Obsessive-Compulsive Disorder: Understanding your anxiety

Everyone double-checks things sometimes. However, people with obsessive-compulsive disorder (OCD) cannot help themselves but indulge in repetitive behaviors, do certain rituals over and over, or have repeated unwanted thoughts. OCD is a medical illness that can have devastating effects on your life.


  • In the U.S., approximately 3.3 million people have OCD.
  • According to the National Institute of Mental Health, 0.3 to 1% of the pediatric population has OCD, and 1-2% of the adult population suffers from OCD.
  • OCD strikes men and women in roughly equal numbers.


  • OCD is an anxiety disorder characterized by repetitive, ritualized behaviors. These behaviors are triggered by uncontrollable, unwanted thoughts (Obsessions) that create an urge to perform a particular activity (Compulsions). The compulsions aim to relieve the anxiety created by the obsessions briefly.
  • People with OCD can’t control their unwanted thoughts and behaviors.
  • OCD is a lifelong disorder that can cause disability.


  • Distress over dirt or contamination
  • Concern with illness or disease
  • A need to keep things orderly or symmetrical
  • Aggressive or violent thoughts of harming one’s self or others
  • Unwanted sexual or religious thoughts


  • Cleaning or washing repeatedly
  • Seeking constant reassurance from others
  • Following a strict ritual or routine
  • Repeatedly ordering or arranging items
  • Repeatedly counting
  • Repeatedly checking
  • Avoiding situations that trigger obsessions


  • OCD usually appears during childhood, adolescence, or early adulthood.
  • Children must undergo a thorough medical and psychological examination, as symptoms of other mental disorders like ADHD, Tourette’s syndrome, or Autism can look like OCD.
  • Most people are diagnosed by about age 19.


  • Stressful or distressing events, like childhood trauma, can increase the risk of OCD.
  • Research indicates that OCD might run in families.


  • Consider getting involved in a support group. Like-minded people can help you overcome the challenges of OCD.
  • Try to follow a healthy diet, exercise regularly, and sleep adequately. These behaviors can positively influence your treatment.
  • If OCD disrupts your daily functioning, you may seek treatment from an experienced clinician. Medications, psychotherapy, and TMS therapy can be beneficial for OCD.


People with OCD are likely to develop other mental disorders – most commonly, major depressive disorder or MDD.

One 2011 study found that people diagnosed with OCD are roughly ten times more likely to experience depression than those without OCD symptoms.

The exact reason is up for debate. However, one popular opinion is that people living with OCD struggle with its symptoms and the adverse effects that come with it. They may not be able to participate in daily activities and socialize. Some may not even be able to relax at home how they’d like to. This struggle likely increases the risk of depression.

People with OCD suffer from irrational and intrusive thoughts, such as not cleaning the room right in three tries can cause a loved one to die. Individuals cannot help but act according to these thoughts, even if they know they are irrational.

Clinicians use the OCD diagnosis criteria outlined in the DSM-5 to diagnose the obsessive-compulsive disorder and other mental health conditions.

The criteria include the following:

  • The person experiences repetitive obsessions, compulsions, or both.
  • The obsessions or compulsions occupy considerable daily time, lasting more than an hour.
  • OCD symptoms are not caused by overuse of alcohol, illicit drugs, or prescription medication.
  • Obsessive thoughts and compulsive behaviors negatively affect the ability to participate in work, social activities, or other areas of life.

Most people with mild to moderate symptoms of OCD may learn to live with them. As such symptoms don’t cause much turmoil in their daily life, they may even rationalize them as not so bad or that they are actually helping them succeed. Thus, they don’t seek treatment.

However, as time goes on, symptoms can grow worse. In some cases, things can get so bad that the individual may completely cut themselves off from society.

Yes, OCD medication can change your personality, which is good. The medicines can help lower the intensity of obsessions and compulsions, which previously may have been dictating your personality.

If you have a first-degree relative, like a parent or sibling, with OCD, you are five times more likely to develop the disorder yourself. The likelihood of a genetic link is higher if you develop OCD as a child rather than as an adult.

The term “backdoor spike” describes the crippling stress that individuals with OCD experience when they worry that symptoms may come back.

A backdoor spike often occurs when an individual has been doing well with their treatment plan for a few weeks or months, leading them to believe that they no longer need treatment.

But then the obsession creeps back. They may start thinking incessantly about why they are not experiencing the symptoms, what would happen if they come back, and whether they can control it.

An OCD backdoor spike can also be deceptive. It may trigger an OCD sufferer to believe that the distressing mental images, fears, and doubts are “signs” of impending danger and, therefore, valid and reasonable.

Yes, OCD symptoms may return if you go through significant life transitions and periods of stress.

For some, these relapses are short-lived and do not require additional treatment; for others, returning to therapy for a short period is necessary to deal with the underlying stress and strengthen their coping mechanisms.

The two main ways to effectively treat OCD symptoms are:

  • Psychotherapy – Psychotherapy is recognized by researchers and healthcare providers as an effective treatment for reducing the frequency and intensity of OCD symptoms.
  • Medicine – Medication, like selective serotonin reuptake inhibitors, can help you by blocking the reabsorption and reuptake of serotonin by nerve cells in the brain, resulting in better mood and relief from OCD symptoms.

If these don’t work for you, there’s TMS or Transcranial magnetic stimulation. Transcranial magnetic stimulation (TMS) therapy is a non-invasive procedure that uses a magnetic field to stimulate the parts of the brain that are thought to be involved in OCD, such as the frontoparietal cortex and the anterior cingulate cortex. And yes, it’s FDA-approved.

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