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Obsessive Compulsive Disorder (OCD)

Person engaging in repetitive handwashing, symbolizing the struggles of obsessive-compulsive disorder (OCD)

Understanding OCD: Obsessions and Compulsions
 

Obsessive-Compulsive Disorder (OCD) is a condition where a person has recurring, unwanted thoughts, ideas, or sensations (obsessions). To try to reduce these thoughts or the discomfort they cause, a person may feel compelled to perform certain behaviors or rituals over and over (compulsions).

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A common example is when someone might have an intense worry about germs (an obsession) and feel the need to wash their hands repeatedly (a compulsion) to feel "safe" or to prevent harm. These rituals are often hard to control and can get in the way of daily life, but they’re not something the person wants to engage in. The thoughts and behaviors can feel overpowering and difficult to ignore or resist.

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However, OCD is treatable with approaches like medication management and therapy, often involving cognitive-behavioral strategies that help them address and manage the cycle of obsessions and compulsions.

Why Treating OCD is Important
 

Proper treatment for OCD can dramatically enhance quality of life by alleviating the distress caused by persistent obsessions and compulsions. OCD can significantly affect your overall well-being and may contribute to other health issues. OCD often causes intense, chronic stress which increases the risk of developing additional mental health conditions such as depression, anxiety, an eating disorder or substance abuse. The stress and tension associated with OCD can also put you at greater risk for cardiovascular problems including high blood pressure, inflammation, high cholesterol, and a weakened immune system. These can also result in greater risk for chronic diseases later in life. However, with effective care, individuals can regain control, reduce anxiety, and help ensure a healthier outlook. 

Diagnosis of OCD

OCD is diagnosed through a comprehensive evaluation conducted by a mental health professional, such as a psychiatrist, psychologist, or primary care provider. The process begins with an in-depth interview to explore specific symptoms, including intrusive, persistent thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) performed to relieve distress. The provider will assess your symptoms and explore the criteria for diagnosing OCD based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

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For a diagnosis of OCD, individuals must experience recurring obsessions or compulsions that are time-consuming (taking more than an hour each day) or that cause significant distress and interfere with daily functioning, work, or relationships. Standardized tools, like the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), are often used to assess the severity of symptoms and to distinguish OCD from other similar conditions. Additionally, medical tests may be performed to rule out physical or neurological causes that could contribute to obsessive-compulsive symptoms.

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This thorough diagnostic process enables clinicians to accurately confirm OCD and to develop a tailored treatment plan, which may include therapy, medication, or a combination of approaches for effective, individualized care.

Symptoms of OCD

Each type of obsession and compulsion can vary in intensity and frequency. People with OCD may experience one or more types and obsessions or compulsions can evolve over time.

 

Examples of Obsessions:

  • Fear of contamination

  • Intrusive thoughts about harm

  • Need for things to be symmetrical, orderly, or arranged "just right"

  • Intrusive thoughts related to sexuality, violence, or inappropriate behaviors

  • Fear of offending religious or moral beliefs

  • Persistent doubts about the strength, stability, or "rightness" of relationships (e.g., with partners, family, or friends)

  • Excessive worry about having or developing a serious illness (often called "health anxiety" or "hypochondriasis" in other contexts)

  • Deep, unrelenting thoughts about life's purpose, the nature of existence, or abstract concepts like reality​​

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Examples of Compulsions:

  • Excessive cleaning, checking, or organizing

  • Repeatedly checking doors, windows, or appliances to make sure they're off

  • Repeating actions or phrases by a certain number

  • Rearranging items until they feel “just right” or balanced

  • Engaging in mental rituals to counteract or “undo” distressing thoughts (e.g., mentally “canceling out” a bad thought with a good one)

  • Reviewing past actions or events to ensure they didn’t make a mistake or offend someone

  • Seeking validation from friends, family, or even strangers to confirm their thoughts or actions are acceptable

  • Avoiding specific places, people, or situations that may trigger obsessions (e.g., not touching public surfaces to avoid germs)

  • Keeping excessive quantities of objects that have little or no value

Treatment for OCD

Treatment for OCD often includes a combination of medication management and psychotherapy, as both are shown to complement each other in effectively reducing OCD symptoms. Some providers may focus more on one approach than the other, but research indicates that using both together generally yields the best results. If medication is prescribed, it is typically an antidepressant that targets OCD symptoms, such as:

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  • SSRIs (e.g., fluoxetine, sertraline) are usually the first-line medications, as they have shown strong efficacy in reducing obsessive-compulsive symptoms.

  • Clomipramine, a tricyclic antidepressant, may also be considered, especially if SSRIs alone aren’t effective.

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Therapy is a key component of OCD treatment, and sessions often involve evidence-based approaches like:

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  • Exposure and Response Prevention (ERP) – This is the gold-standard treatment for OCD. ERP gradually exposes patients to their fears or obsessions without engaging in the compulsive behavior, helping them learn that they can tolerate the anxiety and that it lessens over time.

  • Cognitive-Behavioral Therapy (CBT) – CBT helps patients identify and challenge unhelpful thought patterns that contribute to OCD. It often includes techniques to change responses to obsessive thoughts.

  • Acceptance and Commitment Therapy (ACT) – ACT encourages patients to accept unwanted thoughts and feelings without trying to control them, focusing instead on living according to personal values.

  • Mindfulness-Based Cognitive Therapy (MBCT) – MBCT combines mindfulness practices with cognitive techniques, helping patients detach from intrusive thoughts without acting on them.

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In addition to therapy and medication, other non-pharmacological approaches can support OCD treatment:

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  • Mindfulness practices to help manage anxiety and intrusive thoughts

  • Regular exercise, which has been shown to reduce stress and improve mental health

  • Support groups for shared experiences and encouragement

  • Sleep hygiene to improve overall well-being and resilience

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Each of these approaches works together to help reduce OCD symptoms, allowing patients to lead a more balanced and fulfilling life.

Risk Factors for OCD

Risk factors for Obsessive-Compulsive Disorder (OCD) involve a mix of genetic, biological, environmental, and psychological influences. Common risk factors include:

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  • Family history of OCD

  • History of trauma or abuse

  • Chronic stress or major life changes

  • Certain personality traits, like perfectionism or high levels of conscientiousness

  • Other mental health conditions, such as anxiety or depression

Complications of OCD

  • Avoidance behaviors

  • Depression

  • Social isolation

  • Difficulty with daily functioning

  • Relationship strain

  • Academic or work challenges

  • Substance abuse

  • Physical health problems including skin irritation, headaches, stomach pains 

Resources for OCD

Recognizing and treating OCD is essential. OCD affects not only a person’s mental and emotional well-being but also their physical health, relationships, and overall quality of life. Untreated OCD can lead to significant complications, including heightened anxiety, depression, substance abuse, and suicidal thoughts or behaviors. Early diagnosis and effective treatment improve the chances of managing symptoms successfully, helping individuals regain control, reduce distress, and enhance their quality of life. Through proper care, individuals can experience relief and restore a sense of balance and connection in their daily lives.

 

If you or someone you know needs help for depression Click here for resources for OCD. You can also â€‹Click here to schedule a free 15-minute consultation and find out how Lucent Psych can help you address your symptoms and learn healthy coping strategies. 

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