What is Obsessive-Compulsive Disorder?

Obsessive-Compulsive Disorder (OCD) is an anxiety disorder dominated by obsessions (intrusive thoughts, images) and compulsions (rituals, urges and behavioural responses to the thoughts). OCD isn’t just about washing your hands a lot. This misunderstood condition of intrusive thoughts and compulsive behaviour can rule your life. But what is OCD? And how do you know if you have it?

Causes of OCD

causes of Obsessive-Compulsive disorder





Often, individuals with Obsessive-Compulsive Disorder feel an overwhelming responsibility on their shoulders for keeping others, and themselves safe. (e.g. I must keep bacteria away from my family otherwise they might become ill or die and it will be my fault”).

OCD cycle

Symptoms of OCD

You might feel:

  • your mind being interrupted by intrusive, horrible thoughts repeatedly
  • emotions like fear, disgust, shame, depression, self-doubt, guilt, anxiety
  • an irresistible urge to do something to stop the feelings
  • temporary relief after rituals
  • a need to ask for reassurance or get people to check things for you

Just because you experience one or more of these symptoms, it doesn’t mean you’re definitely affected by OCD. It’s important to talk to your GP or counsellor to get more help.






In order to break the vicious cycle of OCD, we need to change the way we think (and think about thoughts) and change what we do.

OCD cogs

The OCD Bully

Let’s think about an imaginary playground bully in a school. This particular bully isn’t violent, but he taunts, teases, laughs and criticises. Cruel words. Imagine this bully picks on 3 victims this playtime. He approaches each victim with the same taunts: “Hey you! You’re so stupid – give me your lunch money NOW or else I’ll tell everyone how stupid you are!” How does each victim react?

Victim number 1 believes the bully, becomes upset and hands over the money.

Victim number 2 challenges back – “I’m not stupid, I got 8/10 in my spelling test this morning, you only got 4. Get lost!”

Victim number 3 hardly reacts at all. He looks at the bully to acknowledge him, then turns around to go and play football with his friends.

How does the bully react to each? He’s probably going to come back to victim 1 most days. He might have another go at victim 2, but he’ll soon give up. The bully’s probably not going to bother victim 3 much.

Our own OCD bully is just like that playground bully, and instead of reacting like victim number 1, believing the bully and doing as he says, we can choose to react like victim number 2. We can learn to:
Challenge our OCD bully

Simply acknowledge the bully, then let the thought go and shift our focus of attention by doing something else.

Thinking Differently – Letting the thoughts go

Another way of looking at The Mind Bully is this. We tend to react to thoughts by fighting with them, because they are so upsetting, we just want to get rid of them. The best thing to do seems like fighting them away or trying to stop them, but maybe that’s not so helpful. If you try NOT to think about a green elephant right now, for 30 seconds – DO NOT think about a green elephant and DO NOT imagine seeing a green elephant. Try it for 30 seconds.

What happened? You thought of a green elephant? That’s how the mind works. When we’re on a diet, all we can think about is food, right? The more we try NOT to think about something, the more it keeps popping up into our heads. Like trying to push a beach ball down under the water. We have to keep the pressure up and keep pushing down, but it just keeps popping back up into our face. If we let it go, the ball would just drift about. It might nudge us from time to time, but that’s ok, we can just let it be.

accept change let go


fact or opinion



Treatment for Obsessive-Compulsive Disorder

The main treatments are:
psychological therapy – usually cognitive behavioural therapy (CBT) which helps you face your fears and obsessive thoughts without “putting them right” through compulsions
medicine – usually a type of antidepressant medicine called selective serotonin reuptake inhibitors (SSRIs) which can help by altering the balance of chemicals in your brain
CBT will usually have an effect quite quickly. It can take several months before you notice the effects of treatment with SSRIs, but most people will eventually benefit.
If these treatments do not help, you may be offered an alternative SSRI or be given a combination of an SSRI and CBT.
Some people may be referred to a specialist mental health service for further treatment.