Everyone experiences anxiety at some point in their life. Sometimes when we’re stressed or overwhelmed, we can fixate on thoughts or feelings, even when we want to move on and feel or think of something else. This is fairly normal. Many people become fixated with thoughts or activities, and it does not significantly interfere with their relationships or quality of life.

If these intrusive thoughts become an ongoing problem and start interfering with life, it might be a type of anxiety disorder called obsessive compulsive disorder (OCD). The obsessive thoughts people with OCD experience are often disturbing or frightening, and can cause a great deal of anxiety. Many people with OCD feel like they must follow these thoughts with a compulsive action or ritual, to make the discomfort or distress go away.

To understand obsessive compulsive disorder, it might be helpful to understand what “obsessions” and “compulsions” are:

Obsessions: Unwanted and intrusive thoughts, images, or urges that are persistent and cause a great deal of anxiety or distress. These obsessions are often not rooted in fact, or the fear is out of proportion to the threat.

Compulsions: Repetitive behaviours (e.g. washing, checking, ordering, etc.) or mental acts (e.g. praying, counting, repeating phrases, etc.) that are carried out to reduce the anxiety caused by the obsessions.

OCD can be extremely distressing and debilitating. When someone has obsessive compulsive disorder (OCD), they cycle between having intrusive thoughts and performing compulsive acts or rituals. The compulsions might help to temporarily calm the obsessive thoughts, but then the cycle starts over again. Although obsessions are illogical, unwanted and unrealistic, they are difficult to stop or ignore. People with OCD can spend a lot of time every day worrying about obsessions or carrying out rituals; this can disrupt one’s life and relationships.

Obsessive compulsive disorder is different for different people. For some, symptoms can begin in childhood and for others it may develop later. Some common intrusive thoughts/obsessions revolve around cleanliness or contamination (e.g. germs, dirt, etc.), exact order, or fears of harming self or others. However, obsessive thoughts are not always about these subjects. Obsessive thoughts can be about nearly anything.

An important thing to remember is that someone with obsessive thoughts of harming themselves or others is extremely unlikely to actually carry out the thoughts, and find it very distressing to have them since they don't match with their values or intentions.

Some common compulsions might include repetitive hand washing, checking and re-checking things, performing certain tasks in an exact and repetitive manner, cleaning and arranging compulsively or repetitive counting/chanting. These are common, but do not describe everyone’s experience with OCD. Some people have different kinds of compulsions. In some cases, an individual with OCD may have obsessive thoughts without clear or easy-to-identify compulsions that follow.

OCD is not:

• The result of any actions or personal failures of the individual.
• A sign or result of low intelligence or weakness.
• A funny or weird personality trait or “quirk”.
• The same as being a perfectionist or really tidy.

Below is a list of signs and symptoms for obsessive compulsive disorder (OCD). The following list should not be used to diagnose yourself or someone else. It is only intended to provide general information. If you think you might be experiencing a mental illness, you should see your doctor.

These symptoms might not be present all the time, and may get worse with stress. You might notice that many of these signs or symptoms could be explained by any number of issues, not just OCD. Also, remember that every person is different. These symptoms might not describe every person's experience with OCD.

Examples of some common obsessions:

• Contamination by dirt, germs, or other diseases (e.g. by shaking someone’s hand, door handles, etc.).
• Forgetting to do something that could cause harm (e.g. turning off the stove, locking the door, etc.).
• Things not being "just right"; distress when things are shifted or touched.
• Extreme and often irrational focus on exactness and order.
• Having blasphemous thoughts (e.g. against God, against religion, thoughts that feel “unholy”, etc.); preoccupation with religious images and thoughts.
• Thoughts of harming oneself (e.g. while eating with a knife or a fork).
• Thoughts of harming others (e.g. harming babies, pushing someone in front of a train, etc.).
• Forbidden or unwanted sexual thoughts, images or urges (e.g. recurrent pornographic images).
• Thoughts that cause the individual significant distress and that feel like they can’t be stopped.

Examples of some common compulsions:

• Rules and rituals; performing the same action repeatedly.
• Avoidance of situations that can trigger obsessions, such as avoiding touching things someone else has touched.
• Washing, such as washing one’s hands or face excessively.
• Cleaning excessively.
• Checking things multiple times (e.g. making sure you turned your lights off many times; driving home to double check, etc.).
• Arranging things such as arranging your canned goods to face the same way.
• Counting everything or counting in a certain pattern, such as counting footsteps as you walk.
• All compulsions are excessive, are performed to get rid of obsessions temporarily, and interfere with the person’s ability to live their life.

Other thoughts, feelings, behaviours:

• Excessive worrying.
• Feeling apprehensive.
• Feeling irritable.
• Difficulty concentrating.
• Feeling powerless.
• Sense of impending danger, panic or doom.

When someone is experiencing anxiety because of their obsessive thoughts, they can have physical symptoms like:

• Upset stomach, nausea or diarrhea.
• Experiencing muscle tension.
• Feeling restless or wound up.
• Having sleep difficulties.
• Feeling weak or tired.
• Trembling.
• Rapid heart rate.
• Rapid breathing.
• Excessive sweating or sweaty palms.

Like other mental health issues, obsessive compulsive disorder (OCD) and how it is experienced will differ from person to person. Because each case is unique, the treatment will likely be unique for each individual.

OCD can be treated with specific types of therapy, like cognitive behavioural therapy (CBT is a form of talk therapy that helps you understand and cope with harmful thoughts, feelings and behaviours as they happen) and support groups (where you can connect with others going through similar situations and support one another).

Counselling to learn coping skills, relaxation techniques and ways to disrupt compulsive behaviours may also help a person deal with OCD.

Family members of someone who has OCD may participate in therapy, support groups or benefit from learning about it and ways to support their loved one at home.

Medication can also be helpful to help stabilize someone enough to get the most out of therapy, counselling and living life. Every person is different, so if medication is used, it may take a while to find the medication that works best for you.

For some people, spending time in a treatment clinic or hospital is necessary, while for others, outpatient (getting help from a professional without having to actually “stay over” in a hospital) is better.

If you have to wait to get an appointment, there are many places that offer support while you wait. Find out where to call in your area.

Along with treatment from your doctor or therapist, there are things you can do to help and support your own recovery.

Every story is different, and sometimes people need to try different types of supports before they find the right plan for them. Be patient, and don’t give up.

A person living with OCD, like any other person, will benefit from maintaining wellness and having good supports in their life. 

Supporting someone with any type of serious illness can be challenging. Ways to help and support a friend or loved one who is living with obsessive compulsive disorder:

• Know the signs and symptoms of OCD and other anxiety disorders.
• The worries, obsessions and compulsions someone has when they have OCD may not make any sense to you, but they feel very troubling to the person dealing with them. Instead of trying to apply logic or explain the fears away, try thinking of a time when you were really worried and try to empathize with how your friend is feeling.
• You may want to help your friend or make their life easier by assisting them with their rituals. This may not be helpful for someone who is in treatment and trying to learn to cope with thoughts and behaviours on their own.
• Try to avoid being critical. Someone who has OCD is likely already really critical of themselves and knows that their thoughts and behaviours are irrational. They probably need someone around who is non-judgemental.
• Treatment is a process. Medications and therapy can take time to help. Be aware of this and try to be supportive as your friend adjusts.
• Be a sounding board. Listening without judgement and without trying to “fix” their problems can be incredibly helpful.
• Ask your friend how else you can help. It may be as easy as just providing a distraction, or asking them to do simple, relaxing things with you (like hanging out, watching a movie etc.).
• If your friend is in the hospital, go and visit them if you are able. The hospital may be scary and overwhelming for them and a friendly face can help. Make sure to ask about visitor rules first.
• Encourage professional help for your friend when needed (see Help Section)
• Set some boundaries for yourself, and take care. You can’t help someone if you’re feeling overwhelmed yourself.

See the Help Section for more info about helping a friend and self care.