.”
Some people who have had OCD for a long time may stop resisting their compulsive drives because they feel it’s just easier to give in to them.
Most OCD sufferers have multiple types of obsession and compulsion. Someone with OCD may complain primarily of obsessive-compulsive symptoms involving asbestos contamination, but a detailed interview may disclose that he/she silently counts floor tiles and hoards junk mail.
Learn more: Frequently Asked Questions and Do I Have OCD?
Examples of Obsessions
Common types of obsessions include concerns with contamination (e.g., fear of dirt, germs or illness), safety/harm (e.g., being responsible for a fire), unwanted acts of aggression (e.g., unwanted impulse to harm a loved one), unacceptable sexual or religious thoughts (e.g., sacrilegious images of Christ) and the need for symmetry or exactness.
Examples of Compulsions
Common compulsions include excessive cleaning (e.g., ritualized hand washing); checking, ordering, and arranging rituals; counting; repeating routine activities (e.g., going in/out of a doorway) and hoarding (e.g., collecting useless items). While most compulsions are observable behaviors (e.g., hand washing), some are performed as unobservable mental rituals (e.g., silent recitation of nonsense words to vanquish a horrific image).