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Obsessive-Compulsive Disorder (OCD)
An obsessive-compulsive disorder (OCD) is a way your mind tries to cope with stress and uncertainty — but in an extreme and exhausting way. Almost everyone has unwanted thoughts or habits sometimes. With OCD, these thoughts and behaviours start to take over your life. Below, you’ll read what OCD is, how to recognise it, and what can help.
What is a compulsive disorder?
OCD is an anxiety disorder. You experience recurring obsessive thoughts and/or compulsive behaviours. Obsessive thoughts are unwanted thoughts, images, or fears that keep popping up. Compulsions are things you feel you have to do to reduce anxiety — like checking, cleaning, counting, or seeking reassurance.
These thoughts and behaviours take up a lot of time and energy and can seriously affect your daily life.
Everyone has intrusive thoughts sometimes (for example, worrying something bad might happen to someone you love). That’s normal. OCD is when these thoughts don’t go away and start controlling your actions.
How to recognise OCD?
OCD often starts subtly. You might feel a strong need to do things “perfectly” or feel uneasy if things aren’t done a certain way. Relaxing or enjoying good moments can feel hard, because your mind keeps pulling you back into worry.
You may have OCD if this has been going on for a while and you notice:
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Obsessive thoughts.
These are unwanted, often scary or disturbing thoughts or images. They usually don’t make logical sense, but they feel very real and urgent. Examples may include a fear of dirt, germs, or contamination; fear of causing harm (even though you don’t want to), unwanted violent or sexual thoughts, constant doubt about relationships or decisions and feeling overly responsible for preventing bad things from happening
Important to know: these thoughts are not who you are. They are unwanted and often clash with your values.
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Compulsive behaviours
Compulsions are things you repeatedly do to feel less anxious. Common examples include excessive washing or cleaning, constantly checking (locks, appliances, messages), repeating actions or counting, organising or arranging things in a specific way or constantly asking for reassurance.
Some compulsions are visible, others happen only in your head.
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Avoidance
You might start avoiding places, people, or situations that trigger your thoughts. This may feel helpful at first, but over time your world becomes smaller and OCD grows stronger.
Causes
There is no single cause. OCD usually develops through a combination of factors like genetics (it can run in families), personality traits like perfectionism, high responsibility, sensitivity to stress, or a strong need for control and/or stressful or traumatic life events.
Types of OCD
We distinguish between several types of obsessive-compulsive disorders:
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Obsessive-compulsive disorder
With obsessive-compulsive disorder (OCD), you experience obsessive thoughts multiple times a day, with or without compulsive behaviours. Fear of contamination is a common example. You may have an extreme fear of dirt, becoming unclean, or contamination. This is the most common form of OCD.
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Hoarding disorder
With hoarding disorder, you feel a strong urge to collect and keep specific items. Throwing things away is extremely difficult. This often results in large amounts of possessions in your home, leaving little or no usable space.
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Body Dysmorphic Disorder
With body dysmorphic disorder, you believe that there is something wrong or deformed about your body or face. Often, others see no abnormality or only a very minor one. You focus on it excessively and may consider yourself ugly. You may try to hide your appearance or, in extreme cases, seek cosmetic surgery to correct the perceived flaw.
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Skin-picking disorder (Excoriation disorder)
With skin-picking disorder, you feel an urge to pick at your skin. You find it difficult to stop and may damage your skin.
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Trichotillomania
With trichotillomania, you feel an urge to pull out your own hair. This can include hair on your head, as well as eyelashes, eyebrows, or other body hair.
What can you do for yourself?
In addition to getting enough sleep, exercise, and proper nutrition, it is important to share what is on your mind with others and to avoid situations as little as possible. You can also try to limit and delay compulsive behaviours yourself.
At the same time, it is important to seek professional help in time. Do the thoughts and behaviours take up a lot of time and energy? Do they interfere with your daily functioning? Do you notice that you are avoiding more and more situations? If so, seek professional help from a psychologist.
Tips for partners or loved ones of someone with OCD
The following advice is for partners, friends, or loved ones of someone with OCD:
- Learn about OCD to better understand the obsessive thoughts and symptoms of your loved one.
- Reassure the person with obsessive thoughts and offer relaxation where possible.
- Do not go along with the obsessive thoughts or compulsive behaviours — but also do not judge or criticise. Understand that the person truly feels compelled to think or act this way.
- Be mindful of your own boundaries. You can only help someone else if you remain calm yourself.
Treatment
OCD is classified as an anxiety disorder and is highly treatable with therapy. After treatment for an anxiety disorder, obsessive thoughts and urges to perform compulsive behaviours may still occur. This is not unusual; people without OCD also experience intrusive thoughts at times.
Cognitive behavioural therapy (CBT), exposure therapy, and acceptance and commitment therapy (ACT) are commonly used treatments for OCD. These therapies are often combined, helping you to:
- Examine and challenge obsessive thoughts (CBT)
- Create distance from obsessive thoughts (ACT)
- Stop performing compulsive behaviours (Exposure)
Treatment helps you gradually reduce compulsive rituals and let go of avoidance behaviour. You work step by step, in consultation with your therapist. The exercises are challenging but tailored to what you can handle. You set the pace.
The goal of treatment is to reduce symptoms and prevent relapse. During therapy, you learn techniques to deal with obsessive thoughts — both now and in the long term. In some cases, medication may be added in consultation with a general practitioner or psychiatrist.
This helps you regain control over your life and reduces the impact of OCD on your daily functioning.
Help with a compulsive disorder
If you recognise yourself in the symptoms above, professional help can significantly improve your quality of life.
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Treatment is tailored to you. With the right treatment, obsessive thoughts and compulsive behaviours decrease in intensity and no longer limit your daily life.
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Treatment costs are reimbursed by most health insurers if you have a referral from your GP and if there is a DSM-5 diagnosis of OCD.
FAQ
Can OCD go away?
Yes. OCD is highly treatable with therapies such as CBT and ACT. In some cases, additional medication may be prescribed in consultation with a GP or psychiatrist.
Is OCD hereditary?
There are indications that OCD runs in families. This does not mean you will automatically develop OCD if a family member has it, but the likelihood is higher.
Is OCD dangerous?
OCD does not pose immediate danger. However, it can lead to poor self-care and severely affect daily life. For example, excessive handwashing can damage the skin’s protective layer, and compulsive hair pulling can cause skin or hair damage.
Related symptoms
Fear of failure
Almost no one likes to fail. To fall short, to not succeed, to make mistakes. Some find it so bad that they avoid challenges. As a result, they fail to achieve their goals, and this increases anxiety. Do you recognize yourself in this? Read about what fear of failure is, how to recognize it and how to overcome fear of failure.
Social Phobia
Giving a presentation in front of your colleagues or when you get to tell your story in a proposal round; it can be quite scary. Sometimes this anxiety is a major hindrance that can control your entire life. Anxiety about social occasions is a common anxiety disorder that can affect the quality of your life a lot.
Coping with my partner’s anxiety disorder
Your partner, a loved one or loved one has an anxiety disorder. This directly affects you and your interactions with each other. For example, a relationship can be overshadowed by feelings of anxiety. Read how an anxiety disorder can affect a relationship and what you can do for the other person as well as yourself!
Generalized Anxiety Disorder
You worry so much that it affects your daily life. With generalized anxiety disorder (brooding disorder), you keep mulling things over in your head. Learn more about symptoms, causes and treatment of generalized anxiety disorder and get advice on what you can do yourself.
Panic attack
A panic attack is an intense feeling of fear and tension that is often accompanied by various psychological and physical symptoms. It usually begins with a physical sensation, such as a shooting pain or dizziness, that you interpret as something catastrophic. Learn more about panic attacks.
Agoraphobia
Going to a crowded concert or enjoying an evening at the movies? You’d rather stay home. When you suffer from agoraphobia, you find places with many people or situations where you can’t leave immediately frightening. Learn more about agoraphobia; its symptoms, causes, tips for yourself and treatment.
Treatment Anxiety Disorder
An anxiety disorder can be overcome in many cases with the help of therapy. There are different anxiety therapies, depending on which anxiety disorder is involved. Each anxiety disorder expresses itself differently, but the underlying feelings are the same: a fear you want to get rid of.