Obsessive-compulsive disorder (OCD) is a long-term mental health condition characterized by uncontrollable, intrusive, and repetitive thoughts (called obsessions) that lead to compulsive behaviors (called compulsions).

OCD symptoms typically develop gradually and can intensify over time. However, some individuals may experience a sudden onset, with symptoms appearing seemingly overnight. The severity of OCD symptoms often fluctuates—some periods may be manageable, while others, referred to as "flares," occur when symptoms become more intense. Flares are commonly triggered by stress or disruptions to daily routines.

OCD symptoms fall into two categories: obsessions and compulsions. While some people may only experience one type, most individuals with OCD deal with both. These symptoms usually cause significant anxiety and distress, often interfering with work, school, relationships, and daily life.

Obsessive Symptoms

Obsessions are recurring thoughts, mental images, or urges that provoke anxiety, discomfort, or fear. They can relate to nearly any topic or theme. People with OCD often feel ashamed of these thoughts and try to suppress or ignore them, though they rarely succeed in doing so.

Common types of obsessions include:

  • Contamination: Fear of germs, dirt, bodily fluids, or chemicals.

  • Harm: Intrusive thoughts about causing harm to oneself or others.

  • Perfectionism: A need for order, symmetry, or fear of losing or forgetting important information.

  • Religious or moral: Obsessive concerns about morality, right vs. wrong, sinning, or blasphemy.

  • Sexual: Taboo or distressing sexual thoughts, often accompanied by fear of acting on them.

It’s common for someone with OCD to experience more than one type of obsession simultaneously. For example, a person might fear both contamination and accidentally causing harm to someone else.

Compulsive Symptoms

Compulsions are repetitive behaviors or mental actions that individuals feel driven to perform in response to their obsessions. These actions are often aimed at reducing the anxiety caused by obsessive thoughts, but any relief is usually short-lived. Over time, compulsions can become overwhelming and time-consuming, significantly disrupting everyday life.

Common compulsions include:

  • Cleaning and washing: Excessive handwashing, grooming, or cleaning of objects like doorknobs or surfaces.

  • Checking: Repeatedly checking doors, stoves, or locks to make sure they’re secure.

  • Repeating: Saying words, counting, or performing rituals a set number of times.

  • Ordering and arranging: Organizing items in specific patterns or sequences.

  • Mental acts: Reassurance-seeking, reviewing past events, or replacing negative thoughts with neutral or positive ones to “undo” them.

Symptoms in Children

OCD can begin at any age, but most people notice symptoms before turning 18. In children, OCD may appear differently than in adults, especially since young children may have difficulty expressing their thoughts and emotions clearly.

Examples of symptoms in children include:

  • Repeated checking, arranging, or cleaning in specific ways

  • Excessive worry about dirt, illness, or injury

  • Fear of bad things happening to themselves or others

  • Intrusive thoughts or images that cause discomfort

  • Rigid rule-following to prevent something bad

  • Repetitive counting or word repetition

  • Avoidance of people, objects, or situations that trigger anxiety

  • Intense need for order or symmetry

Symptoms in Men and Women

While OCD symptoms can affect anyone, gender may influence how and when the symptoms appear.

People assigned male at birth often experience OCD symptoms earlier, usually in childhood, and tend to report more obsessions involving blasphemous or sexual thoughts. Those assigned female at birth are more likely to experience symptoms after puberty or pregnancy and often have more compulsions related to cleaning and contamination.

When To See a Healthcare Provider

Many people occasionally engage in behaviors like double-checking or reassurance-seeking, especially during stressful situations. However, with OCD, these thoughts and behaviors become excessive, irrational, and interfere with daily life—even when the person is aware that they’re unreasonable.

You should consider seeking help from a mental health professional, such as a psychiatrist or psychologist, if you:

  • Have recurring thoughts or behaviors that cause overwhelming anxiety or distress

  • Spend at least one hour each day on obsessive thoughts or compulsive actions

  • Find that your symptoms affect your performance at work, school, or in relationships

  • Avoid people, objects, or environments due to obsessive fears

  • Perform rituals that bring temporary relief but no real sense of satisfaction

  • Use substances like alcohol or drugs to cope with anxiety or distress caused by your symptoms

A Quick Review

Obsessive-compulsive disorder (OCD) is a chronic condition in which people experience unwanted, intrusive thoughts (obsessions) and feel the need to engage in repetitive actions or mental rituals (compulsions) to relieve distress.

Obsessions may involve fears of contamination, harming others, needing perfection, or intrusive thoughts about religion or sexuality. Compulsions may include excessive cleaning, checking, organizing, or mental exercises like seeking reassurance.

OCD can significantly disrupt daily life, including relationships, education, and work. If you or someone you care about shows signs of OCD, speaking with a healthcare provider can lead to early diagnosis and effective treatment—ultimately improving well-being and quality of life.