Obsessive-compulsive disorder (OCD) often follows a pattern of intrusive thoughts, intense emotions, and repetitive behaviors. It consists of three main elements: obsessions, compulsions, and mental rituals. While some people show more noticeable behaviors, others deal with internal struggles that may not be as obvious. Recognizing the signs of OCD early on is an important first step in finding the right support.
Obsessions are recurring thoughts, urges, or mental images that are intrusive, unwanted, and cause anxiety. While everyone occasionally has distressing thoughts, people with OCD experience them with a frequency and intensity that disrupts their lives. These obsessive thoughts often focus on fears or situations that trigger intense discomfort, and they can come in many forms.
More than 6 million people in the United States deal with intrusive thoughts which are a hallmark symptom of OCD. These unwanted thoughts or images seem to appear out of nowhere, often replaying over and over in the mind. Unlike impulsive thoughts, which might urge someone to act suddenly (like shouting out in a quiet room), intrusive thoughts are deeply unsettling and provoke fear or distress.
Intrusive thoughts often contradict a person’s core values or cause intense discomfort. These thoughts can also be in the form of excessive doubts, like worrying they forgot to turn off the stove or they’ll do something embarrassing in public.
Examples of intrusive thoughts may include:
One of the most common types of obsessions is a fear of contamination or germs. Up to 46% of OCD patients experience severe anxiety over being contaminated, which can be triggered by touching everyday objects like a doorknob.
People with contamination-related OCD often experience heightened sensitivity to disgust. This makes it difficult for them to separate rational fears from irrational ones, especially when they come into contact with objects they perceive as dirty or contaminated. Cognitive errors, such as the “law of contagion,” reinforce these obsessions. This idea suggests that once an item is contaminated, it stays contaminated, no matter how much it’s cleaned. This only worsens the cycle of fear.
Symmetry and orderliness are other common obsessions in OCD that are often associated with an earlier onset of OCD and tend to occur more frequently in men. These obsessions often manifest as a need for things to be arranged in a precise, perfect, or “just right” manner. Those with symmetry obsessions may become distressed if objects are misaligned or out of place and may feel compelled to correct even minor imperfections. This need for order can extend to tasks being performed in a particular sequence or objects being positioned in a certain way.
Another common obsession is unwanted sexual thoughts. People with sexual OCD may experience intrusive thoughts or images about inappropriate or taboo subjects, including:
The intensity of these thoughts can range from mild to severe. Even though these thoughts are most likely not aligned with the person’s true desires, they can often lead to feelings of shame, guilt, or confusion.
Compulsions are repetitive actions or rituals that people with OCD feel compelled to perform, often as a way to reduce the anxiety caused by their obsessive thoughts. These behaviors can take up a lot of time and disrupt daily life as the person tries to find temporary relief from the distress their obsessions create. While the compulsive actions might offer short-term relief, they usually reinforce the obsessive cycle, trapping the person in a loop of anxiety and ritualistic behavior.
Compulsive cleaning or washing often comes from an overwhelming fear of germs or contamination. Individuals may feel the need to clean themselves or their surroundings repeatedly, even when it causes harm or goes beyond what is necessary. This behavior is driven by the need to reduce anxiety related to contamination, not by cleanliness itself. Examples may include:
People with checking compulsions feel a constant need to make sure that everything is safe or in order. These repetitive actions may revolve around confirming that no harm will occur, even though the perceived danger is minimal or nonexistent. Examples can include:
Compulsive counting or repeating behaviors come in the form of performing actions a specific number of times, often out of fear that something bad will happen if they don’t. These rituals can become rigid and exhausting, as the person feels they must get it “just right” to prevent negative consequences. This can look like:
Hoarding compulsions stem from an irrational need to keep or collect items, even those with little or no value. The fear of discarding something important or the anxiety over losing control drives the person to hoard. This can lead to cluttered spaces and difficulty letting go of possessions. This can include:
Mental compulsions are repetitive actions that happen entirely in the mind and are often a way for those with OCD to ease the anxiety caused by obsessive thoughts. Even though they aren’t visible to others, these mental rituals can be just as exhausting as physical compulsions. People with OCD may use mental techniques to neutralize distressing thoughts or to avoid perceived harm. These techniques may include:
Research shows that mental rituals like praying, counting, or mentally checking are experienced as a primary symptom in between 9% and 25% of patients. Despite being common, mental compulsions are often underreported, partly due to the private nature of the rituals and the distressing thoughts they are meant to counteract.
If obsessive thoughts or compulsive behaviors are starting to feel overwhelming, it’s important to recognize when to seek help. When these symptoms disrupt your routine, strain your relationships, or create constant stress, it’s a sign that reaching out to a professional could be the next step.
Don’t let these symptoms take over. Connect with a therapist or other mental health professional who understands OCD and can help guide you
Determining if TMS therapy suits your mental health journey should involve consultation with a qualified professional. At Cura Behavioral Health, we provide comprehensive assessments to help you make informed treatment decisions.
Don’t let a mental health condition hold you back any longer. Schedule a consultation with Cura Behavioral Health today. Our experienced team is ready to answer your questions and create a personalized treatment plan tailored to your unique needs.
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Dr. Kevin Simonson, an esteemed Medical Director at Cura Behavioral Health, brings over 15 years of experience in psychiatry. A graduate from a top medical school, he specializes in the treatment of mood disorders and anxiety, employing a patient-centered approach. His dedication to evidence-based care and his commitment to advancing mental health practices have made him a respected figure in the field. Dr. Simonson’s leadership ensures the highest standard of care for the community at Cura Behavioral Health.
