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Obsessive compulsive disorder (OCD)

Key points

  • Obsessive compulsive disorder (OCD) is an anxiety disorder affecting up to three in 100 people.
  • Symptoms of OCD include unwanted thoughts and repetitive behaviour.
  • Talking therapies and medicines can help to control your symptoms and reduce your anxiety.

Obsessive compulsive disorder (OCD) is a condition in which you have obsessive thoughts and compulsive behaviour (things that you feel compelled to do). It’s thought that OCD affects up to three in 100 people.

About OCD

OCD is made up of two features: obsessions and compulsions.

If you have OCD, you will regularly experience obsessive thoughts that can make you feel anxious. You’re also likely to have compulsions. These are behaviours, thoughts or acts that you feel compelled to do to counteract your obsessions and reduce the anxiety they cause. Even though you may understand that these compulsions don’t make sense, you still feel the need to carry them out to ease the distress associated with obsessive thoughts.

It’s important to remember that everyone has worrying thoughts occasionally. For example, you may worry about whether you’ve left the oven on when you go out. These thoughts usually appear briefly, but go away again easily and don’t cause any further problems. With OCD, you will have repetitive, worrying thoughts. These often prevent you from thinking about anything else. As a way to combat these obsessive thoughts, you will feel compelled to carry out repetitive behaviours.

OCD mostly affects young adults under the age of 25, although it can occur at any age.

Symptoms of OCD

If you have OCD, you will have your own experience of which obsessions and compulsions affect you. These will be different to other people who also have OCD.

Obsessions are often influenced by your personal situation. For example, if you’re very religious, you may have thoughts against religion. There are some common obsessions that many people with OCD experience. Some of the main obsession themes are described below.

  • Contamination obsessions – fearing dirt and germs.
  • Aggressive obsessions – thinking about doing harm to yourself or others.
  • Sexual obsessions – having upsetting thoughts, such as a fear of exposing yourself at work.
  • Health-related obsessions – thinking that you have a serious illness, without having any of the symptoms.
  • Safety obsessions – such as feeling that you are responsible for protecting other people.
  • Religious or moral obsessions – having religious or anti-religious thoughts.

You may feel the need to carry out a compulsive response whenever you have an obsessive thought. Examples are listed below.

  • Excessive hand washing.
  • Checking something again and again, such as making sure a door is locked.
  • Repeated actions such as touching each light switch in the house a certain number of times.
  • Praying or saying a particular phrase over and over in your mind.
  • Ordering or arranging items in a certain way.
  • Hoarding or collecting things that have no use.

Your obsessions and compulsions can take up a lot of your time and get in the way of doing everyday tasks. You may also go to great lengths to avoid situations that could trigger your obsessive thoughts.

Causes of OCD

It isn’t fully understood what causes OCD. However, it’s likely that a number of factors are involved in its development.

  • OCD may run in families. If one of your parents showed signs of OCD, it’s possible that you may develop it too.
  • A stressful or life changing event, such as starting a new job, could trigger OCD.
  • An imbalance in a chemical called serotonin in your brain could play a role in the development of the condition.
  • Certain personality traits, such as being especially neat, may be linked to the development of OCD.

Diagnosis of OCD

If you think you have OCD, and it’s affecting how you live your life, see your GP. He or she will ask about your symptoms. Your GP may also ask you about your medical history. You may feel embarrassed about your symptoms and talking about them but try not to. Remember that your GP will be familiar with treating other people who have similar conditions.

It’s important to be open and honest with your GP about any obsessions and compulsions you have. This will help him or her to make the right diagnosis and recommend the best type of treatment for you. Your GP may refer you to another healthcare professional, who specialises in mental health, for further treatment.

Treatment of OCD

Self-help

There are a number of things that you may wish to try to help manage your symptoms. These can include the following.

  • You may find it useful to attend a self-help group. Here you will be able to share your feelings and experiences with other people who are also affected by OCD. You can get details about self-help groups from charities that support people with OCD. Your GP may also be able to give you information about them. You could try using self-help websites, computer programs and books to help manage your symptoms.
  • Learning a relaxation technique may help you to deal with the anxiety associated with your symptoms. This might include breathing exercises or exercises designed to help you relax your muscles.
  • Taking part in regular physical activity. This could help to reduce your anxiety. Aim to do up to 30 minutes of physical activity each day.
  • Don’t use illegal drugs or alcohol to alleviate anxiety or to push away your obsessive thoughts. Using these can have serious consequences for your physical and mental health.

Talking therapies

You may be offered cognitive behavioural therapy (CBT) to help you manage your symptoms. CBT is a type of talking therapy that can help you to change how you react to your thoughts. If your symptoms are mild, you may be offered a short course of individual CBT. This could be either face to face or by telephone, or group sessions of CBT. This will usually be up to 10 hours with a therapist. If your symptoms are having a more serious impact on your life, you may be offered more intensive sessions of CBT.

One of the main forms of CBT is called exposure and response prevention (ERP). This is used as a way to stop your obsessions and compulsions from strengthening each other. ERP works on the theory that if you’re in a stressful situation for long enough, you will gradually get used to it and your anxiety will go away. In ERP, your therapist will help you to gradually face your fears (exposure). He or she will encourage you to try to stop carrying out your usual compulsions (response prevention) and wait for your anxiety to go away.

Your therapist is likely to ask you to practise this daily. Therefore, you will need to feel able to do so without him or her always being there to guide you. You may feel anxious about not carrying out your usual compulsions but your therapist will manage your treatment to try to prevent this. If you have any questions about what will be involved, ask your therapist or GP. It’s important to understand what will happen in your therapy before you start the treatment.

Medicines

You may be offered medicines if you have more severe OCD, or if your symptoms are mild but don't improve with CBT. If your symptoms don’t improve with CBT your doctor may prescribe you an antidepressant medicine, such as sertraline. These medicines can help to ease symptoms of OCD even if you aren’t depressed.

They work by increasing the levels of serotonin in your brain. You may experience some side-effects while taking these medicines, such as high blood pressure and feelings of aggression. Your doctor will advise you to have regular check-ups in the first few weeks of treatment to monitor any side-effects that you may have.

If these medicines don’t work, you may be offered another type of antidepressant medicine called clomipramine to help reduce your symptoms. Side-effects of this medicine can include feeling restless, high blood pressure and diarrhoea.

You may find that a combination of CBT and one of these medicines helps to make your OCD easier to cope with.

If your OCD is very severe, you may be offered support from a team of healthcare professionals who specialise in mental health. If you’re extremely anxious or if your OCD prevents you from carrying out your daily activities, you may need to go into hospital for further treatment.

Living with someone who has OCD

Living with someone who has OCD can be difficult. The following ideas may help you support someone you know with OCD.

  • Learning more about OCD may help you understand the person you’re supporting.
  • You may find it helpful to accept the obsessions and compulsions that the person has, but without encouraging them. For example, if the person has to clean the bathroom before they can use it there is no need for you to do this as well. Going along with someone’s compulsions can be disruptive and won’t always help his or her anxiety.
  • Where possible, try to support the person if he or she is using a self-help programme. If there are group sessions, you may be able to attend some of these.
  • Encourage the person to seek help from his or her GP or an organisation that can help with mental health issues.
  • You may find it helpful to talk to other people who are in a similar situation to you. You can find details about self-help groups from charities that support people with OCD. Your GP may also be able to give you information about these.


Reviewed by Hemali, Bupa Health Information Team, January 2014.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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