Obsessive compulsive disorder (OCD)

Obsessive compulsive disorder (OCD) is a mental health condition. It causes you to have obsessive thoughts and to carry out compulsive activity. This can be distressing, and it can have a big impact on your life. Treatment can help you keep OCD under control.

Obsessive compulsive disorder (OCD) affects people in different ways. Usually it causes a particular pattern of thought and behaviour.

This pattern has 4 main steps:

• Obsession: an intrusive, distressing thought, image or urge keeps coming into your mind.
• Anxiety: the obsession brings a feeling of intense anxiety or distress.
• Compulsion: you feel driven to carry out repetitive behaviours or mental acts, although you may recognise them as senseless or pointless.
• Temporary relief: the compulsive behaviour brings relief for a short time, but the obsession and anxiety return, and the cycle begins again.

• obsessive thoughts and compulsive behaviours are affecting your daily life
• you're not looking after yourself
• you're finding it hard to manage any responsibilities you have

Find out how to get urgent help for your mental health

Almost everyone has unpleasant or unwanted thoughts at some point in their life. You might worry that you've forgotten to lock the door, or that you could catch a disease from touching other people. Sometimes a violent or offensive mental image appears suddenly and unwelcome.

Most people can put these thoughts and worries into context, and then carry on with their day. They don't keep going back to worries they know are senseless or excessive.

If you have persistent, unwanted thoughts that dominate your thinking, you may have developed an obsession.

Some common obsessions that affect people with obsessive compulsive disorder (OCD) include:

• fear of deliberately harming yourself or others, for example a fear you may attack someone, even though this isn't in your nature
• fear of harming yourself or others by accident, for example a fear you may set the house on fire by leaving the cooker on
• fear of contamination by disease, infection or an unpleasant substance
• a need for symmetry or orderliness, for example you may feel the need to make sure all the tins in your cupboard face the same way

Compulsions are a way of trying to reduce or prevent the harm that an obsessive thought seems to threaten. But the behaviour is either excessive or has no real connection to the fear.

Take a person who fears they'll be contaminated with dirt and germs. They may wash their hands again and again. Or someone who fears causing harm to their family may feel the urge to repeat an action many times, to try to "neutralise" the thought of harm. This kind of compulsive behaviour is particularly common in children with OCD.

Most people with OCD realise that the behaviour is irrational. They may know it makes no logical sense, yet they cannot stop acting on the compulsion.

Not all compulsive behaviours will be obvious to other people.

Some people with OCD (obsessive compulsive disorder) also have, or go on to develop, other mental health problems. These include:

• depression
• eating disorders
• generalised anxiety disorder
• a hoarding disorder

If you have OCD and severe depression, you might also have suicidal feelings.

Nobody knows the exact cause of obsessive compulsive disorder (OCD). But some factors could make a person more likely to have it.

These factors might include:

• genetics
• life events
• personality traits
• chemical differences in the brain

Getting a diagnosis and treatment can help reduce the effect obsessive compulsive disorder (OCD) has on your day-to-day life. If you think you have OCD, you should speak to your doctor.

Many people don't tell their doctor about their symptoms because they feel ashamed or embarrassed. Some also try to hide the symptoms from family and friends.

You shouldn't feel ashamed or embarrassed if you have OCD. Like diabetes or asthma, it's a long-term health condition, and it's not your fault you have it.

Your doctor will probably ask you a series of questions to see if it's likely you have OCD.

If the answers to these first questions suggest you have OCD, the severity of your symptoms will be assessed. Either your doctor or a mental health professional will do the assessment.

It's important to be open and honest. Accurate and truthful answers will help make sure you get the most appropriate treatment.

If you think someone you know may have OCD, it's a good idea to:

• talk to them carefully about your concerns
• suggest they speak to their doctor

How you're treated for OCD (obsessive compulsive disorder) depends on how much the condition is affecting your daily life.

There are 2 main treatments:

• cognitive behavioural therapy (CBT)
• medication

If your OCD has a severe impact on your daily life, you'll usually be referred to a specialist mental health service. There you'll likely receive a combination of CBT and a course of antidepressants.

Children with OCD are usually referred to a healthcare professional with experience of treating OCD in children.

It can take several months before a treatment has a noticeable effect.

If you've tried other treatments and your obsessive compulsive disorder (OCD) is still not under control, you might be offered specialist treatment. Most people improve after receiving treatment.

OCD Action has online support groups where you can connect with other people who have similar experiences. Don't include personal information, such as your name, your location or any personal health conditions.