Understanding OCD
What is OCD?
Obsessive compulsive disorder (OCD) is a mental health condition. The main symptoms of OCD are obsessive thoughts and compulsive behaviours. These can take up a lot of time and affect daily life.
OCD is unlikely to get better on its own. But treatment and support can help you manage your symptoms and have a better quality of life.
1.2%
OCD-UK estimates that around 1.2% of people have OCD, which is around three quarters of a million people in the UK.
Source: OCD-UK (opens in a new tab)
Up to 80%
OCD-UK says research has shown that up to 80% of people report unwanted intrusive thoughts, often much like the obsessions in OCD.
Source: OCD-UK (opens in a new tab)
Most
NHS inform says most people with OCD improve after receiving treatment.
Source: NHS inform (opens in a new tab)
How OCD works
The OCD cycle
Obsessions and compulsions feed each other. Each step leads to the next, so the loop keeps going.
Obsession
An unwanted thought, image or urge keeps coming into your mind.
Anxiety
You feel anxious, disgusted or uneasy.
Compulsion
You repeat an action or mental act to ease the feeling.
Short-lived relief
The relief only lasts a short time, then the obsession comes back.
The cycle starts again
Compulsions make OCD harder to manage.
A closer look
The two halves of the cycle, side by side
In your mind
What are obsessions?
An obsession is an unwanted thought, image or urge that keeps coming into your mind. It can make you feel anxious, disgusted or uneasy.
What you do
What are compulsions?
A compulsion is a repeated action or mental act. You feel you need to do it to ease the feelings an obsession brings. The relief only lasts a short time.
Breaking the loop
Why compulsions keep OCD going
A compulsion can bring relief, but the NHS says the relief is temporary. The obsession and anxiety soon come back, and the cycle starts again.
NHS inform explains that compulsions also make OCD harder to manage. They stop you learning that you can cope with anxiety, and that it may not be as bad as you imagine. See how the OCD loop works.
The NHS says therapy for OCD is usually a type of cognitive behavioural therapy (CBT) with exposure and response prevention (ERP). It helps you face your fears without ‘putting them right’ with compulsions. Find out how ERP treatment for OCD works.
Anxiety over time
- Doing a compulsion
- Facing the fear without one (ERP)
Common themes
Types of OCD
OCD can attach itself to almost any thought, fear or subject. It often focuses on things that are important in a person’s life.
The themes can look very different. But OCD-UK says all types of OCD have the same treatment approach. It deals with both the obsessions and the compulsions.
Contamination
Fears of dirt, germs or illness that lead to washing, cleaning or avoiding things again and again. Covers mental contamination and how treatment can help.
Checking
Checking locks, the gas or your memory again and again, in case something bad happens. Why the doubt keeps coming back, and how treatment can help.
Intrusive thoughts
Unwanted thoughts about harm, sex or religion can be frightening. Learn why, in OCD, they do not mean you will act on them, and how treatment can help.
Symmetry and ordering
A strong urge to arrange, count or repeat things until they feel ‘just right’. It is more than liking things tidy, and treatment can help.
Myths and facts
Common myths about OCD
Many people have the wrong idea about OCD. Here is what UK health bodies and charities say.
Myth
Being ‘a bit OCD’ just means you like things clean and tidy.
Fact
OCD is not a personality quirk. OCD-UK says small quirks that last a moment and cause little distress are not OCD. OCD itself can leave a person unable to get on with their day for hours at a time.
Source: OCD-UK (opens in a new tab)
Myth
Having intrusive thoughts about harm means you might act on them.
Fact
The Royal College of Psychiatrists says a person with OCD is at no greater risk of causing harm than anyone else. If you ever feel you may be about to harm yourself, call 999 or go straight to A&E.
Myth
Compulsive gambling, shopping or drinking is a kind of OCD.
Fact
The Royal College of Psychiatrists says it is not. Those behaviours can feel pleasurable. Compulsions in OCD never give pleasure. They always feel like an unpleasant demand or burden.
Myth
‘Pure O’ is a type of OCD with obsessions but no compulsions.
Fact
‘Pure O’ is not a medical term. OCD-UK says people described as having ‘Pure O’ still have compulsions. Some are hidden mental rituals, but there are nearly always outward ones too, such as checking, asking for reassurance or avoiding things.
Source: OCD-UK (opens in a new tab)
Causes
What causes OCD?
It is not clear exactly what causes OCD. The NHS says several things may play a part:
- Family history. You’re more likely to develop OCD if someone in your family has it. This may be learned behaviour, or it may be because of your genes.
- Differences in the brain. Some people with OCD have unusually high activity in some areas of the brain, or low levels of a chemical called serotonin.
- Life events. OCD may be more common in people who have been bullied, abused or neglected. It sometimes starts after an important life event, such as having a baby or a bereavement.
- Personality. People who are neat, careful and methodical, with high personal standards, may be more likely to develop OCD. So may people who are generally quite anxious or have a very strong sense of responsibility for themselves and others.
OCD-UK says stress and parenting styles have been blamed for causing OCD, but there is no evidence yet that they do. Major stress or a traumatic event may trigger OCD in someone who is already prone to it.
Whatever the cause, OCD is not your fault. The NHS says it is a health condition like any other, so there is nothing to feel ashamed or embarrassed about.
Who OCD affects
OCD at different stages of life
OCD can affect men, women and children. Symptoms can start as early as 6 years old, but OCD often begins around puberty or early adulthood. For some women, pregnancy or birth can trigger OCD, and new fathers may be affected too.
We work with both children and adults. These guides explain what OCD can look like for young people, and during pregnancy and after birth.
Pregnancy and after birth
OCD during pregnancy or after birth is called perinatal OCD. Unwanted thoughts about your baby being harmed are common. In OCD, they do not make you a risk to your baby.
Children and young people
How OCD can show up in children and teenagers, how families can help without feeding it, and where to get support and treatment.
Getting help
How to get help for OCD
You can get treatment for OCD on the NHS or privately. NHS inform advises contacting your GP practice if obsessions and compulsions are affecting your daily life.
We are not an emergency service. If you need help now, see our urgent help page.
Sources
- NHS — Overview - Obsessive compulsive disorder (OCD) (opens in a new tab)
- NHS — Symptoms - Obsessive compulsive disorder (OCD) (opens in a new tab)
- NHS — Treatment - Obsessive compulsive disorder (OCD) (opens in a new tab)
- NHS — Find NHS talking therapies for anxiety and depression (opens in a new tab)
- NHS — Talking therapies (opens in a new tab)
- NHS inform — Obsessive compulsive disorder (OCD) (opens in a new tab)
- NHS inform — Obsessive compulsive disorder (OCD) self-help guide (opens in a new tab)
- Royal College of Psychiatrists — Obsessive-compulsive disorder (OCD) (opens in a new tab)
- Royal College of Psychiatrists — Perinatal OCD (opens in a new tab)
- OCD-UK — Introduction to Obsessive Compulsive Disorder (opens in a new tab)
- OCD-UK — What are obsessions? (opens in a new tab)
- OCD-UK — What are compulsions? (opens in a new tab)
- OCD-UK — Types of OCD (opens in a new tab)
- OCD-UK — Does Pure O Exist? (opens in a new tab)
- OCD-UK — What’s not OCD! (opens in a new tab)
- OCD-UK — What causes OCD (opens in a new tab)
- OCD-UK — OCD during a prenatal or postnatal period (opens in a new tab)
- NICE — Context | Obsessive-compulsive disorder and body dysmorphic disorder: treatment (CG31) (opens in a new tab)
- Mind — What is OCD? (opens in a new tab)
- Mind — OCD and stigma (opens in a new tab)
- NHS — Help for suicidal thoughts (opens in a new tab)
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