If you’re experiencing obsessive-compulsive disorder (OCD), you may feel stuck in a loop: intrusive thoughts (obsessions) show up, and you feel driven to do something, physically or mentally, to get rid of the anxiety they cause (compulsions). This cycle can take over your daily life, interfering with your work, school, relationships, and well-being.
Everyone experiences intrusive thoughts now and then, but for people with OCD, those thoughts feel disturbing, persistent, and meaningful. You might feel unsure of what they say about you, or what you have to do to feel “safe” or morally right again.
In this article, we’ll break down the symptoms of OCD—what obsessions and compulsions can look like, how they change over time, when they usually start, and how effective, evidence-based treatments can help.
Common symptoms of OCD
OCD symptoms fall into two main categories: obsessions and compulsions.
Obsessions are unwanted, intrusive thoughts, images, urges, feelings, or sensations that cause significant distress.
Compulsions are repetitive physical or mental acts done in an attempt to reduce that distress or prevent something bad from happening.
While not an exhaustive list, here are some of the most common OCD symptoms:
Obsessions:
- Fear of contamination (e.g., by germs, chemicals, or dirt)
- Fear of harming others (even accidentally)
- Intrusive sexual or violent thoughts
- Religious or moral doubts
- Needing things to be “just right”
- Fear of losing control or acting impulsively
Compulsions:
- Excessive handwashing or cleaning
- Repeated checking (e.g., locks, stoves, or emails)
- Mental reviewing or replaying events
- Seeking reassurance from others
- Avoiding certain people, places, or objects
Every person with OCD experiences it differently. Some people may struggle with intrusive thoughts that feel taboo or distressing. Others may not realize that their mental rituals are compulsions, especially if they don’t involve visible behaviors (symptoms that can fall under the subtype “pure O”). This is an accurate diagnosis, and a tailored treatment plan—preferably from an OCD specialist—is essential.
How OCD symptoms feel
OCD doesn’t just affect your behavior; it takes an emotional toll, too. Many people experience intense anxiety, guilt, and exhaustion alongside their intrusive thoughts and compulsions. These feelings are part of what makes OCD so distressing and disruptive.
When do OCD symptoms start?
OCD can begin at any age, but symptoms most commonly appear in late childhood, early adolescence, or early adulthood.
There are two peak onset periods:
- Early onset: Between ages 8 and 12
- Late onset: Late teens to early 20s
That said, OCD can also develop later in life in adulthood or after major life stressors, such as pregnancy or trauma. Symptoms often start gradually and may become more noticeable over time.
How are OCD symptoms diagnosed?
A diagnosis for OCD involves:
- Describing your symptoms to a mental health professional
- Completing structured assessments
- Ruling out other conditions
Self-recognition is a great first step. From there, a clinician can help confirm a diagnosis and build a treatment plan.
How are OCD symptoms treated?
OCD is a chronic condition, but with the right treatment, symptoms can become much more manageable. Several treatment approaches are available, and the best plan often depends on the severity of symptoms and personal preferences.
The most effective, research-backed treatments for OCD are:
- Exposure and response prevention (ERP) therapy: ERP is a specialized form of cognitive behavioral therapy (CBT) proven to be effective for OCD. General CBT, if not tailored for OCD, can sometimes be unhelpful or even worsen symptoms.
- Medication: Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and sertraline (Zoloft), can reduce the intensity of obsessions and compulsions for many people.
Other treatment options that may be helpful in combination with ERP therapy include:
- Acceptance and commitment therapy (ACT): Helps people relate to their thoughts differently, without trying to suppress or control them.
- Mindfulness-based strategies: Teach nonjudgmental awareness of thoughts and feelings.
In severe, treatment-resistant cases, options like transcranial magnetic stimulation (TMS), deep brain stimulation (DBS), or intensive outpatient programs (IOPs) may be considered.
Many people benefit from a combination of ERP therapy and medication. If you’re exploring your options, it’s important to work with a mental health professional who specializes in OCD treatment.
When to get help
You should seek help if:
- Your symptoms take up more than an hour a day
- They cause significant distress or impairment
- You’re avoiding people, activities, or responsibilities
Early treatment can prevent symptoms from worsening. OCD is treatable with the right support.
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
Frequently asked questions
What are examples of OCD symptoms?
Intrusive fears (e.g., fear of contamination or harm) and repetitive behaviors like checking, cleaning, or mental reviewing are common OCD symptoms.
Can OCD symptoms go away on their own?
OCD is a chronic condition—symptoms may come and go, but they usually don’t go away without treatment. ERP therapy is the most effective way to reduce symptoms and regain control.
Are mental compulsions part of OCD?
Yes, mental rituals like rumination, mental checking, and reassurance-seeking are common symptoms of OCD and can be just as impairing as physical compulsions.
Can OCD change over time?
Yes, themes and severity can shift due to stress, life events, or developmental changes, but they’re all treatable with ERP.
Bottom line
If you’re dealing with intrusive thoughts and compulsive behaviors that interfere with your life, you’re not alone, and effective help is available. OCD is a chronic condition, but it’s highly treatable. With first-line approaches like ERP therapy and medication—as well as supplemental support—you can break the cycle and reclaim your life. Recovery is possible.
Key takeaways
- OCD involves obsessions and compulsions that can significantly interfere with daily life, relationships, and mental well-being.
- Common OCD symptoms include intrusive thoughts (like fears of contamination or harm) and repetitive behaviors (like handwashing or checking) performed to relieve distress.
- Symptoms often begin in childhood or early adulthood, but OCD can emerge at any age and may worsen without treatment.
- The most effective treatments for OCD are exposure and response prevention (ERP) therapy and medication, particularly SSRIs. Add-on treatment options include ACT, mindfulness strategies, and neuromodulation or intensive outpatient programs (IOPs) for severe cases.