What Are the Signs and Symptoms of Obsessive-Compulsive Disorder?

Disclaimer: This article is for educational purposes only and does not replace expert medical or mental health advice. OCD requires a comprehensive psychiatric evaluation by a qualified clinician. So, always refer to a licensed mental health specialist for diagnosis and treatment.

Obsessive-compulsive disorder, or OCD, is a complex mental health condition that is characterized by obsessive thoughts, followed by mental and behavioral compulsions meant to neutralize or reduce these intrusive thoughts. Articles published in the National Library of Medicine (NLM) report that it impacts 1% - 3% worldwide; therefore, understanding the signs and symptoms of OCD can keep you informed on how best to seek care and make informed decisions.

The International OCD Foundation reports that the common obsessive themes in OCD are as follows:

• Contamination: Contamination-related obsessions revolve around fear of becoming contaminated with or spreading contamination related to germs, dirt, toxins, infections, disease, household items, and so on.
• Perfectionism: Perfectionism-related obsessions are related to things being imperfect, asymmetrical, or uneven. It revolves around performing tasks perfectly and completely, until they feel just right.
• Religion/Morality: Religion, morality, or scrupulous obsessions revolve around fear of offending God, sinning, and being morally right.
• Sex: Sexual obsessions are unwanted thoughts or images related to sexually harming children, relatives, or others.
• Identity: Identity obsessions revolve around concerns or doubts about one’s gender and sexual orientation, despite a consistent history that says otherwise.

• Violence: Violent obsessions are related to the fear of hurting oneself or others.

  Experiencing these violent, intrusive thoughts does not mean you will act on them. However, if you feel at immediate risk of hurting yourself or others, seek emergency services right away.

  If you are experiencing thoughts of hurting yourself or others, please call 9-8-8 immediately if you are in the U.S. If you are outside of the U.S., reach out to your national helpline immediately.

• Miscellaneous: Other obsessions are related to existential questions, relationships, and things that might have happened in the past, and how they can impact you.

The International OCD Foundation reports that the common compulsive mental and behavioral actions in OCD are as follows:

• Washing and Cleaning: Excessively washing or cleaning oneself and things to prevent contact with a potential contaminant. For instance, washing hands fifty times or brushing teeth a dozen times.
• Repetition: Repeatedly performing actions like checking, rechecking, arranging, rearranging, counting, recounting, writing, rewriting, and so on to ensure everything is just right or safe.
• Checking: Repeatedly checking your body, that you did not do something wrong or harm yourself or others.
• Praying and Other Rituals: Repeatedly praying and performing other religious rituals to ensure you are forgiven of your sin or did not offend God.
• Mental Reviews: Mentally reviewing your thoughts, emotions, and actions to ensure you did not hurt yourself or others or did things just right.

Symptoms may suggest OCD when they:

• Obsessive thoughts, followed by compulsive behaviors, are frequent and feel uncontrollable.
• Lead to emotional distress.
• Interfere with daily responsibilities or relationships.
• Driven by anxiety rather than preference or logic.

OCD does not look the same for everyone. Some people experience primarily mental compulsions, while others show more visible behaviors. Symptom severity can also shift over time and may be impacted by stress, anxiety, trauma, life transitions, and other underlying mental health conditions.

Only a qualified mental health practitioner can determine whether symptoms meet the diagnostic criteria as per the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), clinical interviews, family history, physical examinations, and other tools.

While OCD can develop in anyone, clinical reviews and insights indicate certain risk factors can increase the likelihood:

• Genetics: Family studies indicate that having a family member with OCD increases the likelihood of developing this condition - even by 4 times, but this is not definitive.
• Brain Chemistry: Genetic studies have estimated that imbalances in dopamine, serotonin, and glutamate levels can be related to OCD. The SLC1A1 gene, which controls glutamate transport in the brain, has been identified as a potentially crucial factor.
• Gender: Clinical reviews have highlighted that men may report an earlier onset of OCD symptoms, while women may report a later onset - during puberty or the postpartum period.
• Environment: Environmental factors like stress and trauma have been linked with OCD. One systematic review of OCD etiology and symptom severity has indicated that 70% of those with OCD have traced the onset back to a traumatic life event; 30% have linked traumatic life events to worsening OCD symptoms.
• Underlying Mental Health Conditions: Systematic reviews and meta-analyses have indicated that certain mental health conditions co-occur at a higher prevalence rate with OCD, like anxiety disorders, major depressive disorder, bipolar disorder, personality disorders, and other psychiatric conditions.

Yes, OCD can be effectively treated with psychotherapy and medication. In fact, long-term outcomes have indicated that 32% - 74% of those who seek treatment for OCD show significant clinical improvements over a period of time.

Clinical reviews have indicated that exposure and response prevention (ERP) therapy is the widely used therapy for treating OCD. It exposes you to your subject or object of obsessive thoughts under safe and controlled conditions so that you can learn healthier ways to respond to them. Cognitive behavioral therapy can also be used to treat OCD.

Studies published in the NLM say selective serotonin reuptake inhibitors (SSRIs) are the first line of treatment for OCD. But moving beyond this, antipsychotics have also proven to be effective as the second line of treatment. Other double-blind studies have indicated that tricyclic antidepressants like clomipramine can be effective, too. Medication selection and planning must always be made under the close supervision of a board-certified physician or psychiatric practitioner.

The International OCD Foundation also suggests that transcranial magnetic stimulation and deep brain stimulation can also be effective alternative treatments when other treatments do not show effect. However, they are rarely used.

If you are struggling with OCD symptoms, we understand how challenging it can be. Reach out to the NuView Treatment Center today - our expert team of qualified and experienced mental health specialists provides personalized care in a safe, confidential environment where you can heal and move toward a healthier, fulfilling life.

Please do not hesitate to give us a call at (323) 307-7997 to connect with our experts now!

Can OCD symptoms change over time or go away?

OCD symptoms can change in intensity over time. But they typically tend to worsen if left untreated.

Can OCD symptoms be mistaken for personality or just habits?

OCD symptoms are often misunderstood as perfectionism or habits, but clinically significant OCD interferes with daily functioning.

Can OCD symptoms exist without visible compulsive behaviors?

Some tend to experience only mental compulsions, like ruminating and mental reviewing, which can make OCD harder to recognize.

Do people with OCD act on their intrusive thoughts?

Intrusive thoughts in OCD are ego-dystonic, meaning they conflict with a person’s principles and are emotionally discomforting. Most with OCD do not act on these thoughts. If someone feels at risk of harming themselves or others, contact emergency services immediately.

How is OCD different from anxiety disorders with constant worries?

OCD is distinct from anxiety in that it is characterized by intrusive obsessions followed by compulsive mental or behavioral actions aimed at reducing anxiety, rather than worry alone.