OCD Explained: Understanding How to Take Control of Your OCD

sussexpsychtherapy
Aug 9, 2025
5 min read

Obsessive-Compulsive Disorder (OCD) is a mental health condition characterised by persistent, unwanted thoughts and behaviours that can significantly interfere with daily life. At worst, it can be very debilitating. Despite its common occurrence, many people do not fully understand what OCD is, how it develops, or how to access help. This guide aims to shed light on these aspects and provide practical tips for coping.

How Does OCD Develop?

The exact cause of OCD is not fully understood, but researchers believe it results from a combination of genetic, neurological, behavioural, and environmental factors.

Genetics: OCD tends to run in families, suggesting a hereditary component. If a close relative has OCD, your risk may be higher.
Brain Structure and Function: Neuroimaging studies show differences in brain areas involved in decision-making, impulse regulation, and error detection, such as the orbital frontal cortex and basal ganglia.
Environmental Triggers: Stressful life events, trauma, or infections (like strep throat in some cases of PANDAS—Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections) may trigger or exacerbate OCD symptoms.
Learned Behaviours: Some individuals develop compulsions as a way to reduce anxiety from obsessive thoughts, reinforcing the cycle over time.

What are the signs or symptoms of OCD?

The symptoms of OCD usually involve preoccupation with persistent, distressing thoughts (called obsessions) and compulsions (behaviours used to cope with thoughts) that cause considerable distress or disrupt everyday activities. Some examples of the types of thoughts and behaviours typical of OCD are listed below:

Common Types of Obsessions (Unwanted, Intrusive Thoughts)

Fear of contamination or germs
Fear of harming oneself or others
Concerns about symmetry, order, or exactness
Unwanted sexual or aggressive thoughts
Religious or moral doubts and worries
Fear of illness or illness spreading
Obsessive doubts about safety or security

* Typically, these thoughts are irrational and cause significant distress.

Compulsions (Repetitive Behaviours or Mental Acts)

Excessive cleaning or washing (e.g., handwashing, showering)
Repeatedly checking things (locks, appliances, windows)
Rituals or routines that must be performed in a specific way
Arranging or organising objects in precise order
Counting, tapping, or mental rituals to reduce anxiety
Hoarding or difficulty discarding possessions
Repeating words, prayers, or phrases mentally
Avoidance behaviours to reduce anxiety related to obsessions

Additional Features

The obsessions and compulsions are time-consuming (often over an hour a day)
They lead to significant anxiety, distress, or impairment
The individual recognises that the compulsions are unreasonable but feels unable to stop
The symptoms are not caused by another mental health condition or substance use

Can I have OCD without Compulsions?

Yes. 'Pure O' (Pure Obsessional OCD) is a subtype of OCD characterised mainly by intrusive, distressing obsessions without obvious visible compulsions. People with Pure O often experience intense, unwanted thoughts, images, or urges related to themes such as harm, violence, sexuality, or morality, which cause significant anxiety and shame. While they may not engage in obvious behaviours like handwashing or checking, they often perform mental rituals, such as silent prayers, reassurance seeking, or mental rechecking, to try to neutralise their obsessions. These mental compulsions are usually hidden and can be difficult to recognise, making Pure O particularly challenging to diagnose and treat. Despite the name, individuals with Pure O do have compulsive tendencies—they are just more internalised and less outwardly visible, which can lead to feelings of isolation and misunderstanding.

How Is OCD Diagnosed?

Diagnosis typically involves a clinical assessment conducted by a mental health professional, such as a psychiatrist or psychologist. The process includes:

Interview: The mental health professional will ask about your symptoms, their severity, how long you've experienced them, and their impact on your life.
Criteria: To be diagnosed with OCD, symptoms must include obsessions (intrusive thoughts, urges, or images) and compulsions (repetitive behaviours or mental acts). These must cause significant distress or impairment.
Assessment Tools: Sometimes, clinicians use standardised questionnaires like the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) to measure severity.

It's important to differentiate OCD from other conditions like anxiety or general stress, which can have overlapping symptoms but are distinct diagnoses.

Common Myths About OCD

OCD is often misunderstood, leading to misconceptions and stigma. Here are some of the most common myths:

OCD is just about being clean or organised. While some with OCD have contamination fears or need for order, it involves much more than neatness—intrusive, distressing thoughts and compulsions that people feel powerless to control.
OCD is the same as perfectionism. Perfectionism is a personality trait, but OCD involves compulsive behaviours and obsessive thoughts that cause significant distress and impairment, beyond simply striving for excellence.
People with OCD just like cleanliness or symmetry. Having preferences is normal, but in OCD, these become compulsions driven by anxiety, not simple preferences.
You can just stop doing compulsions if you try hard enough. Compulsions are driven by anxiety and feel unavoidable; stopping them usually requires professional help and therapy.
OCD is a rare or unusual disorder. OCD affects about 1-2% of the population worldwide, making it common but often under-recognised or misunderstood.
Only adults get OCD. OCD can develop in childhood, adolescence, or adulthood, affecting anyone regardless of age.

Practical Tips to Help Manage OCD

While OCD can be challenging and highly distressing, there are practical things that you can do to help.

Seek Professional Help - Cognitive-behavioural therapy (CBT), particularly Exposure and Response Prevention (ERP), is highly effective.
There is some evidence that medication such as selective serotonin reuptake inhibitors (SSRIs) can also help reduce symptoms.
Educate Yourself - Understanding OCD helps reduce self-blame and provides insight into managing symptoms better.
Practice MindfulnessTechniques like mindfulness meditation can increase awareness of obsessive thoughts without acting on them, helping to reduce their power.
Establish Routine and Structure - Developing a daily routine can reduce anxiety and create a sense of control.
Gradually Face Fears (with Support) - Under the guidance of a therapist, exposure exercises involve gradually confronting feared objects or situations without performing compulsions.
Limit Rituals - Try to gradually reduce reliance on compulsive behaviours. Set small, achievable goals and seek support when you need it.
Join Support Groups - Connecting with others who have OCD can reduce feelings of isolation and provide encouragement.
Prioritise Self-Care - Adequate sleep, nutrition, exercise, and stress management are vital components of managing OCD.

Final Thoughts

OCD is a complex condition that can significantly impact one’s life, but with appropriate treatment and support, many individuals experience substantial relief. Early diagnosis, and intervention can make a significant difference.

If you or someone you know might have OCD, seeking help from a mental health professional is a crucial first step. Remember, help is available, and recovery is possible.

Book a free therapy consultation to explore support available using the link below:

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How Does OCD Develop?

The exact cause of OCD is not fully understood, but researchers believe it results from a combination of genetic, neurological, behavioural, and environmental factors.

Genetics: OCD tends to run in families, suggesting a hereditary component. If a close relative has OCD, your risk may be higher.

Brain Structure and Function: Neuroimaging studies show differences in brain areas involved in decision-making, impulse regulation, and error detection, such as the orbital frontal cortex and basal ganglia.

Environmental Triggers: Stressful life events, trauma, or infections (like strep throat in some cases of PANDAS—Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections) may trigger or exacerbate OCD symptoms.

Learned Behaviours: Some individuals develop compulsions as a way to reduce anxiety from obsessive thoughts, reinforcing the cycle over time.

What are the signs or symptoms of OCD?

Common Types of Obsessions (Unwanted, Intrusive Thoughts)

Fear of contamination or germs

Fear of harming oneself or others

Concerns about symmetry, order, or exactness

Unwanted sexual or aggressive thoughts

Religious or moral doubts and worries

Fear of illness or illness spreading

Obsessive doubts about safety or security

Compulsions (Repetitive Behaviours or Mental Acts)

Excessive cleaning or washing (e.g., handwashing, showering)

Repeatedly checking things (locks, appliances, windows)

Rituals or routines that must be performed in a specific way

Arranging or organising objects in precise order

Counting, tapping, or mental rituals to reduce anxiety

Hoarding or difficulty discarding possessions

Repeating words, prayers, or phrases mentally

Avoidance behaviours to reduce anxiety related to obsessions

Additional Features

The obsessions and compulsions are time-consuming (often over an hour a day)

They lead to significant anxiety, distress, or impairment

The individual recognises that the compulsions are unreasonable but feels unable to stop

The symptoms are not caused by another mental health condition or substance use

Can I have OCD without Compulsions?

How Is OCD Diagnosed?

Diagnosis typically involves a clinical assessment conducted by a mental health professional, such as a psychiatrist or psychologist. The process includes:

Interview: The mental health professional will ask about your symptoms, their severity, how long you've experienced them, and their impact on your life.

Criteria: To be diagnosed with OCD, symptoms must include obsessions (intrusive thoughts, urges, or images) and compulsions (repetitive behaviours or mental acts). These must cause significant distress or impairment.

Assessment Tools: Sometimes, clinicians use standardised questionnaires like the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) to measure severity.

It's important to differentiate OCD from other conditions like anxiety or general stress, which can have overlapping symptoms but are distinct diagnoses.

Common Myths About OCD

OCD is often misunderstood, leading to misconceptions and stigma. Here are some of the most common myths:

OCD is just about being clean or organised. While some with OCD have contamination fears or need for order, it involves much more than neatness—intrusive, distressing thoughts and compulsions that people feel powerless to control.

OCD is the same as perfectionism. Perfectionism is a personality trait, but OCD involves compulsive behaviours and obsessive thoughts that cause significant distress and impairment, beyond simply striving for excellence.

People with OCD just like cleanliness or symmetry. Having preferences is normal, but in OCD, these become compulsions driven by anxiety, not simple preferences.

You can just stop doing compulsions if you try hard enough. Compulsions are driven by anxiety and feel unavoidable; stopping them usually requires professional help and therapy.

OCD is a rare or unusual disorder. OCD affects about 1-2% of the population worldwide, making it common but often under-recognised or misunderstood.

Only adults get OCD. OCD can develop in childhood, adolescence, or adulthood, affecting anyone regardless of age.

Practical Tips to Help Manage OCD

While OCD can be challenging and highly distressing, there are practical things that you can do to help.

Seek Professional Help - Cognitive-behavioural therapy (CBT), particularly Exposure and Response Prevention (ERP), is highly effective.

There is some evidence that medication such as selective serotonin reuptake inhibitors (SSRIs) can also help reduce symptoms.

Educate Yourself - Understanding OCD helps reduce self-blame and provides insight into managing symptoms better.

Practice MindfulnessTechniques like mindfulness meditation can increase awareness of obsessive thoughts without acting on them, helping to reduce their power.

Establish Routine and Structure - Developing a daily routine can reduce anxiety and create a sense of control.

Gradually Face Fears (with Support) - Under the guidance of a therapist, exposure exercises involve gradually confronting feared objects or situations without performing compulsions.

Limit Rituals - Try to gradually reduce reliance on compulsive behaviours. Set small, achievable goals and seek support when you need it.

Join Support Groups - Connecting with others who have OCD can reduce feelings of isolation and provide encouragement.

Prioritise Self-Care - Adequate sleep, nutrition, exercise, and stress management are vital components of managing OCD.

Final Thoughts

OCD is a complex condition that can significantly impact one’s life, but with appropriate treatment and support, many individuals experience substantial relief. Early diagnosis, and intervention can make a significant difference.

If you or someone you know might have OCD, seeking help from a mental health professional is a crucial first step. Remember, help is available, and recovery is possible.

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