Obsessive-compulsive disorder symptoms usually include both obsessions and compulsions. But it's also possible to have only obsession symptoms or only compulsion symptoms. About one-third of people with OCD also have a disorder that includes sudden, brief, intermittent movements or sounds (tics).
OCD obsessions are repeated, persistent and unwanted urges or images that cause distress or anxiety. You might try to get rid of them by performing a compulsion or ritual. These obsessions typically intrude when you're trying to think of or do other things.
Obsessions often have themes to them, such as:
- Fear of contamination or dirt
- Having things orderly and symmetrical
- Aggressive or horrific thoughts about harming yourself or others
- Unwanted thoughts, including aggression, or sexual or religious subjects
Examples of obsession signs and symptoms include:
- Fear of being contaminated by shaking hands or by touching objects others have touched
- Doubts that you've locked the door or turned off the stove
- Intense stress when objects aren't orderly or facing a certain way
- Images of hurting yourself or someone else
- Thoughts about shouting obscenities or acting inappropriately
- Avoidance of situations that can trigger obsessions, such as shaking hands
- Distress about unpleasant sexual images repeating in your mind
OCD compulsions are repetitive behaviors that you feel driven to perform. These repetitive behaviors are meant to prevent or reduce anxiety related to your obsessions or prevent something bad from happening. However, engaging in the compulsions brings no pleasure and may offer only a temporary relief from anxiety.
You may also make up rules or rituals to follow that help control your anxiety when you're having obsessive thoughts. These compulsions are often not rationally connected to preventing the feared event.
As with obsessions, compulsions typically have themes, such as:
- Washing and cleaning
- Demanding reassurances
- Following a strict routine
Examples of compulsion signs and symptoms include:
- Hand-washing until your skin becomes raw
- Checking doors repeatedly to make sure they're locked
- Checking the stove repeatedly to make sure it's off
- Counting in certain patterns
- Silently repeating a prayer, word or phrase
- Arranging your canned goods to face the same way
Symptoms usually begin gradually and tend to vary in severity throughout your life. Symptoms generally worsen when you're experiencing more stress. OCD, considered a lifelong disorder, can be so severe and time-consuming that it becomes disabling.
Most adults recognize that their obsessions and compulsions don't make sense, but that's not always the case. Children may not understand what's wrong.
When to see a doctor
There's a difference between being a perfectionist and having OCD. OCD thoughts aren't simply excessive worries about real problems in your life. Perhaps you keep the floors in your house so clean that you could eat off them. Or you like your knickknacks arranged just so. That doesn't necessarily mean that you have OCD.
If your obsessions and compulsions are affecting your quality of life, see your doctor or mental health provider. People with OCD may be ashamed and embarrassed about the condition, but treatment can help.
The cause of obsessive-compulsive disorder isn't fully understood. Main theories include:
- Biology. OCD may be a result of changes in your body's own natural chemistry or brain functions. OCD may also have a genetic component, but specific genes have yet to be identified.
- Environment. Some environmental factors such as infections are suggested as a trigger for OCD, but more research is needed to be sure.
Factors that may increase the risk of developing or triggering obsessive-compulsive disorder include:
- Family history. Having parents or other family members with the disorder can increase your risk of developing OCD.
- Stressful life events. If you've experienced traumatic or stressful events or you tend to react strongly to stress, your risk may increase. This reaction may, for some reason, trigger the intrusive thoughts, rituals and emotional distress characteristic of OCD.
Individuals with obsessive-compulsive disorder may have additional problems. Some of the problems below may be associated with OCD — others may exist in addition to OCD but not be caused by it.
- Inability to attend work, school or social activities
- Troubled relationships
- Overall poor quality of life
- Anxiety disorders
- Eating disorders
- Suicidal thoughts and behavior
- Alcohol or other substance abuse
- Contact dermatitis from frequent hand-washing
There's no sure way to prevent obsessive-compulsive disorder. However, getting treatment as soon as possible may help prevent OCD from worsening.