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There are two sets of symptoms that affect people with obsessive-compulsive disorder: obsessions and compulsions.

Obsessions are unwelcome and disturbing thoughts. You may get images or urges that keep coming into your mind. They're difficult to get rid of.

Compulsions are actions that you feel you have to do to stop the obsessive thoughts. You feel you need to do them over and over again. They can be physical actions, like checking that a door is locked. Or they could happen in your mind. Some people repeat a certain phrase in their heads.

Some people with OCD either have obsessions or compulsions. But most have both.¹

Here are some examples of the worrying or obsessive thoughts people have:^{1 2}

• Fear of dirt and germs
• Worrying that something isn't safe, such as a fire or stove
• Thoughts and fears about harming yourself or someone else
• Wanting to have things arranged in a particular way, such as symmetrically
• Thoughts about performing particular sexual acts
• Thoughts that are forbidden by your religious beliefs.

Some common compulsions are:

• Washing and cleaning all the time, sometimes to the point where your hands get red and raw
• Checking things over and over again. For example, some people keep checking that their stove is switched off
• Keeping useless objects (called hoarding)
• Repeating words or numbers in a pattern
• Ordering and arranging things
• Touching or counting things, often in a particular sequence
• Praying.

Most people worry needlessly from time to time and feel they have to do something more than once.¹ It's very common to worry that you've left the stove on, or to check more than once that you've locked the door of your house. But for people with OCD, these obsessions and compulsions happen so often that they can take over their lives. And the effort of trying to control them and to hide them from other people can cause a lot of stress.

Your doctor is likely to diagnose OCD if:³

• You have either obsessions or compulsions. But most people with OCD have both
• You know that these thoughts and actions don't make sense
• The obsessions or compulsions upset you
• They take up more than an hour a day or interfere a lot with your normal life
• Your obsessions or compulsions aren't part of another condition, such as an eating disorder, depression or hypochondria (when you think you're sick but you aren't really)
• Your problems aren't caused by something else. For example, some drugs can cause similar symptoms to OCD.

If your symptoms don't interfere too much with your life, your doctor may say you have mild OCD.¹ They may say you have severe OCD if your symptoms are very distressing and stop you from getting on with your everyday life.

Researchers think OCD often isn't recognized by doctors.⁴ This may be partly because people with obsessions and compulsions are too embarrassed or ashamed to tell their doctors, or just not aware that anything can be done to help them.

On average, people with OCD see three or four doctors before they get the right diagnosis.⁵ And it can sometimes take a long time to be given the correct treatment.^{5 6}

There are some other mental health problems with symptoms that can be similar to OCD. Some of these are:

• Compulsive hair-pulling. This is called trichotillomania
• Body dysmorphic disorder. This is when you're very worried about your appearance
• Tourette's syndrome, sometimes called Tourette's disorder. This causes people to repeat movements, sounds or words. These are known as tics.

Tics and OCD sometimes come together, especially if the OCD or the tics begin in childhood.

Depression and OCD often come together in adults but not so often in children and teenagers. To read more, see our information on Depression in adults and Depression in children.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.