What is OCD?

Obsessive-compulsive disorder (OCD) entails unwanted thoughts (obsessions) leading to repetitive behaviors (compulsions), disrupting daily life and causing distress. Individuals with OCD feel compelled to perform compulsive acts to alleviate stress, perpetuating the OCD cycle. Themes often include specific fears, like germ contamination, leading to ritualistic behaviors. Despite feelings of shame, effective treatment options exist.

What causes OCD?

Risk of developing Obsessive-compulsive Disorder (OCD) may be caused by


Having parents or other family members with the disorder can increase the risk of developing OCD.

Brain changes

Imaging studies have shown differences in the frontal cortex and subcortical structures of the brain in people who have OCD. OCD is also associated with other neurological conditions that affect similar areas of your brain, including Parkinson’s disease, Tourette’s syndrome and epilepsy.

PANDAS Syndrome

PANDAS Syndrome (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections) describes a group of conditions that can affect children who have had strep infections such as strep throat or scarlet fever. OCD is included in these conditions

Childhood trauma

Some studies show an association between childhood trauma, such as abuse or neglect, and the development of OCD.

Symptoms of OCD

Obsessive-compulsive Disorder (OCD) may have symptoms of obsessions, compulsions, or both.


OCD obsessions involve persistent, unwanted thoughts, intrusive urges, or images that repeatedly return and cause distress. Individuals may attempt to ignore or eliminate them through ritualistic behaviors. These obsessions often disrupt thoughts or actions unrelated to the intrusive thoughts. Obsessions generally have themes. Some of these themes include

  • Fear of germs or contamination
  • Doubting or difficulty with uncertainty
  • Requiring things to be orderly and balanced
  • Aggressive or horrific thoughts about losing control and harming oneself or others
  • Unwanted thoughts, including aggression, or sexual or religious subjects

Obsession symptoms may include

  • Fear of dirt or touching objects others have touched
  • Doubts that the door is locked or the stove has been turned off
  • Intense stress when objects aren't orderly or facing the right way
  • Images of driving a car into a crowd of people
  • Thoughts about shouting obscenities in public
  • Unpleasant sexual images
  • Actively avoiding situations that can cause these obsessions, such as shaking hands


OCD compulsions involve repetitive behaviors or mental acts driven by the need to alleviate anxiety linked to obsessions or prevent perceived harm. Despite the intention to reduce anxiety, engaging in compulsions provides little pleasure and offers limited relief. Individuals may create rules or rituals during obsessive thoughts, often unrelated to the perceived issue they aim to address. As with obsessions, there are several themes that compulsions follow, such as

  • Washing and cleaning
  • Checking
  • Counting
  • Ordering
  • Strict routines
  • Demanding reassurance

Compulsion symptoms may include

  • Washing one's hands until their skin is raw
  • Checking doors repeatedly to ensure they are locked
  • Checking the stove repeatedly to ensure it is turned off
  • Counting in certain patterns
  • Silently repeating a word, phrase, or prayer
  • Attempts to replace bad thoughts with good thoughts
  • Arranging canned goods facing the same way

OCD typically manifests in adolescence or early adulthood, although it may begin in childhood. Symptoms tend to develop gradually and exhibit varying severity over one's lifetime. The nature of obsessions and compulsions may evolve over time. Increased stress, especially during periods of transition, can exacerbate symptoms. OCD is often considered a lifelong condition, manifesting with mild to moderate symptoms or reaching a severe and debilitating level.

Diagnosing OCD

There is no test for OCD. Diagnosis is made by analyzing symptoms, medical history, and mental health history. Criteria used in diagnosis include

  • Presence of obsessions, compulsions, or both
  • Obsessions or compulsions consume a considerable amount of time (more than one hour per day)
  • Obsessions or compulsions cause distress or affect participation in social activities, work responsibilities, or other life events
  • These symptoms aren't caused by substances, alcohol, medications, or another medical condition
  • These symptoms aren't explained by a different mental health condition, such as generalized anxiety disorder, eating disorder, or body image disorder

Treating OCD

Serene Mental Health Clinic is your source for prescribing treatment for Obsessive-compulsive Disorder.

Most treatment plans for OCD involve psychotherapy (talk therapy) and medication. If these treatments don't relieve OCD symptoms, Transcranial Magnetic Stimulation (TMS) may be recommended.

Psychotherapy for OCD

The most common and effective type of psychotherapy (talk therapy) to treat OCD include

Cognitive Behavioral Therapy (CBT)

In the course of CBT, a therapist guides the individual in exploring and comprehending their thoughts and emotions. Through multiple sessions, CBT aims to modify detrimental thought patterns and break free from negative habits, potentially replacing them with more constructive coping mechanisms.

Exposure and Responsive Prevention (ERP)

ERP, a form of CBT, involves exposing individuals to situations or images they fear and guiding them to resist engaging in compulsive behaviors. For instance, a therapist might encourage touching dirty objects but prevent subsequent handwashing. By confronting feared situations without negative consequences, individuals learn to recognize that their anxious thoughts are merely thoughts and not necessarily reflective of reality.

Acceptance and Commitment Therapy (ACT)

ACT assists in accepting obsessive thoughts as mere thoughts, diminishing their power. An ACT therapist guides the individual in embracing a meaningful life despite experiencing symptoms of OCD.

Medication for OCD

Serotonin reuptake inhibitors (SRIs), selective SRIs (SSRIs), and tricyclic antidepressants are medications that may be beneficial in treating OCD. SSRIs are commonly suggested for OCD, and are often prescribed at higher doses compared to their use for anxiety or depression. Antipsychotics may also be used in the treatment for OCD.