Information on Obsessive Compulsive Disorder (OCD)

Washing hands

What is it?

This disorder can be looked at in two parts; obsessions - these are repetitive, obtrusive, unwanted thoughts that are experienced and result in unreasonable fears, and compulsions - acts or rituals carried out in response to fears generated by obsessions. The classic OCD condition is that of compulsive hand washing in response to an irrational fear of germs/contamination.

Sufferers of this disorder feel less anxious once they have carried out a compulsion. It is possible to experience obsessive thoughts only and not have the desire to carry out a compulsion. Examples of compulsions are excessive cleaning, counting, checking, measuring, and repeating tasks or actions. Trichotillomania (compulsive hair-pulling) may also be classified under the general umbrella of OCD. Examples of obsessions are worrying excessively about death, germs, illness - usually AIDS, cancer, etc. (this can also be classified as an 'Illness phobia',) having undesirable sexual thoughts, fearing causing harm to others.

DIY Self diagnosis

If you can answer YES to most of the questions it is likely that you are affected by that condition.

During the past 2 weeks:-

  • Do you worry obsessively about contamination by germs/chemicals/dirt and/or that something bad might happen to you/other people, and/or that you might say something you didn’t want to that might upset others.
  • Do you feel compelled to carry out certain behaviours?
  • Do you check, count or repeat things over and over again?

ANXIETY UK strongly advises that people seek further information and guidance from their GP who will be able to make a formal diagnosis.

DSM diagnostic criteria for 300.3 Obsessive Compulsive Disorder

The Diagnostic and Statistical Manual of Mental Disorders (DSM) lists the different categories of mental disorder and the criteria used for diagnosing them. We have more information on the DSM-IV information page.

  1. Either obsessions or compulsions: Obsessions as defined by 1,2, 3 and 4;
    1. Recurrent and persistent thoughts, impulses or images that are experienced at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress.
    2. The thoughts, impulses or images are not simply excessive worries about real life problems.
    3. The person attempts to ignore or suppress such thoughts, impulses or images or to neutralise them with some other thought or action.
    4. The person recognises that the obsessional thoughts, impulses or images are a product of his or her own mind (not imposed from without as with thought insertion).
    Compulsions are defined as 1 and 2
    1. Repetitive behaviours (e.g. hand washing, ordering checking) or mental acts (e.g. praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to the rules that must be applied rigidly.
    2. The behaviours or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviours or mental acts either are not connected in a realistic way with what they are designed to neutralise or prevent or are clearly excessive.
  2. At some points during the course of the disorder, the person has recognised that the obsessions or compulsions are excessive or unreasonable. Note: this does not apply to children.
  3. The obsessions and compulsions cause marked distress, are time consuming (take more than one hour a day), or significantly interfere with the persons normal routine, occupational (or academic) functioning, or usual social activities or relationships.
  4. If another axis I disorder is present, the content of the obsessions or compulsions is not restricted to it (e.g. preoccupation with food in the presence of an eating disorder, hair pulling in the presence of Trichotillomania; concern with appearance in the presence of Body Dysmorphic Disorder: preoccupation with drugs in the presence of a substance use disorder : preoccupation with having a serious illness in the presence of hypochondriasis; preoccupation with sexual urges or fantasies in the presence of a Paraphilia: or guilty ruminations in the presence or major depressive Disorder.
  5. The disturbance is not due to the direct physiological effects of a substance (e.g. drug of abuse, a medication) or a general medical condition.

Specify if with poor insight: If, for most of the time during the current episode, the person does not recognise that the obsessions and compulsions are excessive or unreasonable.

Although people have very different abilities to endure stress, it seems likely that everyone has a breaking point if exposed for long enough to an extreme enough stressor. Once Posttraumatic Stress Disorder occurs, its symptom pattern is remarkably uniform regardless of the individuals’ previous psychological history or cultural background. However different a people are before developing Posttraumatic Stress Disorder, there is a very characteristic human pattern of response to an extreme stressor that includes avoidance of stimuli that remind the person of the stressor, re experiencing the stressor in a number of ways, and increased physiological arousal, particularly on exposure to memory jogging triggers.

Want to know more

This ANXIETY UK site has information on a range of resources to get more detailed information and help.

ANXIETY UK Publications

Peace from nervous suffering video/DVD

  • This programme is a compilation of the series of six interviews Dr Weekes gave with Marian Foster originally broadcast on the BBC TV programme "Pebble Mill at One". The talks include: how to cure the anxiety state, nervous fatigue, phobias (including agoraphobia) and obsessions, depression, and coming through setbacks on the way to recovery. In this recording, a patient now cured of obsessions (OCD) is also featured. For more information visit the website:
  • http://www.drclaireweekes.co.uk

Recommended reading

Brain Lock cover Brain Lock - J. M. Schwartz
ISBN 0060987111
A scientifically proven four-step self-treatment for OCD which enables people to modify their behaviour and their brain chemistry. This work shows how sufferers can cure themselves by their own determination rather than through psycho-pharmaceuticals.
Purchase online | More recommended reading

Recommended Web sites

Web links - to other OCD sites of interest

Useful workbook

  • click here to download a copy of Professor Karina Lovell's OCD self help workbook

Personal experiences

Do you suffer from OCD and want to share your experience with other people? Send us your experience and we will put selected ones here. Unfortunately we are unable to display the email addresses of individuals whose experiences are listed in this section of the website. If you would like to make contact with others who are living with similar experiences, you can do so via ANXIETY UK 'Contact List' which is a service available to all ANXIETY UK members (in both electronic and hard copy format).

I have OCD, but gladly I don't feel that it controls me anymore - rather I control it.

I still feel uncomfortable when things are not how I want them. For example, I like my margarine to stay flat in the tub and I can't stand people gauging out great lumps. I also hate crumbs or anything non-margarine in the tub. Also, I dislike things being off centre; shoes have to be side by side, and completely level at the front; books have to be in order from the largest to the smallest, and I like things being at right angles to other things. A few days ago, I spent half an hour completely unaware that I was adjusting a newspaper so that it was in line with the floorboards (I was watching TV at the time). These however are all little things, and they don't control me like they used to do. For example, I don't scrape the margarine flat anymore, I just get on with life. My hands are not as badly split because of washing them, although probably I still wash them a little too much. In short, I'm getting there, and without medication. I guess I am just looking at life with a little more common sense.

Emma

I think the biggest help a sufferer of OCD can get is an acknowledgement that OCD is a recognised problem.

When I fist saw a programme on the TV about OCD, it was such a relief to see that I was not mad and that others had this problem too. In recognising the problem, I believe that you can start to deal with it. As the thoughts come into your head, you can see if they are caused by an upset in your life and then can look at finding an answer that works for you. And yes, you can, control OCD by understanding yourself.

Gillian

I was diagnosed with OCD three years ago.

Before that, it controlled my life and made living unmanageable. I didn't want to come forward at the time and admit that I had a problem because I had never heard of OCD, but I figured what I was doing was abnormal. In short, it is sites like these that have saved my life. A combination of information sites and help from professionals has made it possible for me to live a fulfilled life.

Kats

I think that it is really important that people are aware that OCD comes in many different forms and isn't always present in the more classic areas such as handwashing and checking.

I was only diagnosed with OCD a year ago and in retrospect I can see that I have had it most of my life (having been misdiagnosed with depression since my late teens). I was unable to associate the 'problems' I had with those of OCD despite having a degree in psychology, as my symptoms were not 'classic'. Now I know I'm not 'weird' and that OCD is a manageable disorder. My thoughts now make a lot more sense and are less threatening or scary.

Victoria

I'm a 29 year old man with OCD.

Its pretty much ruled my life and I've tried anti anxiety drugs, as well as having counselling sessions. For me, health related OCD has been at the forefront of my mind for the past 5 years. Before that it was contamination that resulted in obsessive checking and handwashing (until my hands bled) and an obsessive fear of being violent to others, which was especially tough when my daughter was born. The health OCD took over and I have had every major illness out there (in my mind at least).

The problem with any mental illness is the stigma. I've tried discussing this with friends and have found that some are sympathetic, whilst others think that I am nuts, telling me to 'pull myself together', or 'stop worrying'.

You can't see OCD like you can see a broken leg and in my opinion, this is the exact reason why people find these problems hard to understand.

I suffer with the fear of germs.

Thus I constantly wash my hands and anything else that I feel is contaminated. I have washed pencils, necklaces, watches, and many other material things. I sometimes end up washing my hands so much that my hands crack and bleed. This irrational fear has caused me to lose all self-confidence. Having no-one to understand the situation makes it much harder. This fear has also destroyed my social life. I can't attend parties without freaking out. I even fear walking on the cement in case I step on something gross. Sleeping is the only time of the day that I find solace from my pain. Having this fear has made me unable to live a happy life.

Danielle

I have suffered with OCD for about 9 years.

I still find it very hard to talk about as it's one that doesn't often crop up. I am afraid that I will hurt people. I get all these thoughts and feelings and can't cope with them. I avoid people just in case I have done something to them. I have a sister who is 9 and I can't really go near her as I'm afraid of doing something bad. It's ruined my life. I feel depressed and a failure, also very scared. I just hope that when I start my CBT it will help me as I want to move in with my boyfriend one day and live a normal life.

Charlotte

I have had OCD for as long as I can remember; it comes and goes.

At the moment my main obsession is dog poo. I check my feet constantly, look where I am walking and even look back to make sure there was nothing there. Recently a dog did its dirt on my front and I was seriously distraught. Since then I have been obsessively washing my hands and house just in case someone stood in it and maybe did not know and they have walked it into my hallway. My thoughts are that it will make one of us blind (daft I know) but I read an article about dog fouling and this is what it said. It also said that it affects 2 people in every million. Of course with my OCD I think that I am going to be one of those 2 people. I also have a problem with needles. Even if I stand on a twig I check to make sure it was not a syringe.

It is a horrible thing to live with, and I am currently attending therapy sessions although I am not certain this will help me.

Kelly

I am 24 years old and have had a phobia of illness for most of my life.

Also when I was about 17 I was on anti-depressents. When I was younger I had these fears but didn't have to cope with the issues I do in adult life so as I grew older they became worse. It got to the point where I would dread a certain situation in case someone was ill or I caught an illness. I know they are irrational thoughts but I cannot help thinking them. It has interfered with my life and progressively got worse and has started affecting my day to day routine. I find that in certain situations I need to escape from my fears and just want to run until I find a more open environment. It ultimately ends up in a panic attack. I fear the fact that I may have a panic attack and that in itself can initiate them. I refused to let this get the better of me and have now sought help. I am awaiting my first appointment. I don't want to look back when I get older and regret letting this stop me from doing what I want in life. I am lucky and have a fantastic boyfriend and family to support me but I know they don't truly understand the feelings I get, so it is nice to be able to share them with others who can relate to what I am going through. I have read bits of others' comments and feel a sense of ease knowing someone feels the same way. I only hope my comments can do the same for someone else. This is an illness; it is an illness of the mind and like other illnessess it will get better in time.

Rachel

I have OCD.

I am obsessed with washing my hands and want any excuse to do so. As a teenager I feel really ashamed of my problems and it has took over my school and social life for about 2 years now. I feel trapped but don't really want to get help. My hands are so bad sometimes they turn blue and hardly move. I have to wear lots of creams and gloves to hide them. It has become normal to me but it is really upsetting and my family aren't much support, they have offered help but I feel too ashamed to take it. I feel this will ruin my future life in years to come.

Sarah

I suffered with OCD for two years before I sought help, and I can honestly say asking for help was the best decision I ever made.

If you're suffering from OCD and it's taking over your life like it was mine, then no matter how 'weird' you feel, you need to get help, to get your life back. For me, having OCD was exhausting - it used to take me about two hours, sometimes more to get ready for bed, and I was plagued by my rituals and horrible thoughts all day. It was getting to the point where I could barely function, so I'm glad I got help, and I hope other people feel like they can do the same.

Jennie

I have had OCD for about 20 years now.

It started after I had my first child. I was obsessed with washing and had a fear of germs. I was cleaning things over and over. Things have however changed with OCD for me as now I don't clean as much, but I still wash myself a lot - sometimes I can shower for 3 hours. This makes me very tired. I avoid touching doors and walls in my house. I don't go out much, and feel very anxious when I am out shopping. I sometimes wear gloves to shop so that I don't get contaminated by what other people have touched in the supermarket, like money etc. I have been worse lately, and I know I need to fight OCD, but I find it so hard. My girls have both lived with OCD all their lives, and its awful for them. They get cross at me often. They worry too, that I need to break free. It helps to know that I am not alone. Also, people need to know more about OCD so they can be understanding and not make sufferers of this condition feel inhuman. I do sing and that helps me. Some people say that is so strange, how can I sing when I have OCD? Well, I don't know. I just hope I will be better soon.

Suki

I am a 41 year old woman and have been married for 22 years.

I was a perfectionist in my teens and I developed OCD after I got married. I am driving my husband and children and I make it so unbearable for them to live with me that they are often threatening to leave me on my own. I am only happy when everything is clean and tidy and can't relax until I have carried out my daily 'rituals'. I have always hidden my OCD from people around me but have only recently started to talk about it with friends and other family members. I am very house-proud, clean and tidy, but I wish I didn't feel the urge to tidy up, straighten and check things around the house as this is very time-consuming and taking over my life. I will sometimes not want to go out at evenings and weekends as I feel I need to stay home and put things right. I did finally go for CBT last year, but I can honestly say it made me feel worse and didn't want to do the homework I was given. I know that OCD doesn't disappear overnight and I admit I didn't give the CBT much of a chance to work. Things have got considerably worse ever since my son was diagnosed with a malignant brain tumour 8 years ago. My whole world was turned upside-down and I have never been able to get over the trauma. His illness has always been at the back of my mind, fearing that it may return and I worry over the smallest things. I think about illness and death on a daily basis and often worry about whether I will cope if I lose someone close to me. I feel the urge to clean, staighten and repeat things as though I am making things better by doing so. I wish I didn't feel the urge to follow people around the house after they have had a shower, been to the toilet or used something. I now suffer from anxiety attacks and occasionally suffer from breathlessness at night. I would love nothing more than to be 'normal' and live a happy life and do all the things normal families do.

Gill

Having suffered OCD to the extent that I was constantly repeating tasks believing if I didn't, something bad would happen to a loved on - I knew I couldn't carry on like this.

How I beat it was to refuse to do the tasks that I felt compelled to do. At first, I felt very anxious but when nothing happened the anxiety became less. My OCD is now at the stage where I realise that you can't predetermine things. I don't do the repetitive chores and don't think about anything bad happening as a result. I can now go about business in a normal manner. If anyone is suffering the same problems, just be strong enough to resist the urge to undertake repetitive rituals - as soon as you realise that nothing will happen to you, you will soon get out of the habit.

Claire

Although I have never been diagnosed ,or seen a GP about this, I feel as if I am affected

The symptoms I have (which friends and family members have noticed) are if I touch something with my left hand then I have to even this out by touching the same thing with my right hand, and vice versa. This includes switching plug sockets on and off, itching my leg (if I itch my left leg I have to itch my right leg in exactly the same place). I always have to work from left to right - e.g. when doing the dishes, the draining board has to always be on the right. I also have to chew my food a certain number of times on each side of my mouth before I swallow it. This list could go on and on. I think I need to be diagnosed? I don't really find that this problem affects my day to day life, but for as long as I can remember, I have performed these 'rituals'. I guess it is just part of me and to be honest, I'm not sure that I want to change.

Tilly

Hi everyone.

I've had all sorts of anxiety disorders since I was 17, ranging from body dysmorphic disorder, social anxiety, depression & have just recently developed OCD due to stress.

Having the fear of hurting someone or blurting something out and losing control is pretty scary when you can't seem to rationalise and feel confused. However, no matter how I feel I've learnt to just push myself out there and live life no matter how weird my thoughts are.... I''m living proof that getting out there really does help and even if the thoughts etc. are distressing, getting out and doing something helps so much to subside them. I've got a job in a little shop and although it's hard when I feel like this, I just keep going. Everyone deserves more than living a life of fear, so go grab life by the horns.

Jemma

I am 22 years old and have had OCD for about 13 years or so.

The first time I can remember noticing something was not right was when I was about 9 years of age. I took my slippers off and put them next to each other and they just didn't feel like they were “right”. From then on it went from that each night, moving slippers until they felt right, moving my bedroom door until it felt it was open enough, to being terrified to move/add posters to my bedroom wall in case something awful happened to one of my family. I also went through a phase of being terrified of dying. That seemed to fade away until recently. I also have to check about 8 times that all doors/windows are locked, that house alarm is on. If I hear a noise I'm convinced someone is breaking in. Even things like typing at work etc. I have to delete and then type again for fear of something bad happening.

I knew I had to do something about my thoughts and fears so about 18 months ago I started counselling. It was the hardest thing I've ever had to do, but it's the best thing I ever did. The turn around since starting counselling is remarkable. I do still have all of these thoughts etc but I'm starting to understand them more, not blame myself and not let it control my life quite as much. Its extremely hard going; I get really upset at times, driving myself mad. Even more so the last 6 months or so I have started to be concerned that I have every illness under the sun and that I will die young. I know you shouldn’t worry about these things, but the logic gets overtaken by the fear and I'm looking things up all the time convinced I have things or am going to have things.

I am like most of you have mentioned, very lucky to have a fiancé and parents who are helpful and supportive but I can't get things across to them enough for them to understand how I feel. I know they try their best, but its enough just to have them listening to me and helping. Its not easy and it really does get you down with the “rituals” we have to face each day. I was comforted to know that so many other people have similar things when I first looked into getting help. I really hope that other people can be encouraged to get some help. I have certainly come a long way since I started my counselling but I know that there is still a long way to go too yet.

Jayne