Obsessive-Compulsive Disorder (OCD) Symptoms

Obsessive-Compulsive Disorder involves obsessions, compulsions, or in most cases, both.

Definition of Obsessions – OCD Symptoms

Obsessions are recurrent, unwanted thoughts. Research has shown that intrusive thoughts are also extremely common in people who do not have Obsessive Compulsive Disorder.

The most common intrusive thoughts in people who do not have OCD tend to be fears about: illness, germs, forgetting (e.g, to turn the stove off, lock the door), losing control or going crazy (e.g., causing a scene by taking one's clothes off in public, committing a crime, driving off the road, purposefully self-harming, hurting someone else, kissing someone inappropriately, having kinky sex or cheating).

The main difference in people with OCD isn't the content or topic of their intrusive thoughts but rather their degree of worry about having intrusive thoughts. People with OCD see having intrusive thoughts as dangerous or immoral. They worry that having the intrusive thought will lead to acting on it, or that there is some other danger associated with just having the thought. They equate having a thought with doing the feared action. For example, "If I worry about taking off my clothes in public then I must be going to do this." This thought distortion is called "Thought-Action Fusion."

The more concerned the person with OCD becomes about their intrusive thoughts, the more thought intrusions they experience.

5 Most Common Types of Obsessions

The five most common types of obsessions are

1. Fear of contamination (e.g., germs, viruses). (37.8%)
2. Fear of harm (e.g., fear that doors are not locked, or that electrical outlets will cause a fire). (23.6%)
3. Excessive concern with order or symmetry. (10%)
4. Obsessions with the body or physical symptoms. (7.2%)
5. Unwanted thoughts related to religious beliefs (e.g. thoughts that the person regards as sacrilegious or blasphemous, or fears of going to hell). (5.9%)

Fears about becoming a pedophile, being homosexual, or harming one's children (without any evidence for these fears) are also common.

Definition of Compulsions

Compulsions are usually a response to obsessions—a way to deal with or neutralize them.

Compulsions can be overt actions (things other people can see) or they can be mental actions, such as ritualized praying to try to counteract thoughts the person feels frightened by.

7 Most Common Types of Compulsions

The most common types of compulsions are: checking, cleaning/washing, repeating other types of actions, special words or prayers done in a ritualized way, ordering/symmetry/exactness, collecting, and counting.

Mechanisms of OCD Symptoms

There is some element of biological predisposition to OCD. However, as with other anxiety disorders, the coping mechanisms that people use in an attempt to relieve their anxiety are what cause the problem to snowball.

Examples

Emotional reasoning: For example, if a person usually feels ok when they wash their hands three times and one day they do this but still don’t feel ok, they equate still feeling anxious with evidence that they're not clean and resolve to wash four times from now on.

Worries about going crazy: The compensatory behaviors that people do to deal with unwanted thoughts often cause them to worry that they are going crazy. This generates even more anxiety.

Impaired memory: The more someone checks something, the worse their memory gets for whether they've checked.

Interpersonal stress and work interference: The obsessions and compulsions interfere with work or relationships, generating further stress. For example, if a person does 30 minutes of checking before leaving the house due to their OCD symptoms, their partner may get frustrated and call them "crazy."

Attempts to block out thoughts: As previously stated, the more the person tries to block out the unwanted thoughts, the more they experience them,

OCD is different from other forms of rumination.

Learn about rumination and some strategies for reducing rumination here.

Learn about anxiety symptoms here.