Obsessive-compulsive disorder (OCD) is a mental health condition marked by recurring obsessive thoughts and difficult-to-control, compulsive behaviors.
Obsessive-compulsive disorder (OCD) is a mental health condition marked by recurring obsessive thoughts and difficult-to-control, compulsive behaviors. Though it can be debilitating, effective treatments can help folks manage the symptoms of this mental illness.
What is OCD? Read on to learn more about obsessive-compulsive disorder and how to manage it.
Obsessive-compulsive disorder is a condition where people experience overwhelming and persistent negative thoughts or obsessions, along with repetitive actions (known as compulsions) that are used to reduce the anxiety caused by obsessions.
For those with OCD, obsessive thoughts might include fears of leaving a door unlocked or becoming contaminated. These thoughts often lead to compulsive behaviors that feel like they must be done over and over, like checking things repeatedly or washing hands many times.
Obsessive-compulsive disorder isn’t just about having disturbing thoughts or urges. It’s a serious mental health condition, and it’s tough to manage without support.
Since OCD can involve anxious feelings, it was previously classified as an anxiety disorder. It’s now recognized as part of a broader group called Obsessive-Compulsive and Related Disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This category also includes conditions like body dysmorphic disorder (BDD), hoarding disorder, and trichotillomania (compulsively pulling out your own hair).
Treatment options have become more refined and effective over the years, helping people better manage their symptoms and improve their quality of life.
OCD is actually more common than many people realize. According to research, about one to three percent of people worldwide have obsessive-compulsive disorder.
So, while it can feel like a personal struggle, you’re definitely not alone. Many others are dealing with similar challenges, and lots of support and effective treatments are available to help.
What is obsessive-compulsive personality disorder (OCPD), and how does it differ from OCD? Though the conditions sound similar and share some characteristics, they’re distinct disorders with different features and treatments.
OCPD falls under a category in the DSM called Cluster C personality disorders, which are generally characterized by anxious or fearful behaviors.
People with OCPD often struggle with:
Extreme perfectionism
Rigidity (unwillingness to adjust to others’ needs or ideas)
An intense sense of structure and order
Obsession over minor details
A strong need for control
Unlike OCD — where symptoms can fluctuate with anxiety and triggers — OCPD tends to be more consistent and persistent. People with obsessive-compulsive personality disorder might not realize these traits can be problematic and often believe their way of thinking is correct, which can make it hard to seek help.
Treatment approaches for each condition also differ. OCD often responds to therapies aimed at managing anxiety and compulsions, while OCPD might need a unique therapeutic focus.
The symptoms of OCD usually fall into two main categories:
Obsessive thoughts. These are persistent, unwanted thoughts, mental acts, and urges that cause significant anxiety and fear. You might hear them called OCD intrusive thoughts, and they can be incredibly distressing and distracting.
Compulsive, uncontrollable, repetitive behaviors. To cope with obsessive thoughts, people with OCD often feel driven to do rituals or repetitive actions. They might think these compulsions will relieve the anxiety caused by the obsessions, but they often don’t and can become very time-consuming and difficult to control.
Some common obsessions associated with OCD include:
Fear of contamination, germs, and illness
Repetitive thoughts about sex
Repetitive thoughts about religion
Intrusive thoughts and fears of harming oneself or others
Aggressive thoughts
Need for physical symmetry
Although obsessions of engaging in violence or uncharacteristic sex acts are common in OCD, these thoughts do not translate into actual behaviors. In fact, people with OCD - even if they have violent obsessions - are less likely than the general population to engage in violent behavior. Some subtypes of OCD revolve around specific obsessions, too, like contamination OCD and harm OCD.
Common compulsions associated with OCD include:
Extensive cleaning and excessive hand-washing or bathing
Specific organization or arranging
Excessively checking on things (like locked doors or powered-off appliances)
Repetitive counting
Again, these two symptom categories are often linked, and they usually lead to feelings of anxiety.
Many of us might occasionally have similar thoughts or engage in repetitive behaviors. But those with OCD experience these symptoms in a much more intense and disruptive way.
For someone with OCD, these thoughts and behaviors can take up a large portion of their day and deeply impact their overall quality of life. For example, it might take them two hours or more to take a shower because washing must be done in a specific, ritualistic way, or they have to start over. They often feel overwhelmed and out of control, leading to significant distress and interference with daily activities.
The exact causes of OCD aren’t totally clear. But research suggests a combination of factors — genetic, biological, and environmental — play a role.
For instance, having a close family member, like a parent or sibling, with OCD can increase the likelihood of developing the disorder yourself. That said, researchers haven’t pinpointed a specific gene that causes obsessive-compulsive disorder.
Brain imaging studies have also explored whether OCD patients have different brain structures. Some findings suggest that areas of the brain — such as the frontal cortex — are structurally different in people with OCD.
There’s also been some research on the connection between OCD and certain infections. For example, PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) describes a situation where children suddenly develop OCD symptoms following a strep infection, like strep throat or scarlet fever.
Understanding these factors can help in identifying and managing OCD.
Several factors can increase the likelihood of developing OCD — these are called risk factors.
Obsessive-compulsive disorder risk factors include:
Gender. Research shows that women are about 1.6 times more likely to have OCD than men. Also, women may have a higher risk during the peripartum and postpartum periods (around and after childbirth).
Socioeconomic status. Studies suggest that people with a lower socioeconomic status (where they stand financially and socially) may have a higher risk of developing OCD.
Traumatic experiences. Childhood trauma has been linked to an increased risk of OCD and can make symptoms more severe. Stressful life events are also associated with obsessive-compulsive disorder.
Roughly 90 percent of those with OCD also have another co-occurring mental health disorder. The most common are:
Anxiety disorders like generalized anxiety disorder (GAD), panic disorder, and social anxiety disorder
Mood disorders, such as depression
Impulse-control disorders
Substance use disorders
Eating disorders
Additionally, some folks might experience a tic disorder with OCD. Tics are repetitive physical movements such as clearing the throat, jerking the head, shrugging, or blinking.
To be diagnosed with OCD, you need to have either obsessions or compulsions that take up at least an hour a day and significantly disrupt your daily life.
This means the symptoms aren’t just occasional but ongoing, causing distress and affecting your routine.
Young adults are most frequently diagnosed with obsessive-compulsive disorder — the average age for an OCD diagnosis is around 19. But adults can also develop OCD later in life.
Healthcare providers will need to rule out other conditions (such as generalized anxiety disorder, eating disorders, or body image issues) to make sure the diagnosis is accurate.
Many people with OCD struggle to control their symptoms. Getting a proper diagnosis is a crucial first step toward finding effective treatment and learning how to manage these challenges.
Healthcare professionals have been learning more and more about how to treat OCD. However, as with many mental health conditions, there isn’t a single treatment that works for everyone.
Treating OCD typically involves a combination of psychotherapy and medication. But what works best for you will depend on your unique needs and situation.
These common treatment options for OCD are often used together to provide the most effective support:
Counseling or talk therapy
Antidepressant medication
Antipsychotic drugs
Inpatient programs
Experimental options
Keep reading for details.
According to the OCD Foundation, the first line of treatment considered after a diagnosis is therapy for OCD. There are a few types of psychotherapy treatments.
Healthcare providers may recommend cognitive behavioral therapy (CBT) exposure-response prevention (ERP):
Cognitive behavioral therapy. CBT involves evaluating, identifying, and unlearning unhelpful thoughts and behavioral patterns to create better coping methods. It helps patients manage their obsessive thoughts and compulsions in a healthier way.
Exposure and response prevention. ERP is a form of CBT that exposes someone to specific anxiety triggers or obsessions. It aims to help them work through the issue without falling into compulsive behaviors.
Support groups, whether online or in person, might also be helpful for people with obsessive-compulsive disorder.
Another way to treat OCD is through medication, like selective serotonin reuptake inhibitors (SSRIs). This class of antidepressants is a common choice of OCD medication.
Some FDA-approved SSRIs include:
Fluvoxamine (Luvox®). This was the first antidepressant shown to be effective for treating OCD, and it’s still a popular choice among SSRIs for OCD.
Sertraline (Zoloft®). Sertraline is another effective SSRI found to help with both short-term and long-term treatment of OCD.
Paroxetine (Paxil®). Paroxetine can help decrease OCD symptoms, while others may find it helps them go into remission from obsessive-compulsive disorder.
Fluoxetine (Prozac®). Fluoxetine is an FDA-approved SSRI treatment for OCD because of its ability to affect serotonin levels.
Other SSRIs not approved by the FDA for obsessive-compulsive disorder treatment but sometimes used off-label include citalopram (Celexa®) and escitalopram (Lexapro®). An older medication, clomipramine, is often used if SSRIs don’t work. Clomipramine has substantially more side effects than SSRIs, but it’s also substantially more effective. Since OCD can be so disruptive to a person’s life, for many people, the trade-off is worth it.
Antipsychotic medications usually aren’t a first-line treatment for obsessive-compulsive disorder. But they can be an alternative or used in combination with other OCD treatment options.
When antidepressants alone aren’t working, a healthcare provider or mental health professional may consider adding antipsychotic medication to an OCD treatment plan.
Some examples include:
Risperidone
Aripiprazole
Haloperidol (though it’s not a first-line option since it’s associated with higher chances of side effects)
If you’re taking meds for OCD, make sure to report any side effects to your healthcare provider.
Another OCD treatment option that may be offered depending on the severity of OCD is an inpatient program. Inpatient programs for OCD are often refered to as residential programs, since the treatment duration is longer than a typical inpatient stay.
Most OCD treatment is outpatient, meaning you can live at home and go about your life at the same time. But inpatient programs might be recommended when first-line treatments (therapy and medication) don’t work.
Inpatient programs are also sometimes combined with other obsessive-compulsive disorder treatment options.
Inpatient care involves support and treatment that happens within a facility and usually over a period of a few weeks or a couple of months. Inpatient facilities are often centers specializing in supporting those with severe cases of OCD.
This stimulation technique sends magnetic pulses to stimulate parts of the brain involved in mood regulation and cognitive function. It’s considered noninvasive.
Research shows that transcranial magnetic stimulation can effectively treat OCD, and the first machine to deliver this treatment for OCD was given FDA clearance in 2018.
This is a surgical procedure where a small device (called a brain pacemaker) is installed in the brain. The device sends electrical pulses to different parts of the brain to help regulate brain activity involved in OCD.
Some research on the benefits of deep brain stimulation for OCD is promising, though further research is needed. Also, since it’s a more invasive treatment option, it carries a chance of complications associated with other surgeries.
While obsessive-compulsive disorder can’t be prevented, there are ways to manage it more effectively and prevent the symptoms from worsening.
Research shows that early detection and the follow-up of anxiety or obsessive symptoms in children may be crucial for preventing the course of OCD.
As researchers and healthcare professionals learn more about OCD as a mental health disorder (and better understand the symptoms that occur with it), more treatment options will become available.
In the meantime, in-person or online therapy and medication serve as the gold standard for treating OCD.
Some research shows that healthy lifestyle adjustments can help make OCD symptoms more manageable. Here are some habits to try to build:
Getting enough sleep
Exercising regularly
Eating a healthy, balanced diet
Limiting alcohol
OCD can be a debilitating disorder. But with a healthy lifestyle, therapy, and medication, it can be managed and possibly overcome.
If you or a loved one are showing signs of obsessive-compulsive disorder, start by consulting a healthcare professional to discuss symptoms and a potential treatment plan.
If you think you may be a good fit for medication or have more questions, use our online platform to access psychiatry services.
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