OCD: Types, Signs & Symptoms

OCD symptoms and common signs of OCD, types of OCD, its causes and treatment and how to tell it from OCPD.

ocd symptoms

OCD symptoms and common signs of OCD, types of OCD, its causes and treatment and how to tell it from OCPD.

Obsessive compulsive disorder (OCD) symptoms are more than just being fastidious about cleaning or checking the oven is off.

People with OCD symptoms normally have unreasonable fears (called obsessions) which they try to reduce by performing certain behaviours (called compulsions).

People with OCD symptoms feel compelled to perform these actions, even if they don’t want to.

OCD is thought to affect around 2.3 percent of people at some point in their lives.

Obsessive Compulsive Disorder symptoms

Most people develop OCD symptoms before they are twenty-years-old.

Perhaps the most familiar example of OCD symptoms is people repeatedly washing their hands (a compulsion) to avoid getting a disease (an obsession).

That said, though, some people are considered to have OCD despite ‘only’ having obsessions or ‘only’ having compulsions.

Around 70 percent have both obsessions and compulsions, 20 percent just obsessions and 10 percent compulsions alone.

As with most psychological problems, OCD symptoms involves normal fears which are taken to extreme.

It’s perfectly normal to be worried about disease, but extremely inconvenient to wash your hands 300 times a day.

Both obsessions and compulsions are a matter of degree.

Once OCD symptoms are causing problems in everyday life, it needs addressing.

Common OCD signs

Here are some common obsessions:

  1. Need for orderliness and symmetry.
  2. Fear of dirt or contamination by germs.
  3. Excessive doubt.
  4. Fear of sinful or evil thoughts.
  5. Fear of making a mistake.
  6. Fear of harming another person.
  7. Thinking about acting inappropriately or shouting obscenities.

Here are some typical compulsions:

  1. Getting mentally ‘stuck’ on certain images or thoughts that won’t go away.
  2. Repeated hand-washing, showering or bathing.
  3. Repeating particular words or phrases.
  4. Always arranging things in a certain way.
  5. Constant counting during routine tasks, whether mentally or out loud.
  6. Performing tasks a certain number of times.
  7. Always checking things like locks or ovens.
  8. Collecting or hoarding things with no value.

Most people are fully aware that their thoughts and/or behaviours are unreasonable, some are not.

Stress normally makes the symptoms of OCD worse.

Around one-third of people also make repeated sudden movements or sounds.

These are called ‘tics’.

OCD symptoms: mixing up fantasy and reality

Confusing imagination with reality and being out of contact with reality are two further OCD symptoms (Paradisis et al., 2016).

People with OCD are known to dissociate themselves from reality.

Instead they rely heavily on their imagination.

People with OCD tend to experience ‘inferential confusion’: essentially getting fantasy and reality mixed up.

Dr Frederick Aardema, who has researched this OCD symptom, said:

“It seems that people with OCD are so absorbed by their obsession due to inferential confusion that there is a break with reality.

Specifically, we found that individuals no longer rely on their sensory perceptions or common sense but on their imagination.

For example, they are afraid that their hands are contaminated with germs, so they wash them over and over again because they are convinced that their hands are dirty even though they are visibly clean.”

Types of Obsessive Compulsive Disorder

Some of the different types of OCD include:

  • contamination OCD,
  • scrupulosity OCD,
  • checking OCD,
  • symptomatic OCD,
  • perfectionism OCD,
  • sexual intrusive thoughts,
  • and harming intrusive thoughts.

All OCD symptoms driven by fears (for example, of dirt or breaking a moral code) or intrusive thoughts (such as that they might suddenly commit a violent act).

What causes Obsessive Compulsive Disorder?

It’s not known exactly what causes OCD symptoms, but it’s likely a combination of genetic and environmental factors.

In other words: it runs in the family and it’s likely brought on by stress.

How to reduce OCD symptoms

Adaptive coping skills are the best way for people with obsessive compulsive disorder to reduce OCD symptoms, research finds (Moritz et al., 2018).

Typical adaptive coping skills include problem-solving and acceptance.

People who cope adaptively with OCD symptoms tend to seek support from others, eat properly, exercise regularly and anticipate stressful episodes.

Treatments for OCD symptoms

Typically, people are treated with medication and cognitive-behavioural therapy for OCD symptoms.

There’s some question over whether medication really helps much.

Psychological therapies, though, are usually helpful for OCD symptoms (Melin et al., 2020).

Therapy often involves learning to tolerate anxiety without performing the ritualised behaviour.

However, some people need to combine antidepressants with cognitive-behavioural therapy in order to respond to treatment and reduce OCD symptoms.

CBT involves a variety of techniques including cognitive restructuring, relaxation techniques, behavioural experiments and exposure therapy.

CBT works by targeting both a person’s thoughts and their behaviours.

While most people are not cured, the majority can learn to manage the symptoms and live a normal life.

After treatment, most people see a substantial reduction in their symptoms.


Obsessive compulsive disorder (OCD) is often mixed up with having an obsessive personality.

People with obsessive personalities may, for example, like to have their books arranged alphabetically, without having OCD.

The sign that someone really has OCD is that their behaviours are driven by fear or intrusive thoughts that they are trying to get rid of.

OCD is most definitely not something sufferers derive any pleasure or satisfaction from.

Dr Elizabeth McIngvale, an expert on OCD symptoms, explains:

“Obsessive compulsive personality disorder, in my opinion, is often what society thinks OCD is.

People with OCPD might organize their closet perfectly, have all of their items color-coded and organized by type or category, or if you open their fridge all of their labels are lined up perfectly and everything has a place.

However, individuals with OCPD often talk about the fact that there’s not an unwanted, intrusive thought and there’s no fear attached to these behaviors.

They just organize things a certain way or do these kind of compulsive behaviors because it makes them feel better.

However, with OCD, it is something that individuals don’t enjoy – there’s nothing they like about it, they are doing it because they feel like they have to in order to get rid of the intrusive thought or fear.

It is debilitating and draining and not something that makes the individual feel better and more productive when they are done.”


Author: Dr Jeremy Dean

Psychologist, Jeremy Dean, PhD is the founder and author of PsyBlog. He holds a doctorate in psychology from University College London and two other advanced degrees in psychology. He has been writing about scientific research on PsyBlog since 2004.

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