What Is Obsessive Compulsive Disorder?
Obsessive compulsive disorder (OCD) is a mental health condition characterized by a cycle of uncontrollable, chronic thoughts (obsessions) and repetitive behaviors (compulsions) that severely interfere with daily functioning. 
What Are the Different Types of OCD?
There is officially only one obsessive compulsive disorder, but the disorder can be differentiated with the following symptom subtypes:
- Contamination OCD, which might involve an obsession with cleanliness
- Organization OCD, or “just right” OCD, which might involve an obsession with symmetry, counting, or orderliness
- Checking OCD, which might involve threat overestimation and the need to check things to prevent harm
- Hoarding OCD, which might involve clinging to items that others would consider trash
- Intrusive thoughts OCD, which might involve violent, sexual, or “unacceptable” obsessions
- Tic-related OCD, or Tourettic OCD, which might involve motor tics
- Ruminations OCD, which might cause someone to fixate on philosophical, religious, or metaphysical questions
- Purely obsessional OCD, which involves obsession without outward compulsions
- Relationship OCD, which focuses on “relationship rightness”
- Sensorimotor OCD, which involves body-focused obsessions
It’s important to note, however, that the precise content of someone’s OCD obsessions is almost irrelevant to the mental illness. OCD is about the process of intrusive thoughts and behavior, not the nature of the worries.
In addition to OCD proper, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) also includes these additional disorders under the umbrella term obsessive-compulsive and related disorders (OCRD):
- Body dysmorphic disorder (BDD) and the subtype muscle dysmorphia
- Trichotillomania (hair-pulling disorder)
- Excoriation (skin-picking disorder)
- Hoarding disorder
- OCD and related disorders induced by a substance/medication or due to another medical condition, e.g. Tourette’s syndrome
Someone with obsessive personality traits might casually describe themselves as OCD, but people should remember that OCD is a biological disease that can only be accurately diagnosed by a mental health professional. In contrast, there is a personality disorder called obsessive compulsive personality disorder, which is characterized by perfectionism that is wanted (egosyntonic) as opposed to unwanted (egodystonic), as in the case of OCD.
What Are Some OCD Behaviors?
OCD can manifest in a wide variety of behaviors, but the common denominator is that the sufferer can’t control their actions and they cause considerable distress and functional impairment. For example, someone with OCD might do the following:
- Wash themselves until their skin is painful and raw
- Get caught in interminable checking behaviors to the point where they can’t leave the house
- Spend hours a day getting dressed because strict routines must be followed
- Silently repeat words or phrases, making it difficult to communicate with others
- Avoid certain situations that might contain germs
- Need to perform tasks in specific patterns, such as needing to enter through a doorway five times, every time
- Hoard pieces of trash because they’re unable to discard personal items
If you’re concerned that your behaviors might reflect OCD, you can ask yourself if you’re troubled by how long it takes you to finish certain activities, your need to check things, or your concerns about order. If you feel that you must complete these tasks, you may benefit from speaking to a mental health professional.
What Is the Root Cause of OCD?
Obsessive compulsive disorder is caused by cognitive-affective dysfunction in the brain. But that just begs the question, what causes these structural, chemical, and functional changes?
- Genetics seem to play a role in OCD. Twin studies even show that genes might be more important in OCD that first starts in childhood than in OCD that begins in adulthood.
- Environmental factors also may increase risk. For example, both the experience of trauma and birth complications have been implicated in the development of OCD.
- Beliefs don’t cause OCD, but the condition can reinforce them. For example, a person may have an inflated sense of responsibility, an intolerance for uncertainty, or an overestimation of threat. Maladaptive interpretations of obsessive thoughts can serve to strengthen those thoughts.
- Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) has been blamed for causing OCD symptoms and tic disorders in children.
Who Is at Risk of Developing OCD?
If OCD runs in your family, you have a larger risk of having the disorder yourself due to genetic influence. There’s no clear consensus about environmental risk factors that increase the likelihood of OCD.
It’s important to note, however, that 90% of people with OCD are diagnosed with another simultaneous mental health disorder (comorbidity) in their lifetime. The most common comorbidities are mood disorders, anxiety disorders, substance abuse disorders, and impulse-control disorders. Other comorbidities include eating disorders, autism spectrum disorder (ASD), schizophrenia, and attention deficit hyperactivity disorder (ADHD).
Obsessive Compulsive Disorder Treatment
- Exposure and response prevention (ERP)
- Antidepressants
- Cognitive behavioral therapy (CBT)
- Family therapy
- Metacognitive therapy
- Habit reversal training
- Decoupling
- Support groups/group therapy
- Transcranial magnetic stimulation (TMS)
- Deep brain stimulation (DBS)
Unfortunately, it can take some people a long time to find effective treatment due to a lack of accessibility to the mental health care they deserve. One study discovered an average 17-year lag between onset of OCD symptoms and proper treatment. Finding the right therapy is crucial to overcoming these symptoms and the distress they cause.
How Does OCD Affect Relationships?
OCD is a serious mental health condition that can lead to occupational, functional, and social impairments. For some people with OCD, negative effects on relationships may be the most painful. They may experience shame or fear that prevents them from forming intimate relationships. Someone with relationship OCD may constantly need reassurance from their partner that everything is okay. Chronic doubts can take a toll on relationships, no matter how strong they are in reality.
Obsessions and compulsions can affect everyone, not just the person experiencing them directly. Family members might feel pressured to accommodate a loved one with OCD by participating in the behavior, helping the sufferer avoid their triggers, or otherwise accommodating their OCD. This is a well-intentioned effort to relieve the distress of their loved one with OCD. But in reality, one of the best things you can do to help someone with OCD is to resist becoming so involved in their behaviors. Instead, help guide them toward professional treatment with love, patience, and compassion.