Obsessive-Compulsive Disorder (OCD)

Obsessive-compulsive disorder (OCD) is a long-term disorder where a person experiences uncontrollable and repeated thoughts (obsessions), repeat behaviors (compulsions) or both. People with OCD have time-consuming symptoms that can cause major distress or interrupt daily life.

Obsessions are thoughts, urges or mental images that are repeated, unwanted and make most people anxious.

Some common obsessions of people with OCD are:

• Fear of germs
• Wanting to have things symmetrical or in perfect order
• Fear of forgetting, losing, or misplacing something
• Fear of losing control
• Aggressive thoughts
• Unwanted or taboo thoughts about sex, religion, or harm

Compulsions are repeated behaviors a person feels they have to do, often in response to an obsession.

Some common compulsions of people with OCD are:

• Excessive cleaning or handwashing
• Ordering or arranging items in a certain, precise way
• Checking things, such as that the door is locked, or the oven is off over and over again
• Counting
• Praying or repeating words silently

Everyone rethinks or double-checks things. Not all repeated thoughts are obsessions, and not all habits are compulsions. People with OCD usually:

• Can’t control their obsessions or compulsions, even if they know they’re over the top
• Spend more than 1 hour a day on their obsessions or compulsions
• May feel temporary relief from their anxiety if they complete a compulsion
• Face major problems in daily life due to these thoughts or behaviors

If you or a loved one are having any of these symptoms it is important to talk to your health care provider. Diagnosing OCD can be hard because symptoms like worry, anxiety and low mood — which are often people’s concerns — can be similar to those of other mental illnesses. Also, people with OCD may not tell their provider about their obsessions and compulsions out of fear. Your provider will do an exam and ask about your health to make sure other illnesses or conditions are not causing your symptoms. They may also refer you to a mental health professional.

Even the most severe cases of OCD can be treated. People with OCD are usually treated with therapy, medicine, or a combination of both. No two people experience anxiety the same way, and there is no “one-size-fits-all” treatment. Finding the treatment that works best for you may take some trial and error. It is important to talk honestly with your doctor about how you are feeling.

Psychotherapy (also called talk therapy or counseling) can help by teaching new ways of thinking and behaving to change habits. Evidence-based approaches include cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT). Support groups can also be helpful to hear other people’s experiences. In recent years telehealth (virtual) services have become more common. For people who may have been hesitant to look for mental health care in the past, virtual mental health care might be a good option.

Medicines – The most common medications prescribed for OCD are antidepressants that target serotonin, a chemical in the brain found to be connected to depression and OCD. These medicines can take 8–12 weeks before you start to notice your symptoms getting better. You may need to try a few different medicines before finding the one that works for you. It is important to give medicine a chance to work before deciding if it’s right for you. Your provider can change your dose over time to help with any side effects. Do not stop taking your medicine without talking to your provider. They will work with you and change your treatment plan safely and effectively.

• Alliance Mental Health First Aid Community Trainings
• Alliance Behavioral Health Community Trainings

Alliance Behavioral Health Crisis Line: 877-223-4617
Connect with behavioral health and IDD services and crisis help. Available 24 hours a day, 7 days a week and always answered by a qualified professional or clinician.

Other resources available 24 hours a day, 7 days a week:

• 988 Suicide and Crisis Lifeline: Call, text, or chat 988 (resources for the deaf and hard of hearing)
• National Crisis Text Line: text “HOME” to 741741
• IMAlive Online Crisis Chat: imalive.org
• Veterans Crisis Line: 800-273-8255, press 1 or text 838255
• The Trevor Project: 866-488-7386 or thetrevorproject.org/help LGBTQ youth suicide hotline
• Trans Lifeline: 877-565-8860 or translifeline.org Transgender crisis hotline

Additional resources:

• Suicide Prevention and Statistics: 202-237-2280 or suicidology.org
• Promise Resource Network: 704-390-7709 or promiseresourcenetwork.com
• Reporting Suicidal Content Threats on Facebook: facebook.com/help/contact/305410456169423

Educational Resources

• Substance Abuse and Mental Health Services Administration (SAMHSA)
• International OCD Foundation
• OCD at School – Anxiety and Depression Association of America
• National Institutes of Mental Health (NIMH)
  • Obsessive-Compulsive Disorder: When Unwanted Thoughts or Repetitive Behaviors Take Over
• Durham Network of Care 
• Wake Network of Care