Obsessive compulsive disorder - Symptoms of obsessive compulsive disorder

While obsessive compulsive disorder (OCD) is a condition that can affect people differently, it usually causes a particular pattern of thought and behaviour.

Patterns of thought and behaviour

Most people with OCD generally fall into a set pattern or cycle of thought and behaviour. This pattern has four main steps:

• Obsession your mind is overwhelmed by a constant obsessive fear or concern, such as the fear that your house will be burgled.
• Anxiety this obsession provokes a feeling of intense anxiety and distress.
• Compulsion you then adopt a pattern of compulsive behaviour to reduce your anxiety and distress, such as checking that all your windows and doors are locked at least three times before leaving your house.
• Temporary relief the compulsive behaviour brings temporary relief from anxiety, but the obsession and anxiety soon return, causing the pattern or cycle to begin again.

Obsessive thoughts

Almost everyone has unwanted and unpleasant thoughts, such as a nagging worry that their job may not be secure, or a brief suspicion that a partner has been unfaithful. Most people can put these types of thoughts and concerns into context and are able to carry on with their day-to-day lives; they do not repeatedly think about worries that they realise have little substance.

However, if you have a persistent, unwanted and unpleasant thought that dominates your thinking to the extent that it interrupts your other thoughts, you may have developed an obsession.

Some common obsessions that affect people with OCD include:

• fear of causing harm to yourself or to others through a deliberate action for example, fear that you may attack someone else even though this type of behaviour disgusts you
• fear of causing harm to yourself or to others through a mistake or accident for example, fear that you may set the house on fire by accidently leaving the cooker on, which leads you to repeatedly check the kitchen appliances
• fear of contamination by disease, infection or other unpleasant substance
• a need for symmetry or orderliness e.g. you may feel the need to ensure that all the labels on the tins in your cupboard face the same way
• fear of committing an act that would seriously offend your religious beliefs

Compulsive behaviour

Compulsions arise as a way of trying to reduce or prevent the harm of the obsessive thought. However, this behaviour is either excessive or not realistically connected at all. For example, a person with a fear of contamination by dirt and germs may wash their hands 50 times a day, or someone with a fear of causing harm to their family by thinking of disasters may have the urge to repeat an action multiple times to try and neutralise the thought of harm. This latter type of magical , compulsive behaviour is particularly common in children with OCD.