What Is Obsessive Compulsive Disorder (OCD)?

Therapy and medication can help manage condition

Pencils and pins neatly arranged. Could it be  a sign of OCD.

Therapy and medication can help manage condition

It’s happened to many of us. We leave the house, only to turn back to make sure we’ve turned off the oven or another appliance.

For most of us, checking once is enough to reassure ourselves that all is well. But for people with an obsessive disorder, once is not nearly enough. They check over and over again as if they were compelled to do so.

Obsessive compulsive disorder (OCD) is a mental health condition that affects millions of Americans. It is marked by recurring obsessive thoughts and compulsive behaviors that can disrupt daily life.

“OCD can interfere with school, work, family, and day-to-day activities,” says Arta Shirkhodai, MD, an internal medicine physician at Scripps Coastal Medical Center Vista. "If you or a loved one is experiencing symptoms of OCD, it's important to seek help."

Symptoms of OCD

People with OCD have thoughts or actions that are time consuming and beyond their control. They can have both obsessive thoughts and compulsive rituals, or just one of the two. Symptoms range from mild to severe and can fluctuate over time.

People with OCD may be aware that their thoughts and actions are unreasonable but feel powerless to control them. Many avoid situations that trigger their obsessions or compulsions, which can further impact their quality of life.


OCD obsessions are recurrent, unwanted thoughts that cause distress or anxiety. Common obsessions include invasive thoughts that appliances have not been turned off or doors have not been locked.

There is also fear of germs or contamination. Someone may touch a doorknob or steering wheel and become obsessed with the thought that they have germs. As a result, they engage in the compulsive behavior of repeatedly washing their hands.

Other common obsessions include:

  • Repeated doubts about something done or not done
  • Religious concerns or fears
  • Fear of harming self or others
  • Extreme concern with order, symmetry or precision
  • Fear of losing something important


Compulsions are repetitive behaviors. They’re done to relieve the anxiety or distress caused by obsessive thoughts and often take up a lot of time.

Common compulsions include:

  • Excessive handwashing, showering, brushing teeth
  • Repeated cleaning of household items
  • Repeatedly checking locks and appliances
  • Rituals related to numbers, such as counting

Who gets OCD?

The cause of OCD is unknown. Genetics, brain biology and chemistry and environment may play a role.

OCD usually begins in adolescence or young adulthood. Research has shown that childhood trauma and streptococcal infections can be risk factors.

A subtype of OCD is known as Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS). It is marked by a sudden onset of OCD symptoms or tics. It is believed to be caused by an autoimmune response to strep infection.

What are treatments for OCD?

Treatment for OCD can improve ability to function at school or work and develop and enjoy relationships. “The first step is to talk with your doctor and arrange an evaluation,” Dr. Shirkhodai says.

Treatment may include behavior therapy or medication or both. Selective serotonin reuptake inhibitors (SSRIs) are medications that can help reduce symptoms.

Cognitive-behavioral therapy (CBT) is also commonly used to treat OCD. It focuses on changing the way a person thinks about and responds to their obsessive thoughts and compulsive behaviors.

Exposure and response prevention (ERP) is a specific form of CBT. It involves gradually exposing a person to their feared thoughts or situations while preventing them from performing their compulsive behaviors.

ERP has been shown to be effective in reducing the symptoms. However, it needs to be done consistently and under the care of a professional therapist for weeks or months .

Support groups and individual therapy can also help. They provide a safe and supportive environment for people with OCD to share their experiences and learn coping skills.

OCD vs Obsessive Compulsive Personality Disorder

It's important to distinguish OCD from obsessive-compulsive personality disorder (OCPD), which is a different condition.

OCPD is a personality disorder marked by a preoccupation with orderliness, perfectionism and control. Unlike OCD, people with OCPD do not experience intrusive thoughts or compulsions.

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