Understanding OCD

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What is OCD?

Obsessive compulsive disorder (OCD) is an anxiety disorder. It has two main parts: obsessions and compulsions.

Obsessions are unwelcome thoughts, images, urges, worries or doubts that repeatedly appear in your mind. They can make you feel very anxious (although some people describe it as ‘mental discomfort’ rather than anxiety). You can read more about obsessions here.

Compulsions are repetitive activities that you do to reduce the anxiety caused by the obsession. It could be something like repeatedly checking a door is locked, repeating a specific phrase in your head or checking how your body feels. You can read more about compulsions here.

It’s not about being tidy, it’s about having no control over your negative thoughts. It’s about being afraid not doing things a certain way will cause harm.

You might find that sometimes your obsessions and compulsions are manageable and other times they are impossible to live with. They may be more severe when you are stressed about other things like work, university or relationships.

If you experience OCD during pregnancy or after birth, you might get diagnosed with post-natal or ante-natal OCD. You can find out more about this diagnosis on the Royal College of Psychiatrists website.

What causes OCD?

There are different theories about why OCD develops. None of these theories can fully explain every person’s experience, but researchers suggest that these are likely to be involved in causing OCD:

-‘dysfunctional’ beliefs

-personal experience

-biological factors

Even though we don’t fully understand what causes OCD it can still be successfully treated.

What’s it like to live with OCD?

Although many people experience minor obsessions (such as worrying about leaving the gas on, or if the door is locked) and compulsions (such as avoiding the cracks in the pavement), these don’t significantly interfere with daily life, or are short-lived.

If you experience OCD, it’s likely that your obsessions and compulsions will have a big impact on how you live your life:

Disruption to your day-to-day life. Repeating compulsions can take up a lot of time, and you might avoid certain situations that trigger your OCD. This can mean that you’re not able to go to work, see family and friends, eat out or even go outside. Obsessive thoughts can make it hard to concentrate and can leave you feeling exhausted.

Impact on your relationships. You may feel that you have to hide your OCD from people close to you – or your doubts and anxieties about the relationship may make it too difficult to continue it.

Feeling ashamed or lonely. You may feel ashamed of your obsessive thoughts, or as if they are a permanent part of you and can’t be treated. You might feel that you can’t talk about this part of yourself with others. This can make you feel very isolated. If you find it hard to be around people or go outside then you may feel lonely.

Impact on your physical health. Anxiety caused by obsessions can affect your physical health. You can read more about physical symptoms in our pages on anxiety.

Related disorders

There are some other mental health problems that are similar to OCD because they involve repetitive thoughts, behaviours or urges. They are sometimes called habit disorders.

Body dysmorphic disorder (BDD) is an anxiety disorder related to body image.

Compulsive skin picking (CSP) is the repetitive picking at your skin to relieve anxiety or urges. It can be experienced as part of body dysmorphic disorder. Read more about CSP on OCDAction’s website.

Trichotillomania is a compulsive urge to pull out your hair. Read more about trichotillomania on OCDAction’s website.

Some people with OCD have difficulties with hoarding.

Obsessive compulsive personality disorder (OCPD) is sometimes confused with OCD – but they are not the same thing. OCPD is a type of personality disorder, while OCD is an anxiety disorder.

Co-morbidity (having more than one diagnosis at the same time) with OCD is common, but it can sometimes make OCD difficult to diagnose and treat. For example, if you experience OCD you might be living with other mental health problems as well, such as anxiety or depression.

Experiences of facing stigma

Lots of people have misconceptions about OCD.

Some people think it just means you wash your hands a lot or you like things to be tidy.

They might even make jokes about it.

This can be frustrating and upsetting, especially if people who think this are friends or family, colleagues or even healthcare professionals.

Stigma can make OCD feel difficult to talk about but it’s important to remember you are not alone.

Why some causes lead to OCD

‘Dysfunctional’ beliefs

One theory suggests that OCD develops because of ‘dysfunctional’ beliefs and interpretations.

If you experience OCD you might believe that you have more responsibility for a situation than you actually do. Because of this, your reaction may be out of proportion.

For example, many people experience sudden and intrusive thoughts, such as thinking that they might push someone in front of a train on a crowded platform. Most people dismiss it as a passing thought and do not believe they would actually do it.

If you have ‘dysfunctional’ beliefs you might think that you could actually act on the intrusive thought. This makes you anxious or scared. You may develop a compulsion to try and prevent it happening. This could start an OCD cycle.

Personal experience

Some theories suggest that OCD is caused by personal experience. For example:

if you’ve had a painful childhood experience or suffered trauma or abuse, you might learn to use obsessions and compulsions to cope with anxiety. However this theory doesn’t explain why people who can’t point to any painful experiences might experience OCD.

if your parents had similar anxieties and showed similar kinds of compulsive behaviour – and so you learned that compulsions are a coping technique.

ongoing anxiety or stress or being part of a stressful event like a car accident could trigger the development of OCD or make it worse. Our pages on managing stress have more information on how to help yourself and get support for stress.

Biological factors

Some biological theories suggest that a lack of the brain chemical serotonin may have a role in OCD. However, experts disagree about what that role is. It’s unclear whether a lack of serotonin causes OCD or is the effect of having the condition.

Studies have also looked at genetic factors and how different parts of the brain might be involved in causing OCD, but have found nothing conclusive.

Biological theories do not explain why the condition develops differently in different people; for example, why one person might develop a contamination obsession while another develops an obsession about harming.