What Is Obsessive-Compulsive Disorder (OCD)?

OCD is a on disorder marked by compulsive repetitive behaviors, such as checking things over and over, repeating certain words, and having obsessive thoughts.

Imagine having unwanted, recurring thoughts that fill you with distress or feeling you must repeat specific behaviors over and over and over. For many people, that is their reality. They have obsessive-compulsive disorder, often referred to as OCD.

It’s anything but a rare mental health problem. Studies suggest about 1 in 100 adults in the U.S. has OCD. It can affect children and teens, too. In fact, estimates show about 500,000 (1 in 200) American youngsters have OCD, according to the International OCD Foundation.

OCD symptoms tend to emerge at about age 10, or sometimes in young adulthood, around age 21. Boys are more likely to develop OCD at a younger age than girls. In general, most people who are diagnosed with obsessive-compulsive disorder had symptoms of the disorder by the time they reached young adulthood.

OCD is long-lasting, and the obsessions that characterize OCD can interfere with relationships, work, school, and other aspects of daily life. But there’s good news. OCD symptoms can be managed.

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Understanding obsessive-compulsive disorder

Do you double-check to make sure the lights are turned off sometimes or wonder if you remembered to take out the garbage? Everyone checks and re-checks things sometimes. That doesn’t mean you have OCD.

The symptoms associated with OCD are persistent and can cause ongoing stress. For example, a person with OCD may spend an hour or more every day checking things repeatedly or going through certain routines over and over to temporarily feel less anxiety.

In general, people with OCD can’t control their compulsive behaviors. They don’t repeatedly check certain things or dwell on obsessive thoughts because OCD behaviors give them pleasure. Performing compulsive behaviors, however, may help them feel relief from the anxiety associated with obsessive thoughts and activities.

In addition to obsessive thoughts and behaviors, people with OCD often also have a tic disorder. The National Institute of Mental Health (NIMH) explains OCD is associated with motor tics — sudden and brief repetitive movements like facial grimacing, shoulder shrugging, head or shoulder jerking, and eye blinking.

People with OCD may also have vocal tics, including repeatedly grunting, sniffing, or throat-clearing. It is common for people with OCD to have mood disorders or anxiety disorders, too.

Other symptoms of OCD

People with OCD can have obsessions (repeated urges, mental images, or thoughts that stoke anxiety) or compulsions (repetitive behaviors in response to an obsessive thought) — or both.
Common obsessions associated with OCD include:

• A need to have things symmetrical or in perfect order
• A fear of germs or any type of contamination
• Forbidden or taboo thoughts about sex, religion, or doing harm to self or others
• Constant worry over possibly forgetting, losing, or misplacing things

Common compulsions associated with OCD include:

• Cleaning or handwashing over and over
• Repeatedly checking things (like making sure the oven is off or the door is locked over and over)
• Repeating words, phrases, or prayers
• Arranging and rearranging things, repeatedly

What causes OCD?

An exact cause of obsessive-compulsive disorder hasn’t been identified. Researchers, however, have documented several risk factors for developing the disorder.

No specific genetic connection to OCD has been identified yet, but researchers have found that having a first-degree relative (your mother or father, sibling, or child) with OCD increases the chance of developing the disorder.

Brain imaging studies have revealed people with OCD, compared to people without the condition, often have differences in parts of their brains (the frontal cortex and subcortical structures) involved with emotional responses and controlling behavior. Research is ongoing to better understand the connection between those neurological findings and OCD symptoms.

Studies have also found an association between childhood trauma in some people and obsessive-compulsive symptoms, the NIMH reports. A condition called pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (or PANDAS) has been linked to a sudden onset or worsening of OCD symptoms in children.

Treatment for obsessive-compulsive disorder

If you, or your child, have symptoms of OCD, the NIMH advises talking with your healthcare provider. Your doctor can go over your health history and perform an exam to make sure some other condition isn’t causing signs of obsessive-compulsive disorder. If OCD is suspected, you may be referred to a mental health professional for more evaluation and treatment.

Treatment for OCD can include psychotherapy, medication, or a combination of counseling and medication. Selective serotonin reuptake inhibitors (or SSRIs) are the most common type of medication used to treat OCD.

People respond to medications in different ways, but the NIMH reports most people with OCD who are treated with medication, often along with psychotherapy, can usually manage their obsessive-compulsive symptoms. Note that it can take several weeks and even months for therapy to take full effect.

Since 2018, another type of therapy has been approved for use as an add-on treatment for OCD: transcranial magnetic stimulation (TMS). This type of brain stimulation therapy has been primarily used to treat depression but can also help people with OCD. For more information about this type of brain stimulation therapy, visit the NIMH website.

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