Obsessive-compulsive disorder

What is obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) is characterised by two main elements:

• Obsessions: intrusive, repeated thoughts, images or urges that cause intense anxiety. The person recognises them as their own thoughts (not “voices”), but cannot stop them.
• Compulsions: repeated behaviours or rituals (physical or mental) that the person carries out to reduce the anxiety caused by the obsessions.

OCD affects about 2–3% of the population at some point in their life. It most often appears in late adolescence or early adulthood. Many people, however, receive the diagnosis years or decades late, because the symptoms are easy to hide or are mistaken for a “meticulous personality” or for “being a perfectionist”.

“Pure” OCD: no visible compulsions

An often-missed form: people with intense obsessions and only mental compulsions (prayers, repetitions, rumination, “neutralising” thoughts). From the outside, they simply seem anxious or thoughtful, with no visible ritual. For years, these cases are often mistaken for other disorders or for an “analytical personality”.

The difference between OCD and “being tidy” or “a perfectionist”

Many people are meticulous or tidy, or check their things. The difference that matters:

Personality trait	OCD
You do things well because you want to	You do things because you fear the consequences if you don’t
Brings satisfaction	Brings only temporary relief from anxiety
You can leave them undone	You feel compelled to do them
Takes a reasonable amount of time	Takes up hours of your day
Does not exhaust you emotionally	Exhausts you deeply
Helps you with what you do	Restricts what you can do

How it affects everyday life

Untreated OCD tends to become chronic and to spread gradually. The rituals increase in number and duration, the situations avoided multiply, and the time left for other activities shrinks.

The typical impact:

• Time: patients with severe OCD can spend 4–8 hours a day on rituals
• Career: chronic delays, difficulty finishing tasks, avoiding certain responsibilities
• Relationships: partners and family are often “drawn into” the rituals (repeated reassurance, taking part in checking)
• Physical health: skin damage from excessive washing, chronic tiredness
• Other mental health problems: a higher risk of depression, other anxiety disorders and addictions

Stigma weighs especially heavily in OCD. Many people avoid seeking help because:

• the content of their obsessions seems “shameful” to them (aggressive, sexual, religious thoughts)
• they believe they should manage on their own
• they do not know that OCD is a treatable disorder

When to see a specialist

An assessment is worthwhile if:

• you have intrusive thoughts that cause you anxiety and that you cannot stop
• you spend a significant amount of time on rituals, checking or avoidance
• your family or friends have pointed out certain repeated behaviours to you
• you have visibly narrowed your life to cope with these thoughts
• the content of the obsessions makes you feel “bad” or “dangerous”
• you also have other symptoms: depression, general anxiety, eating disorders

Working with a specialist, you may find that intrusive thoughts gradually lose their hold and your life feels freer again.

Important: if your obsessions contain “bad” thoughts (aggression, sexuality, harm), this does not mean you will ever act on them. Thoughts like these are typical of OCD and arise precisely because you reject them.

The first step

If you recognise yourself in what you’ve read, book a conversation with one of our specialists. Together, we’ll look at what’s going on and what your options are.

Services: Psychiatry · Psychotherapy
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This information is for educational purposes and does not replace a specialist consultation.