Obsessive compulsive disorder (OCD)
Obsessive compulsive disorder (OCD) is an anxiety disorder involving distressing thoughts and repetitive behaviours.
*Last updated: 15 February 2022
Anyone can have OCD. It typically starts during early adulthood but can begin at any age. It can be distressing, time-consuming and interfere with your daily life.
What are the symptoms of OCD?
OCD involves both obsessions and compulsions.
Obsessions are unwanted and unpleasant thoughts or images which come into your mind repeatedly. They can feel like a stuck record and trying to resist them can make them worse.
Compulsions are repetitive actions or thoughts you feel you have to do, often until they feel 'right'. The aim of a compulsion is to try to relieve the anxiety or distress caused by the obsessive thoughts.
Common obsessions include:
- fear of contamination
- fear of causing harm to someone else
- needing things to be balanced or in the right order
- intrusive thoughts or images that may be violent, blasphemous or taboo.
Compulsions commonly involve:
- checking things repeatedly – this could include checking the oven is off, looking up health symptoms online or making sure you have your keys on you
- cleaning things excessively
- counting to a particular number or going through a sequence of numbers
- carrying something out in a particular order or pattern, or a certain number of times
- asking people for reassurance or to check things for you.
Compulsions can be very time-consuming but usually only provide temporary relief from the anxiety.
OCD may make you feel scared, disgusted, tearful or depressed. You may worry you’re going mad or that you’re a bad person because of the thoughts you have. It’s important to recognise that OCD is nothing to be embarrassed or ashamed about. There are effective treatments that can reduce the impact it has on your life.
What causes OCD?
While the exact causes of OCD aren’t yet fully understood, it’s likely there are many different factors that can lead to it. These include:
- family history – if a relative has OCD, you may be more at risk of developing it. This could be because you’ve learned compulsive behaviours as a coping mechanism from them.
- stressful life events such as being bullied, abused or experiencing trauma. OCD may also develop after significant life events such as childbirth or a bereavement.
- differences in the brain – some people with OCD may have lower levels of the chemical serotonin, or areas of increased brain activity.
- personality – neat, meticulous people with high standards may be more likely to develop OCD. People who are anxious or have a strong sense of responsibility may also be more at risk.
We all have worries and anxieties at times, and may have mild compulsions or superstitions (such as not stepping on the cracks in the pavement). However if your thoughts or compulsions seem excessive, cause you distress or affect your ability to carry out your daily life, it’s important to ask for help. OCD rarely goes away by itself but there are effective treatments.
Start by talking to your GP. They may offer you talking therapy, medication or both. Or you may be referred to a specialist OCD service if your OCD is severe. The right help for you will depend on how intense your OCD is and how much it affects your life.
Your GP may offer you self-help resources such as books from the Reading Well scheme called ‘Books on Prescription’. You can find these books yourself in a library or bookshop – you don’t actually need a prescription for them.
OCD-UK has a range of self-help resources including books, discussion forums and online courses.
Your GP can refer you for therapy or you can refer yourself.
Therapy for OCD is usually a type of Cognitive Behavioural Therapy (CBT). There are two types of CBT used with OCD.
- Exposure and response prevention (ERP). This encourages you to face your fear and let the obsessive thoughts occur without performing your usual compulsions. It helps you learn that your anxious or uncomfortable feelings will go away by themselves. It may sound difficult but you can take it at your own pace.
- Cognitive therapy (CT). This helps you change your reaction to your thoughts. Instead of fighting them, you’ll learn to just let them happen. They will often fade away when you stop trying to make them go.
You may be offered a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI). This can improve OCD symptoms by increasing the level of serotonin in your brain.
Specialist OCD services
If your OCD is severe and talking therapy and medication haven’t worked, you may be referred to a specialist service. OCD-UK has more information about these services.