Overview
Obsessive-compulsive disorder (OCD) features a pattern of unwanted
thoughts and fears (obsessions) that lead you to do repetitive behaviors
(compulsions). These obsessions and compulsions interfere with daily
activities and cause significant distress.
You may try to ignore or stop your obsessions, but that only increases
your distress and anxiety. Ultimately, you feel driven to perform
compulsive acts to try to ease your stress. Despite efforts to ignore or
get rid of bothersome thoughts or urges, they keep coming back. This
leads to more ritualistic behavior — the vicious cycle of OCD.
OCD often centers around certain themes — for example, an excessive fear
of getting contaminated by germs. To ease your contamination fears, you
may compulsively wash your hands until they're sore and chapped.
If you have OCD, you may be ashamed and embarrassed about the condition,
but treatment can be effective.
Symptoms
Obsessive-compulsive disorder usually includes both obsessions and
compulsions. But it's also possible to have only obsession symptoms or
only compulsion symptoms. You may or may not realize that your
obsessions and compulsions are excessive or unreasonable, but they take
up a great deal of time and interfere with your daily routine and
social, school or work functioning.
Obsession symptoms
OCD obsessions are repeated, persistent and unwanted thoughts, urges or
images that are intrusive and cause distress or anxiety. You might try
to ignore them or get rid of them by performing a compulsive behavior or
ritual. These obsessions typically intrude when you're trying to think
of or do other things.
Obsessions often have themes to them, such as:
Fear of contamination or dirt
Doubting and having difficulty tolerating uncertainty
Needing things orderly and symmetrical
Aggressive or horrific thoughts about losing control and harming
yourself or others
Unwanted thoughts, including aggression, or sexual or religious subjects
Examples of obsession signs and symptoms include:
Fear of being contaminated by touching objects others have touched
Doubts that you've locked the door or turned off the stove
Intense stress when objects aren't orderly or facing a certain way
Images of driving your car into a crowd of people
Thoughts about shouting obscenities or acting inappropriately in public
Unpleasant sexual images
Avoidance of situations that can trigger obsessions, such as shaking hands
Compulsion symptoms
OCD compulsions are repetitive behaviors that you feel driven to
perform. These repetitive behaviors or mental acts are meant to reduce
anxiety related to your obsessions or prevent something bad from
happening. However, engaging in the compulsions brings no pleasure and
may offer only a temporary relief from anxiety.
You may make up rules or rituals to follow that help control your
anxiety when you're having obsessive thoughts. These compulsions are
excessive and often are not realistically related to the problem they're
intended to fix.
As with obsessions, compulsions typically have themes, such as:
Washing and cleaning
Checking
Counting
Orderliness
Following a strict routine
Demanding reassurance
Examples of compulsion signs and symptoms include:
Hand-washing until your skin becomes raw
Checking doors repeatedly to make sure they're locked
Checking the stove repeatedly to make sure it's off
Counting in certain patterns
Silently repeating a prayer, word or phrase
Arranging your canned goods to face the same way
Severity varies
OCD usually begins in the teen or young adult years, but it can start in
childhood. Symptoms usually begin gradually and tend to vary in severity
throughout life. The types of obsessions and compulsions you experience
can also change over time. Symptoms generally worsen when you experience
greater stress. OCD, usually considered a lifelong disorder, can have
mild to moderate symptoms or be so severe and time-consuming that it
becomes disabling.
When to see a doctor
There's a difference between being a perfectionist — someone who
requires flawless results or performance, for example — and having OCD.
OCD thoughts aren't simply excessive worries about real problems in your
life or liking to have things clean or arranged in a specific way.
If your obsessions and compulsions are affecting your quality of life,
see your doctor or mental health professional.
Request an Appointment at Mayo Clinic
Causes
The cause of obsessive-compulsive disorder isn't fully understood. Main
theories include:
Biology. OCD may be a result of changes in your body's own natural
chemistry or brain functions.
Genetics. OCD may have a genetic component, but specific genes have yet
to be identified.
Learning. Obsessive fears and compulsive behaviors can be learned from
watching family members or gradually learned over time.
Risk factors
Factors that may increase the risk of developing or triggering
obsessive-compulsive disorder include:
Family history. Having parents or other family members with the disorder
can increase your risk of developing OCD.
Stressful life events. If you've experienced traumatic or stressful
events, your risk may increase. This reaction may, for some reason,
trigger the intrusive thoughts, rituals and emotional distress
characteristic of OCD.
Other mental health disorders. OCD may be related to other mental health
disorders, such as anxiety disorders, depression, substance abuse or tic
disorders.
Complications
Problems resulting from obsessive-compulsive disorder may include, among
others:
Excessive time spent engaging in ritualistic behaviors
Health issues, such as contact dermatitis from frequent hand-washing
Difficulty attending work, school or social activities
Troubled relationships
Overall poor quality of life
Suicidal thoughts and behavior
Prevention
There's no sure way to prevent obsessive-compulsive disorder. However,
getting treatment as soon as possible may help prevent OCD from
worsening and disrupting activities and your daily routine.