OCD overview

Overview

Obsessive-compulsive disorder (OCD) is a mental health condition where a person experiences recurring, unwanted thoughts (obsessions) and feels a strong urge to do certain actions repeatedly (compulsions). These thoughts and behaviours can take up a lot of time and feel very distressing.

OCD affects about 1–2% of the population worldwide. It is one of the more common mental health conditions.

OCD can affect anyone – children, teenagers, adults and older adults. It often starts in late childhood or early adulthood, but can begin at any age.

Symptoms

Common symptoms

• Intrusive thoughts about contamination, safety, order, or taboo subjects.
• Fear of harming yourself or others, even if you never would.
• Excessive hand washing, cleaning, or checking things repeatedly.
• Counting, repeating words silently, or arranging items in a specific way.
• Avoiding situations that trigger obsessions, which can interfere with daily life.

Symptoms in children

• Difficulty concentrating at school because of obsessive thoughts.
• Repeating actions many times, such as erasing and rewriting homework.
• Extreme distress if routines are disrupted.
• Asking the same question repeatedly for reassurance.

Symptoms in older adults

• Worsening of existing OCD symptoms or developing new ones later in life.
• Increased anxiety about health or safety of loved ones.
• Repeated checking of doors, stoves, or locks.
• Avoiding social situations due to fear of contamination or causing harm.

Causes

Main causes

• Genetics – OCD can run in families, suggesting a hereditary link.
• Brain chemistry – differences in certain brain chemicals, especially serotonin, may play a role.
• Life experiences – trauma, abuse, or severe stress can trigger OCD in people who are already vulnerable.
• Infections – in rare cases, a streptococcal infection can trigger sudden onset of OCD in children (PANDAS).

Risk factors

• Having a close family member with OCD or other mental health conditions.
• Experiencing a traumatic event or major life change.
• Having a perfectionist personality or high anxiety levels.
• Being diagnosed with another mental health condition, such as depression or anxiety.

When to see a doctor

See a doctor urgently if:

• If you have thoughts of harming yourself or someone else.
• If you are severely distressed and cannot function.

Book a routine appointment if:

• If obsessions or compulsions are interfering with your daily life, work, or relationships.
• If you are spending more than an hour a day on compulsive behaviours.
• If you have had symptoms for weeks or months and they are not improving.

Diagnosis

A healthcare professional, usually a mental health specialist like a psychiatrist or psychologist, will ask about your symptoms, how long you have had them, and how they affect your life. There is no blood test or scan for OCD – diagnosis is made through a detailed conversation.

Tests that may be done

• Clinical interview – you will be asked about your thoughts, feelings, and behaviours.
• Questionnaires – you may be asked to fill out forms like the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).
• Physical exam – sometimes done to rule out other conditions that could cause symptoms.

What to expect at your appointment

The process is confidential and respectful. You can bring a family member or friend for support. The doctor or therapist will work with you to understand your experiences and recommend the best treatment options.

Treatment

OCD is usually treated with a combination of talking therapy and medication. Treatment is very effective for most people and can greatly reduce symptoms.

Self-care at home

• Learn about OCD – understanding it can help you feel more in control.
• Practice relaxation techniques like deep breathing or mindfulness to manage anxiety.
• Set small goals to gradually reduce compulsive behaviours.
• Join a support group (online or in-person) to share experiences with others.

Medical treatments

The main treatment is cognitive behavioural therapy (CBT), especially a type called exposure and response prevention (ERP) where you gradually face your fears without doing compulsions. For some people, medications called selective serotonin reuptake inhibitors (SSRIs) are used to help reduce symptoms. These are usually prescribed by a doctor and take several weeks to work. Always discuss medication options with your healthcare provider.

When is surgery considered?

Surgery is not used for OCD. In extremely severe cases that do not respond to other treatments, deep brain stimulation (DBS) may be considered as a last resort, but this is rare and only done in specialist centres.

Living with this condition

Living with OCD can be challenging, but many people learn to manage their symptoms and lead fulfilling lives. With the right treatment and support, you can reduce the time spent on compulsions and enjoy more freedom.

Lifestyle tips

• Maintain a regular sleep schedule to help manage anxiety.
• Avoid alcohol and drugs, which can make symptoms worse.
• Try to stick to a daily routine that includes time for relaxation and hobbies.

Diet and exercise

A balanced diet and regular physical activity can improve your overall mood and energy levels. Exercise, in particular, helps reduce anxiety and stress, which can ease OCD symptoms.

Mental health and emotional wellbeing

OCD can lead to feelings of shame, guilt, or frustration. It is common to feel depressed or anxious because of the condition. It is important to treat your mental health as a whole, and talk to your healthcare provider if you have symptoms of depression or other conditions.

Prevention

There is no known way to prevent OCD, but recognising early symptoms and seeking help quickly can stop it from becoming severe. Reducing stress and building healthy coping skills may help lower your risk.

Complications

If left untreated

• Difficulty maintaining relationships or holding a job.
• Severe anxiety or depression.
• Social isolation and withdrawal.
• Problems with physical health due to excessive washing or lack of sleep.

Long-term outlook

With proper treatment, most people with OCD experience significant improvement. Many get back to a normal life. Treatment can take time, but it is very effective. You have reason to be hopeful.

Find support

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