Get started
What we treat
Why online therapy
How it works
How it works
Meet the therapists
Wellbeing blog
Log in

What we treat

Obsessive Compulsive Disorder (OCD)

Obsessive-compulsive disorder (OCD) is a common anxiety-related mental health condition that involves a pattern of unwanted thoughts and fears (obsessions) making you do repetitive behaviours (compulsions). While some people develop the condition early in their life, often around puberty, it typically develops during early adulthood.

OCD symptoms can be very distressing and significantly interfere with your quality of life, as well that of your loved ones. If you try to ignore or stop your obsessions, that only increases your distress and anxiety. You may then feel driven to perform compulsive acts to try to ease your stress. Yet despite efforts to ignore or get rid of distressing thoughts or urges, they can keep coming back. This leads to more repetitive, ritualistic behaviour — the characteristic vicious cycle of OCD.

OCD often revolves around certain themes — for example, an excessive fear of being contaminated by germs. To calm these fears, you may compulsively wash your hands until they're sore and chapped.


Symptoms of OCD

There are two main types of symptoms: obsessions and compulsions.


Obsessions are persistent and uncontrollable thoughts, images, urges, worries, fears or doubts that repeatedly appear in your mind. They can make you feel very anxious.

Obsessions tend to have themes to them, for example:

  • Fear of contamination or dirt
  • Needing things to be orderly and symmetrical
  • Aggressive or horrific thoughts about losing control and harming yourself or others
  • Doubting yourself excessively and having difficulty tolerating uncertainty

Examples of obsession signs and symptoms include:

  • Fear of being contaminated by touching objects others have touched
  • Intense stress when objects aren't orderly or facing a certain way
  • Thoughts about shouting obscenities or acting inappropriately in public
  • Doubts that you've locked the door or turned off the stove

Compulsions are repetitive physical behaviours or thought rituals that are performed over and over again in an attempt to relieve the anxiety caused by obsessional thoughts. These compulsions are excessive and often are not realistically related to the problem they're intended to fix.

As with obsessions, compulsions typically have themes, such as:

  • Washing and cleaning
  • Checking
  • Counting
  • Orderliness
  • Demanding reassurance

Examples of compulsion signs and symptoms include:

  • Hand-washing until your skin becomes chapped and raw
  • Checking doors repeatedly to make sure they're locked
  • Checking the stove repeatedly to make sure it's off
  • Counting in certain patterns
  • Silently repeating a prayer, word or phrase
  • Arranging your canned goods to face the same way
Types of thought patterns
  • Because I thought it, I either did it or was the reason it happened
  • Because I thought it, I either want to do it or want it to happen

This way of interpreting thoughts produces the anxiety that sufferers of OCD feel, and the anxiety generates behaviours that are an attempt to cope: repetitive or compulsive acts you feel driven to perform to control your anxiety.

OCD and Intrusive thoughts

Intrusive thoughts are unwanted thoughts that can pop into our heads without warning at any time. They are often repetitive and can take the form of images, sounds, or statements. These thoughts can be disturbing or distressing and can have a negative effect on our mental health and the way we behave.

Although intrusive thoughts are perfectly normal, people who have symptoms of anxiety or depression are most likely to experience unwelcome thoughts.‍

Causes of OCD

The cause of obsessive-compulsive disorder isn't fully understood. None of the different theories about why OCD develops can fully explain every person’s experience, but researchers suggest that the following could contribute to the onset of OCD:

Having 'dysfunctional' beliefs

Essentially, the relationship you have with your thoughts. Those with OCD often believe that they have more responsibility for an external life situation than they actually do. Because of this, their response to their thoughts may be out of proportion, triggering an OCD cycle

Personal experience

Some theories suggest your personal experience might increase the likelihood of developing OCD symptoms. This could be a traumatic childhood experience, a stressful life event or even a behaviour learned from close family members who may have exhibited OCD behaviour patterns

Biological factors

Some researchers believe that low levels of the chemical serotonin in the brain might be related to developing OCD, but it’s unclear whether it’s a cause or an effect of the symptoms. OCD may also have a genetic component, but specific genes have yet to be identified

How to look after yourself when living with OCD

If you have OCD, it’s likely that you’re able to use logic to challenge the obsessive thoughts you’re having. However, you’ll still feel compelled to do whatever it is that decreases the anxiety caused by those thoughts. OCD symptoms can be confusing as they fluctuate in intensity and can change altogether.

Many people suffer from OCD in silence for years as they’re not aware of the condition and are too embarrassed to seek help.

Getting the help you need is key if you think you’re suffering with OCD. The most important thing to remember is that, while OCD can be a severe psychological issue, it responds to psychological treatment, so it is possible to live a life free of OCD.

Some things you can do to help yourself include:

  • Learning about OCD. Learning about your condition can empower you and motivate you to stick to your treatment plan.
  • Staying focused on your goals. Keep your recovery goals in mind and remember that recovery from OCD is a process.
  • Joining a support group. Reaching out to others facing similar challenges can provide you with support and help you cope with challenges.
  • Exploring healthy ways to channel your energy, such as hobbies and recreational activities.
  • Looking after yourself physically. Exercise regularly, eat a healthy balanced diet and get sufficient sleep.
  • Learning relaxation and stress management techniques. When done in addition to professional treatment, meditation, muscle relaxation, massage, deep breathing, yoga or tai chi, for example, may help further ease stress and anxiety.
  • Sticking with your regular activities. Try not to avoid meaningful activities: go to work or school as you usually would and spend time with family and friends. Don't let OCD get in the way of your life.

How to support a loved one suffering from OCD

It can be difficult to know how best to help a friend or family member who is experiencing episodes of OCD. Here are some things to consider:

OCD can have a big impact on the person’s family and friends, who may find some aspects of the condition frustrating or exhausting. 

Family, friends and carers are often unaware of how best to help a loved one suffering with OCD. Symptoms can be hard to understand and can interfere with the daily functioning of a family. 

If you have a loved one suffering from symptoms of OCD, find out as much as you can about OCD and the different ways it can manifest itself, so you can support them as best you can.

While it’s probably best not to assist your loved one with any compulsive behaviours or rituals – something often labelled ‘accommodation’ – it’s important to be patient with them to ensure they don’t feel judged, and to reassure them you’re there to love and support them.

Start the process

If you would like to find out about other mental health support options available in your area, visit the NHS website.

Get started with ieso