Obsessive-compulsive disorder (OCD) is a condition marked by intrusive, unwanted thoughts (obsessions) and repetitive behaviors or mental rituals (compulsions). Millions of people struggling with OCD experience unwanted thoughts that threaten them with doom, resulting in fear towards their own minds.
About 2.3% of U.S. adults will have OCD at some point in their lives. Though anyone can develop OCD, it’s diagnosed more often in women than men.
OCD can look very different from person to person, so it helps to know the common ways it shows up. Some of the most common forms of OCD include:
Checking
Someone who experiences checking will feel compelled to repeatedly check that doors and windows are locked and the stove is off, until they feel at ease that they are not responsible for danger or for hurting another person.
Ordering and Repeating
Someone who experiences ordering feels things need to be in an exact order or spot and repeats these actions until it feels “right.” This can include silently rearranging items, whispering words to themselves, counting words, or insisting their personal belongings remain untouched where they last kept them.
Washing and Cleaning
Someone who experiences excessive washing and cleaning fears contamination for themselves, or fears they might contaminate others. The fear of possible contamination leads to excessive washing in an attempt to ease those fears.
Scrupulosity
Someone who experiences scrupulosity obsesses over religious or moral issues. They may pray excessively or seek reassurance that they are morally sound. This fear stems from the need to “perfectly” maintain religious rules and practices.
Intrusive Thoughts
Someone with this form of OCD experiences unwanted, distressing thoughts or images. Their compulsions are often mental and hard to see, like reviewing, seeking reassurance, or trying to “cancel out” a thought. These thoughts can center on harming others or themselves, questioning their sexual orientation, harming a child, or losing control. They are the opposite of what the person wants, which is exactly why they feel so upsetting. These intrusive thoughts tend to get louder the more someone tries to push them down, or they become tied to rituals meant to make sure they don’t come true.
Hoarding
Hoarding was once considered a form of OCD and is now diagnosed as its own condition, though the two often overlap. Someone who hoards has difficulty throwing away things most people would not think twice about. They develop a strong attachment to seemingly insignificant items and fear letting them go.
Descriptions adapted from The OCD Workbook by Bruce M. Hyman and Cherry Pedrick.
Now, I want to reassure you: if you read that list and wondered whether you have OCD, that’s normal. It’s essential to talk about what OCD is not, so you can tell the difference between symptoms and everyday thinking and worrying.
OCD is not simply being a perfectionist who likes keeping their space neat and tidy. Everyone worries excessively at times, and this is completely normal and separate from OCD. People perform routines and give their attention to small details without having OCD. Some may perform repetitive actions based on their culture or religion that don’t stem from OCD. So how do you know?
How do I know if I have OCD?
With OCD, the thoughts feel unwanted and out of character, and the urge to respond to them is hard to resist. The obsessions and compulsions take up a lot of time (often more than an hour a day), cause real distress, or get in the way of daily life, sometimes making someone feel rigid or stuck. Someone without OCD may also worry a lot, but the worry usually fits the situation and passes.
The common underlying theme here is the fear of change and uncertainty. What happens if you don’t perform that ritual? What will you do to feel safe without checking, cleaning, or seeking reassurance?
Preparing for this change is important for taking control of your fears and changing the narrative. You are safe outside of your OCD. The rituals are habits that have taught your brain it can only feel safe by performing them.
Treatment
The most effective treatment for OCD is a type of Cognitive Behavioral Therapy called Exposure and Response Prevention (ERP). ERP helps you gradually face your fears, resist the urge to perform compulsions, and learn that you can handle uncertainty. For some people, medication prescribed by a psychiatrist or doctor can also help alongside therapy.
If you are struggling with intrusive thoughts or compulsions, you don’t have to figure it out alone. Schedule a free consultation with me at Lived In Wellness.
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Julia Resnick, LCSW is a licensed clinical social worker offering online therapy for adults in New York, New Jersey, and Florida. She has specialized training in ERP for OCD and works with anxiety, depression, chronic illness, and grief.
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This post is for educational purposes only and isn’t a substitute for professional diagnosis or treatment. If you are in crisis, call or text 988.
