Understanding OCD: Signs, Symptoms, and When to Seek Support

Written By Chelsea Fielder-Jenks

Obsessive-Compulsive Disorder (OCD) is often misunderstood as a personality quirk or an intense preference for cleanliness and order. In reality, OCD is a serious, potentially debilitating mental health disorder that affects people of all ages, genders, and backgrounds. As OCD Awareness Month brings these discussions to the forefront, we aim to increase awareness, understand the signs and symptoms, including what's "normal" and what's OCD, and highlight the importance of seeking evidence-based treatment.

What is OCD?

Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by persistent, intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) performed in an attempt to relieve distress. OCD symptoms range in severity and often interfere with daily activities, impacting relationships, academic or job performance, and quality of life.

OCD is widely treatable — Around 70% of people with OCD benefit from Cognitive Behavioral Therapy (CBT) and/or medication, but stigma, limited access to trained professionals, and difficulty finding effective local treatment often create barriers to care.

Signs and Symptoms of OCD: What’s “Normal” & What’s OCD?

It’s important to differentiate between “normal” behaviors or concerns and symptoms that may indicate OCD. For example, while many people worry about contamination or double-checking, OCD symptoms go beyond occasional concerns and can disrupt daily life.

1. Obsessions (Intrusive Thoughts):

  • Normal: Occasionally worrying about cleanliness or leaving the stove on.

  • OCD: Persistent, intrusive fears of contamination or harm that cause significant distress. These thoughts may feel uncontrollable and lead to anxiety, shame, or guilt.

2. Compulsions (Repetitive Behaviors):

  • Normal: Checking that the door is locked before bed or arranging items neatly.

  • OCD: Repeatedly washing hands, checking locks, or counting in specific ways to alleviate anxiety. These behaviors are often time-consuming and can interfere with work, school, or social life.

3. Avoidance Behaviors:

  • Normal: Avoiding specific situations due to minor discomfort (e.g., avoiding heights).

  • OCD: Avoiding places, people, or activities that may trigger obsessions, limiting one’s lifestyle and functioning.

When to Seek Support: If obsessions and compulsions take up an hour or more each day, interfere with daily responsibilities, or cause significant distress, seeking help from a mental health professional can make a positive difference. At Healgood, we have clinicians who specialize in treating anxiety and OCD using evidence-based therapies, including CBT and Exposure and Response Prevention (ERP).

Related OCD Conditions

OCD-related disorders share similar patterns of obsessions and compulsions. These include:

  • Body Dysmorphic Disorder (BDD): Obsessive focus on perceived flaws in appearance.

  • Trichotillomania (Hair-Pulling Disorder): Recurrent urges to pull out one’s hair.

  • Dermatillomania (Skin-Picking Disorder): Compulsive skin picking, leading to tissue damage.

  • Hoarding Disorder: Persistent difficulty discarding items, leading to cluttered, unsafe living conditions.

Facts About OCD

  • Prevalence: OCD affects 1-2% of the population, with symptoms often starting in childhood or adolescence.

  • Impact on Life: The World Health Organization list anxiety disorders, including OCD, as the sixth largest contributor to non-fatal health loss globally. OCD was once ranked by the World Health Organization in the top 10 of the most disabling illnesses by lost income and decreased quality of life.

  • Barriers to Treatment: Despite the availability of effective treatments, stigma, limited access to specialized professionals, and lack of awareness create obstacles for many seeking help.

Evidence-Based Treatment for OCD

At Healgood, we use proven therapeutic approaches, including CBT and ERP, to help individuals with OCD reduce the impact of obsessions and compulsions. CBT helps by changing thought patterns and behaviors, while ERP gradually exposes individuals to triggers without engaging in compulsive behaviors, building resilience over time.

Through these methods, individuals learn to tolerate distress, reduce compulsive behaviors, and regain control of their lives. Research shows that combining CBT with ERP is highly effective for treating OCD, allowing clients to experience lasting change and improved quality of life.

Join Us in Raising Awareness

This OCD Awareness Month, let’s work together to increase understanding and reduce stigma around OCD. Join us at the OCD Awareness Walk on Saturday, November 2nd, and reach out to Healgood to learn more about our evidence-based treatments for OCD and anxiety. Whether for yourself or a loved one, we're here to provide the compassionate support you need.


References

  • American Psychiatric Association (2022). Diagnostic and statistical manual of mental disorders. 5th ed., text rev. Washington, DC: American Psychiatric Association.

  • Clark, David A. & Radomsky, Adam S. (2014). Introduction: A global perspective on unwanted intrusive thoughts. Journal of Obsessive-Compulsive and Related Disorders. Available online 18 February 2014. DOI: 10.1016/j.jocrd.2014.02.001

  • International OCD Foundation. (n.d.). What is OCD?. Retrieved from iocdf.org

  • Jalal, B., Chamberlain, S. R., & Sahakian, B. J. (2023). Obsessive-compulsive disorder: Etiology, neuropathology, and cognitive dysfunction. Brain and behavior, 13(6), e3000. https://doi.org/10.1002/brb3.3000

  • National Institute of Mental Health. (n.d.) Obsessive-Compulsive Disorder. NIMH Information Resource Center. https://www.nimh.nih.gov/health/statistics/obsessive-compulsive-disorder-ocd

  • OCD-UK. (n.d.) “World Health Organisation and OCD.” https://www.ocduk.org/ocd/world-health-organisation/


 

Join team Healgood in raising awareness by participating in the OCD Awareness Walk Saturday, November 2nd, and read on to learn more about OCD and our commitment to supporting those who live with it.

Common Obsessions

Contamination Obsessions:

  • Fear of coming into contact with perceived contaminated substances/things, such as:

    • Body fluids (e.g., urine, feces)

    • Germs/disease (e.g., herpes, HIV, COVID-19)

    • Environmental contaminants (e.g., asbestos, radiation)

    • Household chemicals (e.g., cleaners, solvents, battery acid)

    • Dirt

Violent Obsessions:

  • Fear of acting on an impulse to harm oneself

  • Fear of acting on an impulse to harm others

  • Excessive concern with violent or horrific images in one's mind

Responsibility Obsessions:

  • Fear of being responsible for something terrible happening (e.g., fire, burglary, car accident)

  • Fear of harming others because of not being careful enough (e.g., dropping something on the ground that might cause someone to slip and themselves)

Perfectionism-related Obsessions:

  • Excessive concern about evenness or exactness

  • Excessive concern with a need to know or remember

  • Fear of losing or forgetting important information when throwing something out

  • Excessive concern with performing tasks "perfectly" or "correctly"

  • Fear of making mistakes

Sexual Obsessions:

  • Unwanted thoughts or mental images related to sex, including:

    • Fears of acting on a sex-related impulse

    • Fears of sexually harming children, relatives, or others

    • Fears of performing aggressive sexual behaviors towards others

Religious/Moral Obsessions (Scrupulosity):

  • Fear of offending God, damnation, and/or concern about blasphemy

  • Excessive concern with right/wrong or morality

Identity Obsessions:

  • Excessive concern with one's sexual orientation.

  • Excessive concern with one's gender identity.

Other Obsessions:

  • Relationship-related obsessions (e.g., excessive concern about whether one’s partner is “the one," the partner’s flaws and qualities)

    • These types of obsessions can center around romantic partners, relatives, friends, and other relationships.

  • Obsessions about death/existence (e.g., excessive preoccupation with existential and philosophical themes, such as death, the universe, and one’s role in “the grand scheme.”

  • Real event/false memory obsessions (e.g., excessive concern about things that happened in the past and what impacts they may have had)

  • Emotional contamination obsessions (e.g., fear of "catching" personality traits or personal characteristics of other individuals)

Common Compulsions

Washing and Cleaning:

  • Washing hands excessively or in a certain way

  • Excessive showering, bathing, tooth-brushing, grooming, or toilet routines

  • Cleaning household items or other objects excessively

  • Doing other things to prevent or remove contact with contaminants

Checking that:

  • You did not/will not harm others

  • You did not/will not harm yourself

  • Nothing terrible happened

  • You did not make a mistake

  • Some parts of your physical condition or body

Repeating:

  • Routine activities (e.g., going in or out doors, getting up or down from chairs)

  • Body movements (e.g., tapping, touching, blinking)

  • Activities in "multiples" (e.g., doing a task three times because three is a "good," "right," "safe" number)

Mental Compulsions:

  • Mental review of events to prevent harm (to oneself others, to prevent terrible consequences)

  • Praying to prevent harm (to oneself others, to prevent terrible consequences)

  • Counting while performing a task to end on a "good," "right," or "safe" number

  • "Cancelling" or "Undoing" (example: replacing a "bad" word with a "good" word to cancel it out)

Other Compulsions:

  • Putting things in order or arranging things until it "feels right"

  • Telling, asking, or confessing to get reassurance

  • Avoiding situations that might trigger your obsessions

Chelsea Fielder-Jenks
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