Definition

Obsessive–Compulsive Disorder (OCD) is a chronic anxiety-based condition whereby an individual experiences:

✅ Obsessions

Recurring, Intrusive, unwanted thoughts, images, or urges that lead to fear, anxiety, or distress.
Examples include fear of contamination, fear of harming someone, doubts about safety, recurring sexual or religious thoughts.

✅ Compulsions

Repetitive behaviours or mental acts performed to reduce the anxiety brought about by obsessions.

Examples include excessive handwashing, checking locks repeatedly, counting, repeating mantras , arranging objects.

OCD significantly interferes with daily life, relationships, functioning, and emotional wellbeing.

Causes

OCD develops due to a combination of biological, psychological, and environmental factors.

✅ Biological Factors
• Genetics: There is greater vulnerability if there is family history of OCD or anxiety disorders.
• Brain circuits: Over stimulation in the orbitofrontal cortex, caudate nucleus, and anterior cingulate cortex.
• Neurochemistry: Imbalances in serotonin (5-HT) pathways.

✅ Psychological Factors
• High levels of anxiety or worry of uncertainty
• Fear of failure
• Rigid thoughts
• Intrusive thoughts

✅ Environmental Factors
• Childhood trauma or stressful life events
• Infections (in rare cases, PANDAS in children)
• Learned behaviours from family (e.g., excessive checking or cleaning)

Symptoms

OCD typically includes both obsessions and compulsions, but some people may experience only one.

✅ Obsessions (Common Types)
• Fear of (dirt, germs, infections)
• Fear of harming self or others
• Intrusive violent, sexual, or religious thoughts
• Excessive doubt (“Did I lock the door? Did I turn off the fan?”)
• Intense need for symmetry or exactness
• Disturbing mental images

✅ Compulsions (Common Types)
• Excessive cleaning or washing
• Repetitive checking (locks, stoves, geyser)
• Counting, tapping, or repeating phrases
• Mental rituals (silent prayers)
• Reassurance-seeking
• Rearranging objects

✅ Emotional & Functional Symptoms
• High anxiety or fear
• Guilt and shame about intrusive thoughts
• Exhaustion from rituals
• bAvoiding people, places, or situations
• Difficulty studying, working, or maintaining relationships

Diagnosis

OCD is diagnosed by a mental health professional using clinical evaluation.

✅ Components of Diagnosis
• Clinical interview: nature of obsessions/compulsions, impact on life, duration
• Diagnostic criteria: DSM-5 or ICD-11
• Assessment tools:
• Y-BOCS (Yale–Brown Obsessive Compulsive Scale)
• OCI-R (Obsessive–Compulsive Inventory – Revised)

✅ Diagnosis Criteria
• Obsessions and/or compulsions are time-consuming (more than 1 hour per day)
• Cause significant distress
• Interfere with daily functioning
• Self harm ideation

Treatment

OCD responds well to a combination of therapy, medication, and lifestyle strategies.

✅ 1. Psychotherapy (First-line treatment)

Exposure and Response Prevention (ERP)
• The gold standard treatment
• Gradual exposure to feared thoughts or situations
• Preventing the compulsion (response prevention)

Cognitive Behavioural Therapy (CBT)
• Helps challenge irrational thoughts
• Reduces anxiety and breaks OCD cycles


✅ 2. Medication

Prescribed by a psychiatrist when symptoms are moderate to severe.
Medication helps reduce obsessional thoughts, anxiety, and ritual intensity.

 

✅ 3. Lifestyle Interventions
 • Routine sleep and exercise
 • Reducing caffeine and stimulants
 • Journaling intrusive thoughts
 • Yoga and Pranayam
 • Avoiding alcohol or substances

Living With OCD

Managing OCD requires ongoing effort, patience, and structured routines.

✅ Helpful Strategies:
•Practice ERP-based skills regularly
•Maintain consistent sleep and daily schedule
•Develop healthy coping techniques
•Reduce reassurance-seeking
•Work on avoidance behaviour
•Break tasks into smaller steps
•Recognise intrusive thoughts
•Track progress in a journal
•Join Support Group
•Remember Recovery is a process

Suggestions for Families

Families play a vital role in supporting recovery.

✅ Emotional Support
 • Listen without judgement
 • Short words of encouragement
 • Avoid criticising their behaviour

✅ Practical Support
 •Encourage following therapy plans
• Avoid participating in their rituals
• Help with schedule adherence

✅ Healthy Communication
• Use supportive language
• Avoid giving repetitive reassurance
• Encourage slow and steady progress

✅ During Crises
• Monitor signs of severe anxiety or depression
• Seek professional help if the person feels unsafe

✅ Self-Care for Families
• Set boundaries
• Avoid burnout
• Psycho-Educate yourself about OCD

FAQs

Is OCD the same as being neat or organised?

No. OCD is a clinical disorder with intrusive thoughts and compulsive rituals—not just a preference for cleanliness.

Many people recover significantly with therapy and medication. Long-term management is necessary.

Sometimes. Intrusive thoughts are unwanted and it will help if you seek professional help from a psychologist or psychiatrist.

No. OCD has many subtypes including harm OCD, sexual intrusive thoughts, religious OCD, and symmetry OCD.

When obsessions/compulsions take more than 1 hour a day, cause distress, or impair daily functioning.

Yes. OCD can begin in childhood or adolescence.

Yes, stress and fatigue increase the intensity of intrusive thoughts and rituals.

Medication reduces symptoms but is most effective when combined with ERP therapy and regular counselling sessions.