OCD Symptoms: Obsessions, Compulsions, and Examples of Manifestations

Intrusive thoughts and repetitive actions are familiar to many, but this is not always OCD. Below is how to tell one from the other, which symptoms are typical, and when a doctor is needed.

What OCD is and how it manifests

OCD is obsessive-compulsive disorder, also called obsessional neurosis. A person repeatedly experiences intrusive thoughts and repeats actions that they cannot control or stop. This interferes with life.

The myth that OCD is about neatness is incorrect. Cleaning may be one of the symptoms, but more often a person "gets stuck" on an action that they feel obliged to repeat. They usually recognize their experiences as distressing.

The cause is unknown. Heredity, biology and brain chemistry, and environment may play a role. Most often OCD begins in adolescence or young adulthood. Prevalence is estimated at 1–3% in adults and approximately 1 in 200–500 in children and adolescents. The first symptoms usually appear at ages 10–30, and a person first sees a psychiatrist between ages 25 and 35.

Obsessions: intrusive thoughts

Obsessions are recurring thoughts, urges, or mental images that cause anxiety. They come involuntarily. Typical themes: fear of dirt or contamination; fear of forgetting, losing, or misplacing an item; fear of losing control over one's behavior; anxiety about harm to oneself or others; unwanted thoughts about sex or religion; aggressive thoughts about oneself or others; a need for things to be arranged evenly and precisely. A person does not choose these thoughts, and they are usually extremely distressing.

Compulsions: repetitive actions and movements

Compulsions are behaviors that a person feels obliged to repeat in order to reduce anxiety or stop obsessions. Common variants: excessive handwashing and cleaning, repeated checking (whether the door is closed, whether the stove is turned off), compulsive counting, arranging things in a specific order. Some people with OCD have Tourette syndrome or another tic disorder: tics are sudden twitches, movements, or sounds that a person cannot stop.

Examples of OCD symptoms

• a person returns home to check the stove and still is not sure they turned it off;
• washes hands and cleans excessively because of fear of dirt or contamination;
• arranges objects symmetrically and rearranges them until it feels "right";
• compulsively counts to reduce anxiety;
• is haunted by recurring anxious thoughts that someone will be harmed.

OCD in children: what to pay attention to

OCD also occurs in children. Boys are more often diagnosed at an earlier age than girls. The risk is higher if a close relative — a parent, brother or sister, or child — has OCD, especially when it began in childhood or adolescence. Other factors: features of brain structure and function, childhood trauma such as abuse, and temperament — shyness, frequent low mood, anxiety in childhood. In some cases, symptoms appear after a streptococcal infection. Children and adolescents experience the same obsessions and compulsions described above, and tics are also possible.

When signs require seeing a doctor

Not everyone who notices intrusive thoughts has OCD. A disorder is usually discussed when a person cannot control their thoughts and behavior, even while understanding they are excessive; spends at least an hour a day on them; does not derive pleasure from the actions but feels brief relief of anxiety; and as a result has noticeable problems in daily life.

Diagnosis begins with a conversation with a doctor: they perform an examination and ask about health history to rule out other causes. If there are no physical causes, an OCD test or a referral to a mental health specialist may be considered. OCD can sometimes be difficult to recognize — symptoms resemble other anxiety disorders and may co-occur with them. Severity is assessed using the Yale–Brown scale.

OCD by itself is not a reason to call an ambulance. 103 and 112 — for a life-threatening condition.

This material is for reference: it does not replace a doctor's consultation and does not establish a diagnosis.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer