Obsessive-Compulsive Disorder (OCD) is a mental health condition where a person experiences unwanted, repetitive thoughts, ideas, or images known as obsessions. To ease the discomfort caused by these thoughts, they may feel compelled to repeat certain behaviours or mental rituals called compulsions. These actions—like washing hands, checking things repeatedly, counting, or arranging objects—can take up significant time and interrupt daily life, work, and relationships.
Many people experience intrusive thoughts or repeated behaviours occasionally, but in OCD, these thoughts are persistent, intrusive, and difficult to control. The compulsions also tend to be rigid and time-consuming. Even when someone recognizes that their thoughts may not be realistic, they often feel unable to stop the cycle.
A diagnosis usually requires obsessions and compulsions that consume more than an hour a day, cause distress, and interfere with day-to-day functioning. OCD can begin in childhood, adolescence, or early adulthood, and affects both men and women.
Obsessions
Obsessions are repeated, intrusive thoughts or mental images that trigger intense feelings such as fear, anxiety, guilt, or disgust. People with OCD often know these thoughts are created by their own mind but still find them deeply distressing. They may try to neutralize or escape them through compulsive behaviour or distraction, but the relief is temporary.
Common obsession themes include:
Fear of contamination through people or objects
Intrusive sexual thoughts or images
Disturbing religious or moral fears
Fear of harming oneself or loved ones
Worry that something is incomplete or incorrect
Extreme focus on order, symmetry, or precision
Fear of losing or throwing away something important
Random intrusive sounds, words, or images with no clear meaning
Compulsions
Compulsions are repeated behaviours or mental actions someone feels pressured to perform in response to an obsession. These rituals temporarily reduce anxiety, reinforcing the cycle and making the behaviour more likely to continue. In severe cases, compulsions can consume large portions of the day.
Examples of compulsions:
Excessive or ritualistic washing, showering, or grooming
Repetitive cleaning of household items
Placing or arranging objects in a precise way
Repeatedly checking locks, appliances, or switches
Constant reassurance-seeking
Counting or repeating actions a certain number of times
Avoiding specific situations, people, or places that may trigger anxiety
Avoidance may provide short-term comfort but can worsen symptoms and impact functioning over time.
Treatment Options
With proper care, many individuals experience significant improvement and are able to live more fulfilling lives. Treatment may help restore routine functioning, relationships, and overall emotional well-being.
1. Cognitive Behavioural Therapy (CBT – Exposure and Response Prevention)
A highly effective treatment for OCD is a specialised form of CBT called Exposure and Response Prevention (ERP). In ERP, individuals gradually face the situations that trigger their obsessions while resisting the urge to perform their usual compulsions. Over time, they learn that the feared consequences do not occur and that anxiety naturally reduces. ERP is usually done step-by-step, starting with situations that cause mild anxiety and slowly progressing to more challenging ones.
Although ERP can initially increase anxiety, it is considered one of the most effective therapies for OCD.
2. Medication
Selective Serotonin Reuptake Inhibitors (SSRIs)—commonly used for depression—are also effective for OCD. Doses for OCD are often higher and may take several weeks to show full benefit. Some people respond better to one medication than another, and treatment choices may depend on the individual’s symptoms, preferences, and other health conditions.
Often, a combination of CBT and SSRIs is recommended, especially for moderate to severe OCD.
3. Neurosurgical Treatments
For individuals who do not respond to therapy or medication, advanced treatments may be considered. Procedures like gamma ventral capsulotomy or deep brain stimulation (DBS) have shown promise in severe cases, although they are typically reserved for individuals with significant impairment. DBS is less permanent than surgical methods but requires ongoing specialized medical care.
Supporting a Loved One with OCD
Support from family members, partners, or caregivers can make a meaningful difference. Helping with exposure exercises or providing encouragement without reinforcing compulsions often contributes to better treatment outcomes.
Self-Care and Lifestyle Support
Healthy routines can make coping with OCD easier. Good sleep, balanced nutrition, physical exercise, and quality time with loved ones support emotional well-being. Relaxation techniques like meditation, yoga, or visualization may also help reduce stress (outside of ERP sessions).
Related Conditions
Some conditions often appear alongside or are closely connected to OCD, such as:
Hoarding Disorder
Body Dysmorphic Disorder
Trichotillomania (Hair-Pulling Disorder)
Excoriation (Skin-Picking) Disorder
FAQs
Early signs usually include recurring intrusive thoughts, excessive worries, and repetitive behaviours such as checking, cleaning, or counting. These actions often feel impossible to control and may start interfering with daily life.
OCD typically does not go away without treatment. Symptoms may reduce temporarily but often return or become stronger. Therapy and medication can significantly improve long-term outcomes.
Exposure and Response Prevention (ERP), a type of Cognitive Behavioural Therapy (CBT), is considered the most effective treatment. Many people also benefit from medications like SSRIs or a combination of both.
Offer emotional support, encourage treatment, and avoid participating in compulsions. Patience and understanding can make the recovery process easier.