What is Obsessive-Compulsive Disorder (OCD)?

Many people think that Obsessive-Compulsive Disorder (OCD) is just another way of saying that someone is a perfectionist, or likes things to be neat. This is not true, and over simplifies a disorder that can have very serious affects on a persons everyday life. OCD is a disorder consisting of two parts: the ‘obsession’ and the ‘compulsion’. Obsessions tend to be thoughts, while compulsions are usually behaviours.

Obsessions are persistent, intrusive and unwanted thoughts, images or urges. Someone with OCD usually knows that their obsessions are irrational or inappropriate, but they are not able to control them. This causes strong feelings of anxiety.

Compulsions are repeated behaviours that the person performs to try and lessen the anxiety caused by the obsession. These activities can be different for different people. Some common compulsions include: counting, touching, washing and checking.

For a diagnosis of OCD, the obsessions and compulsions must significantly interfere with your ability to live your life and cause you a great deal of distress.

Examples of common obsessions:

  • Obsession about being in contact with germs (e.g., by shaking hands, touching a doorknob/keyboard, etc.), leading to intense anxiety about disease/death resulting from those germs
  • Obsession about whether or not some action was performed (e.g., door was locked; oven was turned off), leading to intense anxiety about the consequences if the action wasn’t done (e.g., house will be burgled; house will catch fire and someone will die)
  • Exactness and Order: Obsession about having things in a particular order (e.g., pencils perfectly lined up; morning routine followed in precise order), leading to intense anxiety about devastating and usually unrelated outcomes (e.g., his or her grandmother will die; the school will burn down; he or she will fail an exam) when things are moved, are not placed in a specific way, or are generally disordered.
  • Obsession about impulses to commit a violent, aggressive, or horrible action (e.g., to hurt someone; to swear loudly in class), leading to intense anxiety about what would happen if this impulse cannot be controlled and you were to act on the impulse

Examples of common compulsions:

  • Repeatedly washing or cleaning, often of the hands. This compulsion is often related to contamination obsessions
  • Repeatedly checking to make sure a task was performed, like locking the door or turning off the oven. This compulsion is often related to obsessions about doubts
  • Repeatedly putting things in a particular order or requiring that things have a certain symmetry. This compulsion is often related to obsessions about order and control
  • Repeatedly counting things to reduce anxiety (e.g., floor tiles, numbers in general)
  • Repeatedly performing a specific behaviour in order to counteract the obsession. For example, someone who has obsessions about doing something inappropriate in school may tap their desk repeatedly to try prevent the obsession from coming true
  • Repeatedly asking others for reassurance that everything is okay or that you have performed some task (e.g., turning off the oven, locking the front door)

OCD should not be confused with Obsessive-Compulsive Personality Disorder, in spite of their similar names. Someone with Obsessive-Compulsive Personality Disorder does not have obsessions and compulsions; rather, they have a rigid way of interacting with the world that insists on control, orderliness, and perfection.

How does OCD affect young people?

OCD often begins in adolescence or early adulthood, although it can start in childhood. The disorder is often more serious if it begins in childhood, although approximately 40% of people with childhood-onset OCD will recover by the time they are adults

OCD can make daily life very stressful for young people. Rituals usually take a lot of time, and can make you late for school, work or other activities. This often results in tension or arguments in the family. You may be unable to enjoy time with friends or have fun if OCD takes up all your spare time. At school or work, obsessions and rituals like checking, erasing and re-doing tasks can affect attention, focus, and completion of tasks. Getting through a day with OCD can be exhausting, and the stress can make you sad, angry or depressed.

What causes OCD?

Studies have identified a number of things that could lead to the development of OCD. Research has found that the brains of people with OCD may work differently than those who do not have the disorder. If you have a close family member with OCD, you have a higher chance of developing the disorder,but some young people develop OCD without any known family history of the disorder. A stressful or traumatic event, like being involved in a car accident or other violent incident, could trigger the start of OCD symptoms. If left untreated, everyday anxiety and stress in a person’s life will worsen the symptoms of OCD.

Can OCD be treated? 

OCD can successfully be treated. Most often, OCD is best treated by a combination of psychotherapy (talk therapy) and medication. Deciding which treatment is best for you should be done with the guidance of a mental health professional. Psychotherapy will help you to change your thinking patterns and behaviours that cause you distress. A type of medication often superscribed for people with OCD is Selective Serotonin Re-uptake Inhibitors (SSRIs). This medication helps to treat the obsessions and compulsions, reduces anxiety and treats depression. As with all treatment and recovery from a mental health disorder, it is also very important to maintain a healthy lifestyle and ensure you get enough sleep, regular exercise and follow a balanced diet.