What is OCD like? Symptoms, Causes, Health Risks & Treatment Options

It’s important to remember that OCD can look different in different people, and this list won’t cover every possible manifestation of the disorder. However, some of most commonly occuring forms are identified as:

Harm obsession

This form of OCD is characterized by intrusive thoughts involving violent acts against another person, or fearing they could cause someone else harm. Compulsions often involve avoiding the risk of causing harm to others, like hiding/avoiding knives and sharp objects.

Perfection / Symmetry

Also known as “Just Right” OCD, this subset involves the need for things to be correctly aligned or symmetrical. Compulsions can include aligning, ordering, touching and tapping.

Checking Compulsions

As the name suggestions, this form of OCD presents with checking-based compulsive behavior. People with this OCD often believe that they could cause something bad to happen to themselves or others, creating anxiety. Compulsive checking is used to gain a sense of certainty that they did lock the door, turn off the oven, tuck their children in, etc.

Contamination / Cleanliness

Contamination OCD is characterized by a patient becoming concerned by illness or germs, or in some cases “clean eating.” Compulsions can include excessive washing or avoiding areas where it's more likely to come in contact with germs, like crowded public places.

Sexual OCD

Sexual obsession OCD, often under-diagnosed according to “Psychology Today,” involves unwanted thoughts of a sexual nature that those experiencing them find disturbing.

Get a more in-depth look at the 4 main types of OCD.

Each subset of OCD can have its own symptoms, signs and triggers, but some of the most commonly occurring include:

Obsessions are thoughts, images or impulses that occur over and over again and feel outside of a person’s control. Typically, people do not want these thoughts and even realize they don’t make sense. Obsessions often bring fear, doubt, and a consuming need to do things the “right way.” Common obsession symptoms include:

Fear of Contamination

When a person is overly concerned by illness or germs, they may be struggling with contamination OCD. Worry over touching items that may be contaminated, as well as a fear of spreading contamination, are prevalent with this fear. Concern over cleanliness may lead to avoiding social situations that could trigger anxiety.

Unwanted and Intrusive Thoughts

Thoughts take many forms. In the case of OCD, thoughts are distressing and usually follow a theme, such as doubt that tasks were done correctly, such as turning off the oven or locking doors. Other examples include:

• Needing things to be orderly or symmetrical, and feeling intense stress when objects are not a certain way
• Aggressive or horrific thoughts about losing control and harming themself or others
• Unwanted thoughts about aggression, sexual or religious subjects

To neutralize the intensity of ruminations, people with OCD use compulsive, repetitive behaviors or thoughts as a temporary solution. Important to note is that they would rather not have to do these time-consuming tasks but feel driven to engage in compulsive behavior. Typical compulsions include:

Excessive Hand-washing

Intrusive thoughts create uncertainty, thus causing the need to perform a stress-reducing action. For those afraid of contamination, this often means excessive washing and cleaning of both themselves and objects around them. The repetitive washing of body and hands goes well beyond cleanliness and can cause skin to become chapped, raw or bleed.

“Checking” of Locks, Stove, etc.

Individuals with OCD often worry that harm will come to themselves or others. To ease these feelings, as well as ease the fear that they have forgotten to complete a task in order to keep everyone safe, they may compulsively perform many actions, including:

• Checking stove, doors repeatedly
• Counting in patterns
• Arranging items until it “feels right”
• Mental review of events/praying to prevent harm
• Repeating routine activities

The signs and symptoms of OCD in adolescents mimic those of adults, but young people often do not realize their obsessions and compulsions are out of the ordinary. Symptoms appear gradually over time, but there are signs to watch for:

Early-age Rituals

Rituals are important for child development, such as having an established eating or sleeping schedule. However, rituals can be problematic when children or adolescents become obsessed with doing them the “right way” and cannot complete tasks or move on until they’ve repeated the ritual to perceived perfection.

Counting

Like adults, children and adolescents with OCD often have the compulsive need to count. Homework may take hours as they rewrite the same number or word to get it “just right.” Similarly, they may be consumed by patterns and ordering objects a certain way.

Intense Need for Reassurance

As thoughts become distressing, children and adolescents may reach out to parents for reassurance — checking if doors are locked, windows closed, etc. — and keep asking until discomfort is relieved, and they feel confident nothing bad will happen. Though harmless once in a while, this need for reassurance is often not satiated and questions are repeated over and over.

While medication is helpful for managing symptoms, therapy is often an essential component for recovery from OCD. The following are proven methods to manage OCD so it does not control a person’s life:

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy is rooted in the idea that our thoughts, feelings, and behaviors are interrelated. In other words, our thoughts can influence behaviors, our behaviors can influence emotions, emotions can influence thoughts, and so on. There are two main components of CBT: cognitive change methods (exploring how thoughts and beliefs influence our emotions) and behavior change methods (looking at how our behaviors in situations can trigger or perpetuate symptoms).

CBT provides patients with the awareness and skills to identify and modify dysfunctional thoughts, emotions and behaviors that are causing them pain or interfering with their quality of life. Once unhelpful or distressing thoughts and behaviors are identified, patients can begin to make changes to their previous assumptions, thinking styles and behavioral responses.

Exposure & Response Prevention (ERP)

Exposure & Response Prevention is an evidence-based therapeutic intervention designed to help people safely confront their fears and interrupt patterns of avoidance and anxiety. Patients are supported by trained therapists throughout the exposures. Exposure work has been found to reduce emotional distress and improve overall functioning.

See how Pathlight uses ERP to treat OCD.

Treatments for OCD vary, but patients seeking help through Pathlight Mood & Anxiety Center (Pathlight) can find hope in recovery in our Residential and Partial Hospitalization Programs.

The OCD track is focused on supporting patients in managing triggers and experiencing success. It utilizes a specific form of Cognitive Behavioral Therapy (CBT) called Exposure & Response Prevention (ERP) — an evidence-based treatment for OCD and other anxiety disorders. The specialty track includes OCD individual and group therapy, family therapy for ongoing support and education, and psychiatric assessments to modify OCD treatment plans.

With guidance from Pathlight's highly experienced therapists, patients learn and practice CBT skills, making gradual, systematic and sustained progress towards recovery from mood and anxiety concerns.