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Obsessive Compulsive Disorder (OCD): Symptoms, Diagnosis And Treatment Explained

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Obsessive compulsive disorder (OCD) affects roughly 1.2% of the UK population, equating to 12 in 1000 people.

“OCD is often thought of in individuals who like order and symmetry, however it is much more than that,” Dr Sarah Crawford, counselling psychologist at Nightingale Hospital, tells HuffPost UK.

“There is often a hidden side to OCD which leads to intense distress and feelings that one is going mad in some way.”

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What is it?

OCD is an anxiety disorder involving an obsession that people are unable to control.

“We have thousands of thoughts that enter our minds every day – some negative, some positive and some neutral,” explains Dr Crawford.

“With OCD, these thoughts are unpleasantly intrusive in nature, causing anxiety and distress.

“Many sufferers are aware of the irrationality of their compulsions but feel the urge to perform them and find it immensely difficult to stop. And then they often feel ashamed.”


People with OCD will experience different obsessions and compulsions, which will affect their lives in varying amounts. 

Some people may experience obsessions such as persistent thoughts, pictures, urges or doubts that appear in the mind again and again.

“They interrupt your thoughts against your control and can be really frightening, graphic and disturbing,” says Lucy Lyus, information manager at mental health charity Mind.

Common themes of obsession are: fear of causing harm or failing to prevent harm, unwanted sexual thoughts, unwanted religious thoughts and fear of contamination.

“Obsessions are often linked together,” explains Lyus. “For example, you might experience a fear of contamination and a fear of doing someone harm by accidentally making them ill.”

Compulsions are repetitive activities that a person feels they have to do. The aim of a compulsion is to try and deal with the distress caused by obsessive thoughts.

“So for instance, if someone has a fear of harming a housemate through leaving the oven on then they may engage in an obsessive ritual to check the hob multiple times to neutralise this obsessive thought before being able to leave the house,” says Dr Crawford.

Common compulsions include physical compulsions (such as washing or checking) or mental compulsions (such as repeating a specific word or phrase).

Examples include repeating actions like touching every light switch in the house every time you leave, or checking things, for example reading an email 10 times before sending it.

According to Dr Crawford, many sufferers will have more than one obsession or compulsion which can change over time, creating considerable disruption in life.

“The symptoms then become frustrating and may lead to total avoidance of anxiety provoking situations or cues,” she explains.

“While again this relieves the anxiety in the short term, it does not allow the individual to learn that they are not in danger and so the OCD is perpetuated and made worse.”


If a GP suspects that you may have OCD, they should refer you to a mental health professional for an assessment, which will involve being asked a number of questions.

“One of the main things that professionals consider in diagnosing OCD or a related disorder is how your symptoms affect your life,” explains Lyus.

“They will especially consider how long rituals take, how often thoughts occur and how bad they make you feel, the extent of any avoidance behaviour and, ultimately, how much your OCD is stopping you from living the life that you want to live.”

She adds that many people feel like they have some OCD-like symptoms or behaviour. For example, if you double check the door at night or get upset if things are not in a specific order. However if this behaviour is not having any noticeable impact on your life or if you’re not finding it intolerable, then a health professional is unlikely to diagnose you with OCD.


The two main treatments for OCD are psychological therapy (such as CBT) and medication, to help alter the chemicals in the brain.

Cognitive behavioural therapy (CBT) is a talking treatment that focuses on how your thoughts, beliefs and attitudes affect your feelings and behaviour. 

“There’s a lot of evidence that CBT is effective for treating OCD,” explains Lyus. “But it can be challenging and may make you feel more anxious at first.”

OCDAction have a CBT checklist to help you make sure that the therapy you are receiving is the most effective for treating OCD.

In addition to therapy, you may also be offered medication such as:

:: Antidepressants – these are recommended by NICE for the treatment of OCD. 

:: Tranquillisers – if you are experiencing very severe anxiety you may be offered these.

:: Beta-blockers – occasionally prescribed to treat the physical symptoms of anxiety.

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