Learning library · Understanding your diagnosis
OCDObsessions and compulsions
What OCD really is beyond the stereotype, how the obsession–compulsion cycle works, and why specialized therapy is so effective.
What OCD is
Obsessive-compulsive disorder, or OCD, is more than liking things tidy or double-checking the stove. It's a long-lasting condition of obsessions, compulsions, or both, that take up time and cause real distress.
OCD is treatable, and it isn't your fault. It usually starts between late childhood and young adulthood, though it can begin at any age.
Obsessions and compulsions
Obsessions are unwanted thoughts, urges, or images that keep coming back and cause anxiety. Common themes include fear of germs, fear of harm coming to yourself or others, needing things symmetrical or just right, and unwanted taboo thoughts.
Compulsions are things you feel driven to do in response, like washing, checking, counting, arranging, or repeating words in your mind.
A compulsion may bring brief relief from the anxiety. But the obsession comes back, and the cycle repeats, again and again.
Getting a diagnosis
People with OCD often know their thoughts or rituals are excessive, but can't control them. The symptoms can take up an hour or more a day, and get in the way of work, school, or relationships.
A clinician asks about your thoughts, your rituals, and how much time they take. Questionnaires like the Y-BOCS-II, which you may see under Assessments in your portal, help measure how you're doing over time.
Treatments that help
A kind of cognitive behavioral therapy called exposure and response prevention, or ERP, is especially helpful for OCD. With a therapist, you gradually face the thoughts and situations that set off your anxiety, while practicing not doing the compulsion. With practice, many people find their symptoms ease.
Medicine can help too. Serotonin reuptake inhibitors, including SSRIs, are the medicines most often used for OCD, and they can take several weeks or longer to help. Many people do best with therapy and medicine together.
For OCD that hasn't improved with other treatments, there are further options, such as a form of brain stimulation.
When to reach out
If obsessions or compulsions are taking up your time or getting in the way of your life, talk with your care team. You can start with a message in your portal.
If you ever have thoughts of harming yourself, call or text 988, any time, day or night. This video is general education, not medical advice. Your provider can help you find the right plan for you.
3 min · captions with the CC button · 5 chapters · animated diagrams