Obsessive-compulsive disorder symptoms usually include both obsessions and compulsions. But it's also possible to have only obsession symptoms or only compulsion symptoms. About one-third of people with OCD also have a disorder that includes sudden, brief, intermittent movements or sounds (tics).

Obsession symptoms

OCD obsessions are repeated, persistent and unwanted urges or images that cause distress or anxiety. You might try to get rid of them by performing a compulsion or ritual. These obsessions typically intrude when you're trying to think of or do other things.

Obsessions often have themes to them, such as:

  • Fear of contamination or dirt
  • Having things orderly and symmetrical
  • Aggressive or horrific thoughts about harming yourself or others
  • Unwanted thoughts, including aggression, or sexual or religious subjects

Examples of obsession signs and symptoms include:

  • Fear of being contaminated by shaking hands or by touching objects others have touched
  • Doubts that you've locked the door or turned off the stove
  • Intense stress when objects aren't orderly or facing a certain way
  • Images of hurting yourself or someone else
  • Thoughts about shouting obscenities or acting inappropriately
  • Avoidance of situations that can trigger obsessions, such as shaking hands
  • Distress about unpleasant sexual images repeating in your mind

Compulsion symptoms

OCD compulsions are repetitive behaviors that you feel driven to perform. These repetitive behaviors are meant to prevent or reduce anxiety related to your obsessions or prevent something bad from happening. However, engaging in the compulsions brings no pleasure and may offer only a temporary relief from anxiety.

You may also make up rules or rituals to follow that help control your anxiety when you're having obsessive thoughts. These compulsions are often not rationally connected to preventing the feared event.

As with obsessions, compulsions typically have themes, such as:

  • Washing and cleaning
  • Counting
  • Checking
  • Demanding reassurances
  • Following a strict routine
  • Orderliness

Examples of compulsion signs and symptoms include:

  • Hand-washing until your skin becomes raw
  • Checking doors repeatedly to make sure they're locked
  • Checking the stove repeatedly to make sure it's off
  • Counting in certain patterns
  • Silently repeating a prayer, word or phrase
  • Arranging your canned goods to face the same way

Symptoms usually begin gradually and tend to vary in severity throughout your life. Symptoms generally worsen when you're experiencing more stress. OCD, considered a lifelong disorder, can be so severe and time-consuming that it becomes disabling.

Most adults recognize that their obsessions and compulsions don't make sense, but that's not always the case. Children may not understand what's wrong.

When to see a doctor

There's a difference between being a perfectionist and having OCD. OCD thoughts aren't simply excessive worries about real problems in your life. Perhaps you keep the floors in your house so clean that you could eat off them. Or you like your knickknacks arranged just so. That doesn't necessarily mean that you have OCD.

If your obsessions and compulsions are affecting your quality of life, see your doctor or mental health provider. People with OCD may be ashamed and embarrassed about the condition, but treatment can help.

Aug. 09, 2013