People with OCD have persistent thoughts, ideas, and images that enter their conscious mind and are seen as senseless and intrusive. Some common obsessive thoughts are that a small oversight by the person will result in inconceivable catastrophe for themselves, other people or the world at large. Other common obsessions are contamination, putting things in order, violent impulses, and sexual imagery. Persons with this disorder recognize that these unwanted thoughts (such as fears of hurting their children) are abnormal and would not act on them, but the thoughts are very disturbing and difficult to discuss with others. These thoughts are more than simply excessive worries about real-life problems.
Persons with OCD are often distressed by the shame, lack of control, and time consumed in carrying out compulsive behaviors. Relationships with family and friends suffer and academic and work achievement can also be impaired. The potentially devastating consequences of OCD can even include attempted suicide secondary to distress caused by OCD symptoms.
Obsessions and compulsions are time consuming, cause significant distress, and interfere with daily routine, social, or occupational functioning. However, many of the symptoms of OCD overlap with generalized anxiety disorder and major depression, and OCD may coexist with these disorders. One study reported a 17-year gap on average between the onset of symptoms and appropriate treatment for OCD, due in part to the difficulty in establishing the diagnosis and to the reluctance of OCD sufferers to seek help. People seldom present to a doctor with complaints of intrusive obsessive thoughts because of the shame that accompanies these symptoms. However, at some point during the course of the disorder, the person recognizes that the obsessions or compulsions are excessive or unreasonable and significantly interfere with their functioning at work or school and with their social activities or relationships.
Some people are only bothered by obssessive thoughts that recur while others are compelled to do certain behaviors in response to these thoughts.
Compulsions are urges or impulses to repeat actions which are performed in a stereotyped manner (such as touching, counting, or arranging things). The compulsions may also be unseen acts such as praying, counting or repeating words silently. These actions are done in an attempt to alleviate the anxiety which most frequently results from having obsessive thoughts. Often the person believes this behavior must be done according to rigidly applied rules and will help defend them and others from potential harm. Such behaviors may cause physical signs such as a serious dermatitis in a compulsive hand washer. Other behaviors can be disabling because of the time required to perform them over and over again. As with many anxiety disorders, obsessive-compulsive symptoms worsen at times of stress.