What are some common OCD symptoms?

Understanding mental health can be confusing for many, as diagnostic terms are often misused in popular culture. Obsessive-compulsive disorder (OCD) is a common mental health disorder, affecting both adults and children. Knowing the signs and symptoms to look out for is the first step in helping identify OCD and the best way forward.

OCD is a disorder characterized by recurring, uncontrollable thoughts, known as obsessions. These thoughts may lead someone with OCD to develop behaviors that they are unable to resist and feel compelled to repeat. It's common to misidentify perfectionism, organizational skills and control-related behaviors as signs of OCD.

Although obsessive compulsive behaviors can occur at any stage of life, it is rare for someone to develop them after age 40. OCD affects people on average at age 19 to 20 and often begins in childhood before the age of 14 for 25% of people.

The symptoms of OCD fall into two categories: obsessions and compulsions.

Obsessions are defined as repeated, persistent and unwanted thought patterns, urges or mental images. Obsessions tend to have a theme and can interfere with everyday life. They may include:

• Unwanted, confusing thoughts, which can be aggressive, sexual or religious in nature
• Fear and intense anxiety surrounding uncertainty
• Fear of germs, contamination or dirt
• An intense desire to keep things in order, organized, symmetrical or perfect
• Overwhelming feelings of losing control, aggression or causing harm to yourself or others

These obsessions may lead to the desire to perform rituals or repetitive behaviors. This is in response to anxiety around repeated thought patterns, known as compulsions. Compulsions are associated with behaviors such as:

• Obsessive cleaning of the environment or yourself, such as repeated hand-washing, cleaning spaces in the house, bleaching surfaces
• Compulsive counting in certain patterns
• Ordering things in a particular way, such as arranging food in a certain manner before eating, lining up shoes in a specific way
• Repeatedly checking things, such as locks on doors or appliances to see if they are turned off
• Strictly following specific routines or demanding reassurance, such as repeating phrases, prayers or words multiple times per day

The symptoms of OCD are very similar with children and adults. Although OCD typically begins in young adults, it can also start in childhood. The major difference is that children display behaviors that may be confused with tics, where the individual makes sudden repetitive movements or sounds that are usually seen as involuntary, often seen in Tourette syndrome (TS) or attention-deficit/hyperactivity disorder (ADHD). This makes it harder to diagnose in children.

OCD symptoms can overlap with other mental health conditions.  However, children may have other conditions that commonly occur with OCD including ADHD, depression, and eating disorders.

Anxiety is associated with OCD, specifically related to excessive thoughts and worries that affect your quality of life and ability to function. Those with OCD tend to experience repetitive thoughts and behaviors for at least an hour a day, making it hard to perform everyday tasks. The inability to carry out compulsions can bring on intense anxiety and distress. This is where OCD differs from the general anxiety that everyone can experience from time to time.

Knowing the signs and symptoms to look for in yourself or in someone you care for can help you seek diagnosis and treatment for OCD in the early stages. By working with a treatment team, including a therapist, people can take back control from their obsessions and compulsions. With time, this may help them lead a happier, more balanced life.

Clinically reviewed and updated by Julie McDaniel, MSN, RN, CRNI October 2023.