Symptoms of OCD

The main symptoms of OCD are, as the name implies, obsessions and compulsions. There are many types of each, however, and a person's symptom pattern may change over time.

Obsessions

Obsessions are recurrent, persistent and intrusive thoughts. They are both unpleasant and anxiety-provoking, and the person experiencing them generally knows that the thoughts are irrational and excessive. The person may try to resist the thought, but it can be overwhelming and uncomfortable. Compulsions are often performed in order to "neutralize" these thoughts and make them go away.

Compulsions

Compulsions are repetitive behaviors or rituals frequently aimed at "neutralizing" obsessive thoughts. A person usually feels that he must perform the act in a very specific way, or perform it a certain number of times, to make the obsessive thought go away. Again, the person typically realizes that his actions are irrational, but resisting the impulse can seem overwhelming.

How Obsessions and Compulsions Are Related

To be diagnosed with OCD, a person may have either obsessions or compulsions. At least 75% of people with OCD, however, have both obsessions and compulsions. The obsession is often a fear of something terrible occurring (like getting a fatal illness or burning one's house down). The compulsion, then, is an irrational attempt to prevent this dreaded event from happening (by washing one's hands excessively or checking the stove over and over).

Patterns of Symptoms

OCD symptoms differ from person to person, but there are some common patterns. The most common types of OCD are as follows:

1. Contamination and Washing:

   A person may fear being "contaminated" (by germs, blood, dirt, etc.). To avoid being "contaminated," the person avoids touching certain objects (toilets, door knobs, other people, etc.) and may perform excessive hand washing or showering. Some people become so afraid of contamination that they are unable to leave their homes.

2. Doubt and Checking:

   A person doubts that she has really locked the door, turned off the stove or turned off the light. As a result, she checks the door, the stove or the light switch again and again.

3. Intrusive Thoughts:

   In this type of OCD, there is an obsession without a compulsion. A person simply has repetitive, disturbing thoughts, often involving violence or aggression.

4. Symmetry:

   A person may be overly preoccupied with keeping the items on her desk in a specific order, or with rearranging the refrigerator contents a certain way.

5. Other Types:

   OCD may take a number of other forms, including hoarding, counting and praying. Approximately half of all people with OCD have multiple obsessions and compulsions.

_{Source: Sadock, Benjamin J and Sadock, Virginia A. Synopsis of Psychiatry, Ninth Edition. Philadelphia: Lippincott, Williams & Wilkins, 2003.}