Obsessive Compulsive Disorder (OCD)
What is OCD?
OCD is a type of anxiety disorder that is made up of two parts, obsessions and compulsions, that are connected in a cycle.
Obsessions
Obsessions are unwanted thoughts, feelings, images, urges, doubts or worries that persistently come into your mind. You may worry about what they mean or why you are having them, and they often cause high levels of worry and distress.
Compulsions
Compulsions are the things that you do to try and alleviate the worry, distress or discomfort that the obsessions are causing. They can be physical or can be things that you do in your head. Physical compulsions might be something like checking a door is locked, whilst a mental compulsion may be something like repeating a specific word to yourself.
What causes it?
It is not fully understood what causes OCD. It is sometimes best to think of it as a list of ingredients that make this specific type of worry. There are some examples of what we call “biological factors” – which means something physical in the body or brain. It is also suggested that having a strong sense of responsibility can be a factor in developing OCD. When you feel heightened anxiety or stress, you might interpret your intrusive thoughts to be true, which can be especially distressing because OCD often targets the things you value most. OCD can make you question your identity, such as worrying if you are a good person. These distressing thoughts pressure you to engage in repetitive and compulsive behaviours to help soothe the anxiety.
What is important to remember is that it is not your fault and with the right support and help the symptoms can have less of an impact on your life.
What are the symptoms?
Intrusive thoughts are unwanted thoughts that suddenly appear in your mind. We often can’t control when these thoughts first appear, and we can experience lots of intrusive thoughts throughout the day. Sometimes these thoughts get “stuck” in your mind and OCD can make you excessively ruminate about them.
The thoughts can sometimes feel random and meaningless but other times they can feel scary, shameful and offensive. They can go against our values and beliefs and make us feel very uncomfortable.
For people with OCD these unwanted intrusive thoughts can become obsessions.
Obsessions
People with OCD have obsessions that cause distress, and they can have a huge impact upon daily living. Examples of obsessions might focus on:
- Worrying you’ve already harmed someone by not being careful enough. For example, that you’ve knocked someone over on your bike.
- Worrying you’re going to harm someone because you’ll lose control. For example, that you’ll push someone in front of a train.
- Experiencing violent intrusive thoughts or images of yourself doing something violent or abusive. These thoughts might make you worry that you’re a dangerous person.
- Worrying about your relationships. For example, having doubts about whether a relationship is right, or worrying people may dislike you or leave you.
- Experiencing sexually intrusive thoughts. For example, you might worry that you could be sexually harmful, or that you have inappropriate sexual attractions.
- Obsessing about contamination, for example dirt or germs. You might worry that you’ve been contaminated and that you’re spreading the contamination, or that other people are. Or you might worry that you have a disease or might get one.
- Obsessing about mental contamination. You might experience feelings of dirtiness, discomfort or feeling incomplete or tainted. These feelings may be triggered by a certain person, place or object. They may also be triggered by your own thoughts, images or memories.
- Worrying or doubting about your identity. For example, having obsessions or compulsions about your sexuality or gender identity, or having constant doubts about your beliefs or values.
- Worrying that you’re a bad person. For example, constantly checking whether you’ve thought something bad, worrying you may say something offensive or constantly thinking about things you regret from the past.
- Obsessing about your body. This could include constantly worrying about how you look or feel; or feeling very conscious of physical sensations like blinking or swallowing.
- Worrying about the future. For example, getting intrusive thoughts about you or a loved one getting ill, or something bad happening in the world.
- Fearing that something bad will happen if everything isn’t ‘right’, for example, if things are not clean, in order or symmetrical.
You may feel that you cannot share the details of your thoughts because you worry that other people may be shocked or distressed by them, or will judge you for having such thoughts.
Compulsions
Compulsions are the actions or behaviours you may take to prevent your bad thoughts from happening, or to try and bring down the anxiety feeling when those intrusive thoughts occur.
The compulsions are repetitive and time consuming which means it can cause delays to you going to school, seeing friends, or may even stop you from doing these things altogether. They also might not make sense, which can cause even more anxiety and confusion, especially when you feel that you must do them. Examples of compulsions can include:
- Washing your hands, body or things around you a lot
- Touching things in a particular order or certain time number of times
- Arranging objects in a particular way
- Saying things again and again (aloud or in your head)
- Counting to a certain number
- Doors and windows to make sure they are locked
- Your body or clothes for contamination
- Your body to see how it responds to intrusive thoughts
- Your memory to make sure an intrusive thought didn’t actually happen
- Your route to make sure you didn’t cause an accident when you travelled somewhere
- Your phone or computer to see if you’ve sent something offensive or embarrassing
- Trying to replace an intrusive thought with a different image
- Trying to replace a negative feeling with a positive one
- Doing something again and again until it feels ‘right’
- Repeatedly asking other people to tell you that everything is alright
- Saying or doing things to test other people’s reactions
- Repeatedly apologising to people
- Confessing your intrusive thoughts to people and asking what they mean
- Constantly telling yourself that your intrusive thoughts aren’t true
- Thinking about the same thing again and again as an attempt to solve it
- Trying to fix your intrusive thoughts by thinking about what they mean
- Doing research on the internet about your obsessions
- Trying to detangle the truth of past experiences from the obsessive thoughts
- Avoiding situations or people that make you anxious.
- Avoiding access to things. For example, removing anything from your home that could hurt someone
- Delaying or putting things off (procrastination) to avoid feeling anxious or uncomfortable
In short anything can become compulsive if you can do it, think it or say it. Sometimes the compulsion will be clearly linked to the thing you’re worried about, and sometimes it will be less clear. It’s important to note that compulsions can also change over time.
Related to Obsessive Compulsive Disorder (OCD)
Advice to help me
OCD can feel overwhelming, but there are some things you can do to help manage or even reduce your OCD symptoms. This 2-minute video gives some useful advice, which we’ve also explained below.
If you can, tell someone what you are going through. Reaching out for support may feel scary, or you may not know who to speak to, but try starting with someone you trust or someone who cares for you. You could also speak to your GP, here is a tool to help you have this conversation.
Practicing breathing and relaxation techniques can help release and soothe some of your intense feelings. Try laying or sitting in a quiet distraction free room, closing your eyes and focusing on your breathing. Take slow breaths, in for a count of four and out for a count of four. If it feels difficult to pay attention to your body, you could try this guided video.
Try and practice letting your thoughts pass over you. Don’t fight them or give them meaning but acknowledge them and then let them pass. You could treat them as a passing cloud, background noise or a leaf in the wind instead of a threat. Tappy is an app with a keyboard feature where you can type distressing thoughts and press send to watch them float away, without being saved anywhere.
Try and resist your compulsions. You could use distraction techniques to delay acting on your thoughts, without trying to ignore them completely. Maybe you could also practice a grounding technique – such as the 1-2-3-4-5 technique. Find 5 things you can see, 4 things you can feel, 3 things you can hear, 2 things you can smell, and 1 thing you can taste. Mind have some useful tips on how to restrict your compulsions.
Separating yourself from your OCD can help you feel you have more power over it and can help you reduce self-blame. Try and imagine your OCD as an external character, you could give it a name and visualise what it looks like – it could be a bully, a monster or a misguided protector?
Can you identify what makes your OCD worse and can you do anything about possible triggers. It might be that your thoughts are worse when you haven’t been sleeping well, when you are really stressed, or when your hormones are affected by your menstrual cycle. Focus on the things within your control, for example, being able to say no to something if you are really busy so you don’t feel burnt out.
Try and look after yourself. This might include eating a balanced diet, getting enough sleep, connecting with those around you and developing the things in your life that supports your resilience.
Find time for you; OCD can be time consuming, and you may find that you don’t spend time on things you previously enjoyed. Try and do an activity you enjoy each day. This could using a colouring book, doing something creative, or listening to music. This self-care resource has lots of ideas to try.
Be patient with yourself when you are trying these strategies. Recognise that OCD is really difficult, and some days will be better than others. Be kind to yourself and give yourself credit for the strength it has taken to keep going.
Who can help me?
Accessing support in your local area, or on-line, may be useful if you are experiencing mental health difficulties that are having mild or moderate impact on your daily life . Based on your symptoms, age and where you live, the support below might be useful for you:
Thrive hubs can help you understand your options.
Our service is designed to advise, guide, signpost and get help for young people within Manchester currently facing mental health and emotional wellbeing issues.
Learn more about Thrive HubsFor young people looking for emotional wellbeing support, this website offers a range of information and services, including counselling, psycho-social support, and cognitive behavioural therapy.
An on-line resource with lots of advice and information for young people.
We provide mental health support within education settings across Manchester, including primary and secondary schools and colleges
We provide mental health support within education settings across Salford, including primary and secondary schools and colleges.
We provide mental health support within education settings across Trafford, including primary and secondary schools and colleges.
CAMHS Services
A referral to a CAMHS service might be useful if you are experiencing mental health difficulties that are having a significant impact on your daily life. Based on your age, symptoms and where you live, the following services might be appropriate for you:
We are an NHS service that offers support and treatment to children and young people up to 18 years old who are experiencing challenges with their mental health and wellbeing. We also support parents, carers, and families of these children and young people
The Community Eating Disorder Service (CEDS) is a specialist CAMHS community team (Child and Adolescent Mental Health Service), for children and young people aged 5 – 17 who may be presenting with an eating disorder or eating disorder difficulties. We provide specialist evidence-based therapeutic interventions to young people and their families, through a range of treatments, as well as physical health monitoring.
We are a specialist Child and Adolescent Mental Health Service (CAMHS) working with deaf children and their families. We cover the North of England and have teams in York, Manchester and Newcastle.
Emerge 16-17 CMHT provide a wide range of community based mental health services, including risk and duty support, to young people aged 16 and 17.
Galaxy House helps young people with a range of mental health difficulties including eating disorders and medically unexplained symptoms, as well as managing associated behaviours such as self-harm. Admission lengths vary depending on the young person’s needs and their care pathway. We work closely with families and community agencies to enable young people to be discharged from hospital at an appropriate time in their recovery. In addition to its 12 beds (all single rooms with 2 en-suite) Galaxy House has living, dining, therapy and outdoor space. It also has its own school provided across 2 classrooms within the building, which provides National Curriculum education from 9.30am to 3.15pm each weekday by staff from Royal Manchester Children’s Hospital School. Referrals may be for consultation, second opinion or for consideration of admission.
The Manchester CAMHS team for Looked After Children is a CAMHS team for children and young people cared for by Manchester City Council.
We are an NHS service that offers support and treatment to children and young people up to 18 years old who are experiencing challenges with their mental health and wellbeing. We also support parents, carers, and families of these children and young people.
We are an NHS service that offers support and treatment to children and young people up to 18 years old who are experiencing challenges with their mental health and wellbeing. We also support parents, carers, and families of these children and young people.
We are an NHS service that offers support and treatment to children and young people up to 18 years old who are experiencing challenges with their mental health and wellbeing. We also support parents, carers, and families of these children and young people.
We are an NHS service that offers support and treatment to children and young people up to 18 years old who are experiencing challenges with their mental health and wellbeing. We also support parents, carers, and families of these children and young people.
We are a specific CAMHS team for young people who may have been involved in the youth justice system. We are based within Manchester Youth Justice supporting Children who may be on a statutory court order or on intensive supervision.