Obsessive-compulsive disorder (OCD)

Symptoms of OCD

On this page:

• What are intrusive thoughts?
• What are obsessions?
• What are compulsions?
• Types and examples of compulsions
• Are there different types of OCD?
• How can I be sure I have OCD?
• What is ‘Pure O’?

What are intrusive thoughts?

An intrusive thought is an unwanted thought that pops into your mind. You could experience the thought as a:

• Feeling or sensation
• Memory
• Urge
• Mental picture

It may be triggered by something else. Or it might come into your mind for no obvious reason.

Intrusive thoughts are very common. It’s estimated that we have thousands of thoughts each day. Because we have so many different thoughts, some of them will be random, meaningless or confusing.

Sometimes intrusive thoughts may feel scary, shameful or offensive. They might go against our values or beliefs. For example, you might get a thought about hurting someone. This could feel shocking and disturbing to you.

We can’t control or get rid of intrusive thoughts. But just because a thought comes into your mind, it doesn’t mean you agree with it or that it’s true.

For those of us with OCD, intrusive thoughts can become obsessions. And the things we do to try to get rid of intrusive thoughts can become compulsions.

You can find out more about coping with intrusive thoughts on our self-care for OCD page.

What are obsessions?

Obsessions are when our intrusive thoughts are very hard to manage. They make us feel very distressed and have a negative impact on our daily life. Our worries and doubts may feel stuck in our mind. We may worry about what they mean or why they won’t go away.

You might feel you can’t share them with others or that there’s something wrong with you that you have to hide. You might feel shocked or distressed that you’re capable of having such thoughts.

Remember: obsessions are not a reflection of your personality. People with OCD are very unlikely to act on their thoughts.

What are compulsions? 

Compulsions are repetitive things that you feel you have to do to reduce the distress or uncertainty caused by obsessions.

You might feel like you have to continue doing the compulsion until your distress or doubt goes away and things feel right again. You might know that it doesn’t make sense to carry out a compulsion. But you still feel unable to resist doing it.

Compulsions might make you feel better at first. But you may find the more you do a compulsion, the stronger the urge is to do it again. This can increase obsessions and distress in the long-term and can lead to an unhelpful cycle of thoughts and behaviours.

Compulsions can feel very time-consuming, tiring and overwhelming. They may stop you being able to go about your daily life or do the things you want to do.

Compulsions can:

• Be things you do physically
• Be things you do in your head, such as rumination. When compulsions are internal and don’t involve physically doing something, some people refer to this to as Pure O
• Involve a number, such as feeling like you have to complete a compulsion a specific number of times without interruption
• Involve someone else, such as asking others for reassurance

Types and examples of compulsions

Anything can become compulsive. If you can do, say, or think it, it can become compulsive. Sometimes the compulsion will be clearly linked to the thing you’re worried about. And sometimes it will be less clear. The types of compulsions you do may change over time.

Some examples of compulsions are listed below. Doing some of these things doesn’t mean you have OCD. And you may have OCD but have different compulsions to those listed here.

Rituals

• Washing your hands, body or things around you a lot
• Touching things in a particular order or at a certain time
• Arranging objects in a particular way
• Saying things again and again

Checking

You might repetitively check:

• Doors and windows to make sure they are locked
• Your body or clothes for contamination
• Your body to see how it responds to intrusive thoughts
• Your memory to make sure an intrusive thought didn’t actually happen
• Your route to make sure you didn’t cause an accident when you travelled somewhere
• Your phone or computer to see if you’ve sent something offensive or embarrassing

Correcting thoughts

• Repeating a word, name or phrase in your head or out loud
• Counting to a certain number
• Trying to replace an intrusive thought with a different image
• Trying to replace a negative feeling with a positive one
• Doing something again and again until it feels ‘right’

Reassurance

• Repeatedly asking other people to tell you that everything is alright
• Saying or doing things to test other people’s reactions
• Repeatedly apologising to people
• Confessing your intrusive thoughts to people and asking what they mean
• Constantly telling yourself that your intrusive thoughts aren’t true

Rumination

• Thinking about the same thing again and again
• Trying to solve or fix your intrusive thoughts by thinking about what they mean
• Doing research on the internet about your obsessions

Avoidance

• Avoiding situations or people that make you anxious. For example, stopping driving to cope with intrusive thoughts about running someone over
• Avoiding access to things. For example, removing anything from your home that could hurt someone
• Delaying or putting things off (procrastination) to avoid feeling anxious or uncomfortable

Are there different types of OCD?

Sometimes OCD is separated into ‘types’. For example, you may hear people talking about ‘contamination OCD’ to mean obsessions and compulsions about dirt or germs.

Some of us find it helpful to label our OCD in this way. It might make it easier to make sense of our OCD or to find others with similar experiences.

Or we might find this type of labelling unhelpful. We may have obsessions and compulsions that don’t fit into a common ‘type’. Or labelling our OCD as a particular type might make it harder to notice new obsessions or compulsions that don’t fit this type.

You may prefer to use the word ‘themes’ to describe the different topics of your obsessions and compulsions. You may have one theme, or lots of different ones. They may change or come and go over time. Some themes may bother you more than others.

Some doctors or therapists may talk about different types of OCD. But different types of OCD are not separate diagnoses.

OCD can attach to anything. If you can think of it, it can become an obsession or an OCD theme.

Some themes are more common than others. But if you have a theme that’s less common, this doesn’t mean that your OCD isn’t real. Or that you deserve support less than anyone else.

These are some examples of OCD themes or types.

Harming someone or violence

• Worrying you’ve already harmed someone by not being careful enough. For example, that you’ve knocked someone over in your car
• Worrying you’re going to harm someone because you’ll lose control. For example, that you’ll push someone in front of a train or stab them
• Violent intrusive thoughts or images of yourself doing something violent or abusive. These thoughts might make you worry that you’re a dangerous person

Relationships

• Worrying about your relationships. For example, having doubts about whether a relationship is right. Or worrying people may dislike you or leave you. This can be about anyone in your life, including your partners, friends, family members or strangers
• Sexual intrusive thoughts or images. These could be related to children, family members or to sexually aggressive behaviour. You might worry that you could be a paedophile or a rapist. Or that you’re sexually attracted to someone in your family

Contamination 

• Contamination, for example by dirt, germs or faeces. You might worry that you’ve been contaminated and that you’re spreading the contamination, or that other people are. Or you might worry that you have a disease, or might get one
• Mental contamination. You might experience feelings of dirtiness, discomfort or feeling incomplete. These feelings may be triggered by a certain person, place or object. They may also be triggered by your own thoughts, images or memories

Your identity

• Worries or doubts about your identity. For example, having obsessions or compulsions about your sexuality or gender identity. Or having constant doubts about your beliefs or values
• Worries about whether you’re a bad person. For example, constantly checking whether you’ve thought something bad, worrying you may say something offensive or constantly thinking about things you regret from the past
• Obsessions relating to your body. This could include constantly worrying about how you look or feel. Or feeling very conscious of physical sensations like blinking or swallowing

The future

• Worries about the future. For example, getting intrusive thoughts about you or a loved one getting ill or hurt. Or something bad happening in the world
• Fear that something bad will happen if everything isn’t ‘right’. For example, if things are not clean, in order or symmetrical

Anxiety and arousal

Intrusive sexual thoughts may lead you to constantly monitor and check your genitals. This attention and the anxiety you’re feeling may actually increase blood flow and physical arousal. This can make you feel as if you are aroused by the intrusive thoughts when in fact the opposite is true. Many people with this type of OCD call this ‘groinal response’.

How can I be sure I have OCD? 

It’s understandable to want to be sure about whether you have OCD or not. Especially if it’s helped you get the support and understanding that you need. Or if it helps you feel less alone or ashamed about your intrusive thoughts.

But for those of us with OCD, our need for certainty can make our symptoms worse. It’s very common for those of us with OCD to worry about whether we really have OCD. This is sometimes called ‘meta OCD’.

You might have intrusive worries or doubts about whether your OCD is real or serious enough. You might worry that you’ve lied to people or wasted people’s time by seeking support. Or you might worry that you’re using OCD to cover up the fact that your intrusive thoughts are true.

You may then use compulsions to try to cope with these worries. This could include ruminating about whether you have OCD, or seeking reassurance from others. Or you might research OCD on the internet, or stop your treatment to test whether your symptoms get worse. This can have a big impact on recovery.

If you’re struggling with this, try to remember that we can never be certain about anything. This includes whether we have OCD or not. And try to resist compulsions if you can.

Our pages on treatment and self-care have information on seeking support and managing symptoms.

What is ‘pure O’?

Pure O stands for ‘purely obsessional’. People sometimes use this phrase to describe a type of OCD where they experience distressing intrusive thoughts. But they don’t have any external signs of compulsions, such as checking or washing physical things. The name is slightly misleading as it suggests that there are no compulsions at all.

With pure O, you still experience compulsions. But rather than things you do physically, they will be things you do in your mind. Because they’re sometimes not as obvious as physical compulsions, they can be harder to spot. Or it can be hard to define exactly what these compulsions are.

These are some examples of mental or internal compulsions:

• Checking how you feel – for example, you might check to see if you are still in love with your partner
• Checking bodily sensations – for example, you might check to see if you were aroused by an intrusive thought
• Checking how you feel about a thought – for example, you might check whether you’re still upset by the thought
• Repeating phrases or numbers in your head
• Checking if you still have a thought – for example, first thing in the morning
• Thinking about a problem over and over
• Reassuring yourself over and over again that you’re a good person or that your thoughts aren’t true

You can read more about pure O on the OCD-UK website.

OCD and stigma

On this page:

• What are stigma and misconceptions?
• Stereotypes about OCD
• Trivialising OCD
• False ideas about OCD being useful
• Feeling guilt or shame about OCD
• Coping with stigma about OCD

What are stigma and misconceptions?

You may experience different types of stigma or misconceptions around OCD. Stigma is a negative opinion or belief about a certain characteristic or experience. This can include stigma about having a mental health problem.

Misconceptions are beliefs or ideas which are inaccurate. They’re often based on inaccurate, misunderstood or misleading information.

Experiencing these can be frustrating and upsetting. Especially if they come from a friend, colleague, family member or healthcare professional. We may also hold negative opinions about our own mental health. This is sometimes called self-stigma.

Stereotypes about OCD

There are lots of unhelpful stereotypes and misconceptions about OCD. For example, some people think it just means you wash your hands a lot or that you like things to be tidy.

When there are so many incorrect stereotypes about OCD, it can be harder for those of us with OCD to recognise the symptoms in ourselves. And it may make it harder to explain our experiences to others.

Trivialising OCD

OCD is often trivialised. Some people might make jokes about it or describe themselves as a ‘little bit OCD’. Or companies might use OCD stigma in their advertisements. For example, using phrases like ‘Obsessive Christmas Disorder’ to sell Christmas products.

False ideas about OCD being useful

Some people have misconceptions about OCD being useful or meaning that you’re very organised. You may hear them saying they wish they had OCD or that you’re lucky to have it.

Feeling guilt or shame about OCD

You may feel guilty about your thoughts and feelings. If you find your intrusive thoughts offensive or shameful, you may feel like you can’t share them with anyone. You may worry about how people will react.

Or you may worry about whether your thoughts are true or what they mean. You may also feel guilty about things you’ve done or said when unwell.

Having these sorts of feelings about your OCD can lead to self-stigma. It could also make it harder to seek support.

Coping with stigma

Stigma about OCD can make it difficult to talk about. But it’s important to remember you’re not alone.

There are things you can do to support yourself, and people who can help. There are also ways to help change other people’s understanding.

Here’s some ideas you could try:

• Show people this information to help them understand more about OCD
• Get more involved in your treatment. These pages on seeking help for a mental health problem give guidance on having your say in your treatment. They also cover making your voice heard, and steps you can take if you’re not happy with your care
• Know your rights. Mind’s pages on legal rights have more information
• Take action with Mind. See Mind’s campaigning page for details of the different ways you can get involved with helping challenge stigma
• Share your story. Sharing your experiences with others can be a powerful way to raise awareness. You could do this through peer support groups or you could share your experiences online
• Be kind to yourself if you feel self-stigma or feel guilty about intrusive thoughts. Our self-care for OCD page has more information

Causes of OCD

There are different theories about why someone develops OCD. No theory can fully explain every person’s experience. But research suggests that it may be to do with personal experiences, and biological factors. This page explains more about these factors.

On this page:

• Personal experiences and OCD
• Biological factors and OCD 

Even though we don’t fully understand what causes OCD, it can still be successfully treated. See our page on OCD treatment for more information.

Personal experiences and OCD

Some theories suggest that OCD is caused by personal experience. For example:

• If you’ve had a painful childhood experience, or suffered trauma, abuse, discrimination or bullying, you might learn to use obsessions and compulsions to cope with anxiety
• If your parents had similar anxieties and showed similar kinds of compulsive behaviour, you may have learned OCD behaviours as a coping technique
• Ongoing anxiety or stress could trigger OCD or make it harder to manage
• Pregnancy or giving birth can sometimes trigger perinatal OCD. Read more about perinatal OCD

Biological factors and OCD

Some theories suggest that OCD may be caused by something physical in our body or brain. These are sometimes called biological factors.

Some biological theories suggest that a lack of the brain chemical serotonin may have a role in OCD. However, it’s unclear whether this is a cause or an effect of the condition.

Studies have also looked at genetic factors and how different parts of the brain might be involved in causing OCD. But they haven’t found anything definite.

You can read more about the causes of OCD on the OCD-UK website.

Is childhood OCD caused by an infection?

Some experts have noted that some children seem to develop OCD symptoms very suddenly after having a streptococcal (or strep) infection. For example, strep throat or scarlet fever.

This is sometimes referred to as PANS (Paediatric Acute-onset Neuropsychiatric Syndrome) or PANDAS (Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus).

More research is needed into why this can happen and the best options for treatment.

You can find more information and support from the charity PANS PANDAS UK.

Self care for OCD

Obsessive-compulsive disorder (OCD) can be difficult to manage. Sometimes, things we might try to feel better can make our OCD worse. But there are ways to manage OCD symptoms and improve your wellbeing. And with the right support, it’s possible to feel better. This page has some ideas you could try.

On this page:

• Managing intrusive thoughts and uncertainty
• Managing compulsions
• Using distraction and visualisation
• Improving your wellbeing
• Connecting with others

Managing OCD can be an ongoing process. You may find that there are times where things feel manageable and other times where it’s much harder. Try to be patient with yourself.

And remember that different things work at different times. If something isn’t working for you or doesn’t feel possible just now, try something else. Or come back to it.

If you try any of the tips on this page and they start to become compulsive, read our information below on ‘What if my self-care becomes compulsive?’

Watch: How to look after yourself when you have OCD

Watch our animation about taking care of yourself when you experience OCD – including how to cope with compulsions and intrusive thoughts. Our thanks to Mind for allowing us to share this animation.

Managing intrusive thoughts and uncertainty

These tips can help to manage intrusive thoughts, and find ways to cope with uncertainty.

Try to accept intrusive thoughts

• It’s understandable to want to get rid of thoughts that you find distressing or worrying. But often, the more we try to get rid of a thought, the more it comes into our mind. It can start to feel like the thought is stuck in our head, no matter what we do
• Try to remember that intrusive thoughts are very common. Some studies have estimated that we have over 6,000 thoughts a day. And most people report that they sometimes have thoughts that bother them. Or that they find confusing, shameful or frightening
• Try to sit with the thoughts that come into your head, rather than trying to get rid of them or make them better
• It may help to name the thoughts. For example, you could think or say to yourself “there’s that intrusive thought again” or “here’s that thought that makes me feel scared”
• Some people find that if they exaggerate or make fun of their intrusive thoughts, it can make the thought less powerful
• Try a grounding object. Keep a small object with you to hold and focus on when you feel bothered by your thoughts. For example, you could use a stone, a fidget toy or a piece of fabric. OCD UK sell ‘just a thought’ wristbands and badges to help remind you not to give meaning to every thought

Try not to attach meaning to every thought and feeling

• Just because we have a thought, it doesn’t mean that we agree with it or that it’s true. Sometimes it’s just a thought
• Try to remember that you don’t need to justify or explain every thought or feeling. Sometimes we just feel a certain way, and that’s ok
• Try to avoid black and white thinking. Remember that many things can be true at one time. For example, if someone you love is upset with you, this doesn’t mean that you’re a bad person or that they’ll stop caring about you

To understand this, try to imagine you had the thought “I’m a bad person”. It can help if you:

• Try not to argue with the thought – “I’m not a bad person because…”
• Try not to replace the thought – “No, I’m a good person”
• Don’t push away or try to stop thinking about the thought
• Try not to reassure yourself “I’m not as bad as some people”
• Avoid doing things to fix the thought, like doing a kind act to prove to yourself that you’re a good person

All the things above might make you feel better in the short term. But they still mean you’re paying attention to the thought.

Let the thought sit there. Try to accept that it’s there and that it feels distressing. You don’t need to agree with the thought. But try to accept that you can never be totally sure whether it’s true or not. And try to remember that your distress won’t last forever.

Accept uncertainty

• Try to remember that almost nothing is certain. And that it’s normal to have doubts
• We can never be totally sure that our worries aren’t true or that something bad won’t happen. This can feel very upsetting and scary. But the more we try to achieve certainty, the more time we spend thinking about our doubts. This often makes us feel more anxious and uncertain
• Accepting doubt doesn’t mean something is or isn’t true or that you don’t care whether it’s true. It just means that you’re accepting that you can’t be fully certain
• Some people find it helpful to reverse the questions they’re worried about. For example, rather than thinking “Am I completely sure that I’m not a bad person?”, you might think, “Am I completely sure that I’m not a good person?”
• Remember that you’re not responsible for everything. If you feel a great sense of responsibility, try to think of all the other parts of a situation that you have no control over
• Focus on what you can and can’t control. It may help to make a list of the things you can change, and the things you can’t. Try to accept the things you have no control over
• Remember that it’s not always possible to ‘follow our gut feelings’ or ‘trust our instincts’. This can be unhelpful for those of us with OCD. The things that make us want to act on compulsions often feel like our ‘gut instinct’

Managing compulsions

Try these tips to help manage your compulsions.

Identify your compulsions

Recognising your compulsions is often a key first step towards managing OCD.

Compulsions are things we do, say or think to try and make ourselves feel better. It can be hard to recognise compulsions, especially if we’ve been doing them for a long time or if they bring us comfort.

Anything can become compulsive. It can be hard to work out when things stop being helpful and start becoming compulsions. For example, some people have told us that they struggled in the pandemic. They said it was hard to separate things they were doing to follow guidelines, from things they were doing because of their OCD.

Some signs that something might be a compulsion include:

• It feels very urgent
• You feel the need to do it, even if it doesn’t make sense
• You feel if you do it one more time, you’ll feel better
• Doing it makes you feel better at first, but then you need to do it again
• You find yourself doing it more and more over time
• You feel panicked or distressed about not being able to do it
• You feel distressed or anxious while doing it
• You feel like you don’t have control over whether you do it or not
• You feel a rush of relief or comfort after doing it
• You feel stuck or trapped in the action, conversation or thought
• You feel like a part of you doesn’t want to do it, or you feel like you’re watching yourself from outside of your body
• You feel ashamed, embarrassed or guilty about doing it, but can’t stop
• You can’t explain clearly why you need to do it, either to yourself or to others
• You find yourself spending more and more time doing it
• You keep thinking it will work, and then feel frustrated and disappointed when it doesn’t
• You find yourself prioritising doing it over other things that are important to you, or it makes you act out of character or against your values

You may not feel all these things. Or there may be things you feel that aren’t listed here.

Resist, delay or reduce compulsions

It may help to try finding ways to resist, delay or reduce your compulsions. These tips explain different ways to do this.

Resist

• Try to sit with distressing feelings or thoughts without doing things to make yourself feel better. It will probably feel very unpleasant at first. This feeling may last a while, but it won’t last forever. Try to focus on accepting the feeling, rather than trying to make it go away
• If you feel the urge to do a compulsion, or if you find yourself starting to, stop. Take a breath and try to resist doing it
• Resisting compulsions is very difficult at first. But with practice, it does get easier
• Try to remember that giving into compulsions will only make your OCD stronger
• Do something to distract yourself. This may help focus your attention away from the urge to do the compulsion
• Practise exposing yourself to things you fear and sitting with the difficult feelings without doing compulsions. It might help to schedule in a time to practise. Or you may prefer to try as things come up. If possible, it’s usually safer and best to do this with the support of a trained professional, especially at first. See our page on treatment for OCD
• Remember, if you’re actively exposing yourself to your fears, it’s really important to also practise not doing the compulsions. If you’re struggling with this or finding it’s making you feel worse, it may be more helpful to stop and seek support from a professional
• Start small. List all the compulsions that you do. Then put them in order of the ones that you find most distressing or hardest to resist. Start by challenging the least difficult ones, and work your way up the list
• Rather than doing a compulsion, try reacting to intrusive thoughts in a way that doesn’t engage with them. For example, you could think or say to yourself, “maybe”, “that could be true, who knows”, or “ok, but I can’t control that”
• Try to practise challenging everyday compulsions. Even if it’s not related to a distressing thought, practising resisting any compulsive urges might be helpful.
• Trust that you can cope. Difficult feelings or doubts can feel unbearable. But try to remember that you can cope and that you don’t need to get rid of them to feel better

Delay

• If it feels impossible to resist, try delaying compulsions. Rather than doing them straight away, try to sit with your feelings for a short amount of time. Next time, try waiting a little longer. It may help to set timers

Reduce

• Another option is to reduce your compulsions. This could mean doing them less, for a shorter amount of time, or in a slightly less satisfying way. Try to reduce them more and more each time
• If you have done a compulsion, you might still be able to challenge yourself by undoing it. For example, if you need to do things an exact number of times to feel safe or complete, you could do it one more time to challenge the compulsion
• Try to avoid replacing a compulsion with a different compulsion. For example, if you compulsively check your phone to make sure you haven’t sent something accidently, try not to replace this by avoiding using your phone. This is another form of compulsion. It will have the same effect of giving you temporary reassurance, which is unlikely to be helpful in the long term
• Make notes for yourself. Remind yourself of what has worked and not worked in the past. This could be in a journal or on your phone

Using distraction and visualisation

These tips could help find ways to distract yourself from your compulsions.

Distract yourself 

When trying to resist compulsions, it may help to focus your attention on something else.

• There are many ways you can distract yourself. It could be doing something creative, watching a film or TV show, doing something practical or going for a walk. Different things will work at different times, so think about what might work best for you
• Try not to wait until you feel ‘ready’ to distract yourself. When we’re feeling distressed, the idea of distracting ourselves may feel impossible. Try making a start, even if you doubt it’ll help
• Take things slowly and try not to worry if you don’t feel better at first
• When distracting yourself, try to bring your attention to the moment. If your attention goes back to your worries, try to gently re-focus on the present
• Try to focus on what you can see, hear, smell, taste or feel. It may help to name these things. For example, if you’re watching TV, try focusing on what people are doing or saying, rather than worrying whether you’re enjoying the show
• When doing an activity, it can help to say what you’re doing out loud or in your mind. This can help focus your attention

Simon’s story: Living with OCD

Watch Simon share his experience of OCD, and how it affected his daily life. And learn how he’s found coping mechanisms in his passion for photography and trains. Our thanks to Mind for allowing us to share this film.

Try visualisation

Visualisation is a way of imagining different scenes and environments. Some visualisation techniques may be useful for managing OCD.

You could imagine the following:

• Your OCD is a separate person to you. Some people give their OCD a name. This may help you to separate yourself from your symptoms
• Your OCD is an animal, monster, bully or object
• You’ve put your OCD in a box or in the corner of the room. This may act as a reminder that you don’t need to pay attention to it
• Yourself without OCD. Try to think about how you might react to intrusive thoughts
• Your intrusive thoughts are leaves in the wind. Or they’re spam emails that you can notice but not pay much attention to

Improving your wellbeing

If you’re struggling with your mental wellbeing, there are lots of things you can do to take care of yourself.

Look after yourself

• Think about what might make your OCD worse. This could include stress, lack of sleep, big changes, times of uncertainty, anxiety, hormones, or difficult events in the news. Positive things, such as big events or feeling happy may also trigger intrusive thoughts about something going wrong. Knowing what might make your OCD worse could help you to prepare for difficult times
• Try a relaxation technique. Relaxation can help you look after your wellbeing when you’re feeling stressed, anxious or busy
• Try mindfulness. Mindfulness can help to reduce stress and anxiety. It isn’t right for everyone. But for some people, it can be helpful as part of managing OCD. Learn more about mindfulness
• Try to improve your sleep. Sleep can give you the energy to cope with difficult feelings and experiences. Read our tips to improve your sleep
• Think about your diet. What we eat can affect how we feel, including our mood and energy levels. Read more about food and mental health
• Try to do some physical activity. Any kind of physical activity can help our mental health. It’s important to find something that works for you. Visit these pages about physical activity and mental health to find out more, including activities you could try
• Spend time in nature. This can improve our wellbeing. See this information about nature and mental health to learn more, including different ideas for being in nature

Be kind to yourself

• Celebrate your wins, no matter how small. It may help to keep a journal where you record things that you’re proud of or grateful for
• Be patient with yourself. It might feel impossible at first, but the more you practise, the more you may find you can manage your OCD
• Accept that setbacks happen. Take things one step at a time. You may have times where you can manage your symptoms better than at other times. Having more difficult times doesn’t mean you’ve failed or gone backwards. Ups and downs are a normal part of managing OCD
• Treat yourself with compassion. Managing OCD can be really difficult. Sometimes this might mean that you have less energy or time for other things in your life. It’s ok to prioritise your mental health and do things at your own pace
• Forgive yourself. OCD can sometimes lead to us doing or saying things that we regret. Or things that go against our values. Try to remember that we all make mistakes, especially when we’re struggling with our mental health. It’s ok to forgive yourself and move forward
• Write a compassionate letter to yourself. You could acknowledge how distressing your thoughts and feelings are. But also remind yourself that you can get through this and manage your OCD
• Focus on your values. Sometimes it can feel like OCD defines us as a person. But this isn’t true. Try to focus on the things that matter to you. This could be your values, interests, opinions or passions. It’s ok if we have doubts about our values, remember that nothing is ever completely certain or perfect

Take care online

• Be mindful around compulsive behaviour online. This could include spending lots of time searching for information online. Or constantly checking your phone. Or it might involve arguing with people or asking people for reassurance on social media
• Comments we read online can trigger our doubts and fears. Try to remember that things are often more complicated than they seem online
• Take regular breaks from the internet if you can
• If there’s content that you find distressing, or that you use in a compulsive way, try to stop or reduce the time you spend on it
• Try to be purposeful about your time online. Ask yourself, are you checking your phone or doing an internet search because you need to? Or is it to reassure yourself or avoid a difficult feeling?
• See Mind’s pages on looking after your mental health online for more information

Connecting with others

You might worry that people won’t understand OCD. And it can feel scary to put some of your experiences into words. But talking about your OCD may help you feel less lonely and more able to cope.

Connect with those around you

• Talk to someone you trust about your OCD. Find a quiet space to talk where you won’t be interrupted. You could show them this information to help them understand. Some people find it helpful to write their feelings down and then talk about this together
• Tell people what you need from them. People may want to help but not know how. Try to be as open as you can about what you need. This might include helping you to resist compulsions, helping to distract you, or giving you some time to yourself. It may help to talk about this at a time when you’re feeling well, so that you’re prepared for more difficult times
• Try to avoid asking for reassurance again and again. Asking for reassurance from others is a very common compulsion. It can be very difficult to resist in the moment, especially if you feel distressed. Instead of asking them for reassurance, try sharing that you’re struggling with your OCD right now. Ask them to help distract you. If you can’t resist asking them for reassurance, you could start by saying “This could be OCD, but…”. This lets them know that it might be OCD
• Develop code words or signs with people close to you. For example, you could have a name for your OCD that you both use. It may be easier to use this word in the moment, rather than trying to explain how you’re feeling
• Spend time with others. You might not feel ready to talk openly about your OCD yet. But spending more time with friends and family may help you feel more comfortable around them. And in time, more able to share your experiences

Try peer support

Making connections with people with similar or shared experiences can be helpful. You could try talking to other people who have OCD to share your feelings, experiences and ideas for looking after yourself. For example, you could:

• Try an online peer support community, such as Mind’s Side by Side, OCD-UK’s online forums or OCD Action’s online forums
• Find support through social media
• Find a local support group through an organisation such as OCD Action, OCD-UK and Top UK

If you’re seeking peer support online, it’s important to look after your wellbeing. See here for more information about looking after your mental health online.

Try self-help resources

Self-help resources for OCD are designed to help you develop coping strategies. They’re often based on cognitive behavioural therapy (CBT). Make sure any resources you use are from a trusted organisation.

• You could try OCD-UK’s self-help resources
• You can ask your GP to recommend a self-help book from a Reading Well scheme. This scheme is supported by most local libraries. So you can go and check the books out for free – you don’t need a prescription from a doctor

What if my self-care becomes compulsive?

Anything can become compulsive. This could include any of the self-care tips listed on this page.

For example, you may start to use peer support in a compulsive way to reassure yourself that you definitely have OCD. Or you may become compulsive about things like exercise or sleep. This can feel very frustrating and confusing.

If you’re worried this may be happening, try to use the techniques above to resist the compulsions. Or try to set boundaries with yourself. For example, you may limit the time you spend on a self-care activity. Or it may help to try something different for a while.

If you’re struggling, it may be better to seek support from your GP or a therapist if you can.

Treatment for OCD

On this page:

• Talking therapy
• Medication
• Accessing treatment
• What if I’m worried about talking to my doctor?
• Specialist OCD services
• Social care support

Talking therapy for OCD

You may be offered talking therapy for OCD. This might be on its own, or along with medication.

Cognitive behavioural therapy (CBT) with Exposure and response prevention (ERP)

CBT with ERP is the most recommended talking treatment for OCD. It combines two types of therapy:

• Cognitive behavioural therapy (CBT) focuses on how your thoughts, beliefs and attitudes affect your feelings and behaviour. See our page on CBT to learn more
• Exposure and response prevention (ERP) is designed to treat OCD. It encourages you to confront and accept your obsessions, and resist the urge to carry out compulsions

You may be offered CBT with ERP in person or over the phone. And it could be one-to-one or in a group. It depends on your needs and the services in your area.

During ERP, your therapist may encourage you to do, say or think things about your obsessions or fears. Then they will help you to try to tolerate the distress or uncertainty, instead of doing a compulsion.

Your therapist should help you do this at your own pace and support you along the way. They will usually start with smaller challenges and help you build your confidence in resisting compulsions.

ERP aims to help you see that the uncomfortable feelings will eventually go away, even if you don’t perform a compulsion.

This type of therapy can be challenging. At first, it might make you feel more distressed. It may help to talk to a healthcare professional about any concerns before you start ERP. They can answer any questions you have about what it involves.

Seeking therapy privately 

Waiting times for therapy on the NHS can be long. And the services we need are not always available. Because of this, you may consider going private. Unfortunately, this can be expensive so may not be possible.

Some private therapists offer a sliding scale of payment, depending on your circumstances. So it may be worth checking their website or contacting them to see if this is something they can do.

It’s important to find the right support for your needs. Certain types of therapy that focus on your past experiences or on finding meaning in your thoughts are not recommended for OCD. They can make symptoms worse.

It may help to talk to any potential therapist and ask how much experience they have with treating OCD. Or it might help to search for people who include ERP within their therapy.

Visit Mind’s page on seeking private therapy to find out more.

Medication for OCD

You may be offered the following medications for OCD, either on their own or alongside talking therapy:

• Selective serotonin reuptake inhibitors (SSRIs) – this is a type of antidepressant. Research has shown that it can also help to treat OCD
• Clomipramine – this is a tricyclic antidepressant. You may be offered this if you try an SSRI but it doesn’t help

Different people find different medications helpful. You can talk to your doctor about your options. You might find you need to try out a few different types of medication before you find one that works for you.

Medication helps some people. But isn’t right for others. Before deciding to take any medication, it’s important to have all the facts you need to make an informed choice.

This includes information about any potential benefits and side effects of the drug. If you don’t understand any aspect of a medication you’re offered, don’t be afraid to ask as many questions as you feel you need to.

For more information, see Mind’s pages on things to consider before taking medication and your right to refuse medication. For guidance on how to come off medication safely, see these pages on coming off medication.

How can I access treatment for OCD?

The first step to getting treatment for OCD is usually to visit your GP. Your GP should ask about your symptoms and discuss different treatment options.

If you live in England, you may also be able to refer yourself to an NHS talking therapies service directly. You can find your nearest NHS talking therapies service on the NHS website.

This service offers treatment for depression, anxiety, and some other mental health problems – including OCD. Waiting times for this can vary, and can sometimes be long.

The treatments you’re offered will depend on how much OCD is affecting your life, and how much distress it’s causing you. It may also depend on any treatments you’ve tried in the past, and whether these worked.

The National Institute for Health and Care Excellence (NICE) – the organisation that produces guidelines on best practice in healthcare – suggests that treatment for OCD should include talking treatments or medication, or both. The NICE website has full guidelines and recommendations for treating OCD.

If you feel a treatment isn’t working for you, it’s a good idea to discuss this with your GP. There may be others available.

What if I’m worried about talking to my doctor?

You might feel scared about telling anyone, even a doctor, about your intrusive thoughts. You may worry you’ll be judged about graphic or offensive thoughts. Or that the doctor might report you to the police or social services. Or you may find it hard to share how much time your compulsions take up.

This might make it feel difficult to get the right help. But it’s important to be as open as possible, so you can access the best treatments for you.

Before your appointment, it may help to note down the ways your OCD is affecting your life, how much your symptoms distress you and how much time they take up. This may help you to remember what you need to say in the moment. You could also ask someone you trust to go with you.

Mind has more information about talking to a GP about your mental health. OCD Action also has a page on preparing for a GP appointment about OCD. And OCD-UK has a GP Ice Breaker that you can print, complete and take with you.

Specialist OCD services

If your OCD is very severe and medication or talking therapy haven’t helped, you may be referred to a specialist OCD service. Unfortunately, not all areas have specialist services and you might have to travel outside your local area.

OCD-UK has more information about NHS specialist OCD treatment services.

Social care support

Depending on how your OCD impacts your life, you may be eligible for social care. Social care services support people who struggle to manage day-to-day activities. You can read more about social care in Mind’s guide to health and social care rights.

Helping someone with OCD

Supporting someone with obsessive-compulsive disorder (OCD) can be overwhelming and confusing at times. You might struggle to understand their experiences. But your support and understanding can make a big difference. It can take practice and patience to work out how best to help. This page has ideas that you could try.

On this page:

• Learn more about OCD
• Recognise and understand compulsions
• Help them to manage compulsions
• Work together
• Help them to get treatment
• Be kind and patient with them
• Be kind and patient with yourself

There’s also information about what to do if their obsessions or compulsions are about you.

Watch: How to help someone with OCD

Watch Mind’s animation to find ideas for supporting someone with OCD – including helping them manage their compulsions and obsessions, and recognising how they’re feeling. Our thanks to Mind for allowing us to share this animation.

Learn more about OCD

• Find out as much as you can about OCD. This can help you understand what your friend or family member is going through. You can read more on our What is OCD? and OCD symptoms pages. Or get information from other charities, like OCD-UK and OCD Action
• Look at blogs, videos or posts from people with OCD. For example, you can search for stories about OCD on Mind’s Your Stories pages
• Remember that everyone’s experiences are different. One person’s experience of OCD may be very different to what the person you know is going through
• Try to talk to the person about their OCD. No information will be able to fully explain what they’re going through in the same way
• Try to keep an open mind. OCD can be complicated and confusing. Your friend or family member may tell you things that worry or don’t make sense to you. Try to remember that they may have kept their experiences secret for a long time. They may be worried about your reactions. Try to listen without judgement and let them know that you’ll be there to support them
• Challenge stigma if you can. There’s still lots of stigma about OCD. If you hear or see someone talking about OCD in a way that stigmatises, stereotypes or trivialises OCD, try to challenge this. This could be through explaining your experiences or sharing information on OCD stigma. It’s not always easy or safe to challenge people, so if don’t feel able to do this, that’s ok too

Recognise and understand compulsions

OCD has two main parts: obsessions and compulsions. Compulsions can make people feel better at first. But in the long-run, compulsions make OCD symptoms worse.

One of the hardest things about supporting someone with OCD is working out how to help them resist compulsions.

You might even help their compulsions without knowing it. For example, if you check things for them, give them repeated reassurance or help them avoid things they find distressing. This is sometimes called accommodation.

It’s natural to want to help someone, especially if they’re distressed. You may feel guilty about not helping them. Or you might not know how else to support them.

But the more you help someone with their OCD compulsions, the more they might feel like they need help. This can make their obsessions and compulsions stronger over time.

Instead, it can help to try recognising their compulsions. They may have one main compulsion, or lots of different ones. These might change over time. Some signs they may be struggling with a compulsion include if they:

• Get distressed or agitated if they can’t do something
• Need to do something again, but the more they do something, the more they seem to need to do it again
• Spend more and more time doing something
• Have the same conversations with you, over and over again
• Can’t seem to let go or move on from difficult situations or feelings
• Need to do things which don’t make sense to you
• Act out of character or against their values
• Keep asking you for reassurance, apologising or asking if you’re sure about something
• Ask you to check something again and again
• Seem more distracted or distant than normal at times
• Avoid certain things
• Struggle to manage daily responsibilities at times 

Help them to manage compulsions

Managing compulsions can be a very complicated and difficult thing to do. But it’s an important part of managing OCD. There are some things you can do to try to help:

• Agree on an approach that feels right for you both. For example, you might decide that you will say “we’ve agreed I won’t answer questions like that to help you manage your OCD”
• Encourage them to challenge compulsions where appropriate. For example, you could try to remind them that compulsions are unhelpful in the long term
• Resist giving reassurance. Seeking reassurance is a very common symptom of OCD that often involves those around them. For example, they may ask you whether they did something wrong. Or they may ask you to confirm that their memory of an event is true. Try to gently explain that you don’t want to make their OCD worse by reassuring them
• Try not to use logic to reassure them. For example, if they’re worried that they’ve hurt someone, you might try to help by explaining all the reasons this is unlikely to be true. This might reassure them in the short term, but may make them feel the need to seek this reassurance again
• Be gentle but consistent. In the moment, they may feel hurt or rejected if you don’t help with their compulsions. Try to give gentle, simple explanations without getting into discussions about their obsessions. For example, you could say, “I love you but we agreed that I wouldn’t help with this” or “I know this is hard, but I think this could be your OCD talking right now”
• Use code words or signs if it helps. For example, you could plan a word or symbol between you to symbolise OCD. This may be useful to use in the moment when someone is distressed and struggling to explain their feelings
• Try to validate their feelings, rather than help with compulsions. For example, you could say, “I understand that you’re feeling really upset right now”
• Encourage them. Remind them of times when they’ve managed to resist compulsions in the past
• Try to stay calm and patient. It’s understandable to feel confused, upset or frustrated if we’re seeing someone we care about in distress. But remember that by not engaging with compulsions, you’re trying to help support them
• Remember that resisting compulsions takes practice for you and them. Take things one step at a time
• Help to distract them. Suggest things you can do together to take their focus away from their OCD. This could be things like watching a film or going for a walk. They may find it hard to believe a distraction will work in the moment. It may help to start an activity yourself and let them join in gradually
• Offer a hug or other emotional support instead of helping with a compulsion
• Compromise with the compulsions you help with at first. For example, if you help them with a number of compulsions, you may need to slowly reduce the number you do
• Help delay the compulsion. For example, rather than offer reassurance straight away, you could ask them to wait a set amount of time before you talk. Try to increase the delay a little bit each time
• Help them to reduce compulsions. For example, you could suggest ways they could spend less time on their compulsion, and encourage them to reduce them more and more each time
• Try not to judge yourself if you sometimes help with compulsions. It’s likely that this will happen at times. You may need to do so in a crisis situation or it may happen without you realising. Try to think about how you could manage that situation differently in the future

Work together

• When they’re feeling well, talk and plan for times when they might struggle in the future. It might help to write your agreed plans down. For example, you may want to go through the above tips about resisting compulsions together and decide which ones might work best
• Use visualisation. It may help to think of the OCD as something or someone separate. You could suggest they give their OCD a name that you both use. This might help you to explain that it’s the OCD you don’t want to help, not them
• Share your own intrusive thoughts. People with OCD can feel very ashamed and alone about the thoughts they experience. It may help if you share some of your own intrusive thoughts if you feel comfortable doing so. This might help them realise that having them is common. Learn more about intrusive thoughts
• Try to avoid minimising their feelings or saying things like, “just don’t worry about it”. Instead, try to acknowledge that they’re struggling right now
• Think about whether you’ve taken on too much responsibility. If you feel like you’re doing too much for them, try to take a step back and encourage them to do certain things themselves. You may need to do this in small steps
• Try to sit with their distress. It’s understandable that you want to help someone feel better when they’re upset. Especially if they’re directly asking you for help. But accepting difficult thoughts and feelings is a big part of managing OCD. Rather than trying to fix their problem or make their distress go away, try to help them accept it and sit with it
• Try to work together and be consistent if you’re part of a group supporting someone, for example, a family or group of friends
• Always include the person you’re trying to support when you’re making decisions about how best to support them

Help them to get treatment

People can find it difficult to talk to their GP about their OCD and seek treatment. Here are some ways you could support them:

• Remind them that the appointment will be confidential and that the GP is there to help them get treatment
• Help them practise what they’re going to say to their GP. Or help them write notes to take with them to their appointment
• Offer to go with them to speak to their GP. You can read more about supporting someone to seek help
• Ask them what you can do to make things easier. Learning to manage OCD can be challenging. For example, they may feel agitated, tired, anxious or depressed before or after attending therapy sessions
• Seek advice on how to help. If they’re getting treatment, you could both talk to their GP or therapist about the best ways you can help them manage their symptoms
• Offer hope. They may feel that things will never get better, especially if they’re finding treatment hard. Or if they experience setbacks. Remind them that many people with OCD do benefit from treatment. They may find it helps to read about people who are successfully managing their OCD, or have recovered from OCD, in Your Stories

Be kind and patient with them

• Try not to judge. Remember that their fears are very real to them, even if they seem unrealistic, irrational or extreme to you
• Celebrate wins with them, no matter how small. If you’ve noticed that they’ve coped with a situation well, tell them. Or you could celebrate ways that you’ve coped well together
• Focus on the whole person. OCD can have a big impact on self-esteem and take over people’s lives. Try to recognise and celebrate other things about them or your relationship
• Remember that they’re trying. Coping with OCD is not straightforward. Someone may be managing their symptoms well for some time and then have a setback. This can feel distressing and frustrating to watch. But try to remember that they’re not choosing to struggle. And that they may be feeling very confused and distressed too. Try to remind them that setbacks are a normal part of managing OCD and encourage them that they can cope
• Encourage them to be compassionate with themselves. OCD can come with a lot of guilt and shame. Encourage them to treat themselves with kindness

Be kind and patient with yourself 

• Take time to look after yourself too. Supporting someone with OCD can be frustrating and upsetting at times
• Find out more about looking after yourself in these pages on how to cope when supporting someone else and improving your wellbeing. You can also visit the Carers UK website
• Share experiences, ask questions and get support from other people in the same situation. The OCD Action forum and OCD-UK forum have sections for family, friends and carers. You might find these helpful
• Think about what you can and can’t control. It may help to write things down. As much as you may want to help, you cannot be completely responsible for someone else’s mental health. All you can do is try your best to support them
• Ask for support. If you’re struggling, reach out to others and ask for help. This could be through people close to you, or through your GP or a therapist
• Take things one step at a time. You’re not always going to do or say the right thing and that’s ok. If you don’t manage a situation as well as you could have, try to forgive yourself and move forward
• Try not to be hard on yourself. Supporting someone with OCD can come with a lot of guilt. If you resist helping someone with compulsions, you may feel guilty about their distress. And if you do help with compulsions, you might feel guilty for not resisting. Try your best and remember that OCD management takes practice and patience, both for the person experiencing it and for those supporting them

What if their obsessions or compulsions are about me?

Anything can become obsessive or compulsive. And OCD can often attach to things that are most important to people. This includes the people they love.

Obsessions and compulsions about relationships are very common. This is sometimes called ‘relationship OCD’. This can impact any relationship, including partners, friends and family members.

You may sometimes find that their OCD starts to become about you, or your relationship with them. For example, they may develop obsessive worries that you no longer care about them. They may compulsively ask you to reassure them that you do. Or they may worry that they no longer care about you and may compulsively confess this to you.

This can be very challenging. It may be harder to help them manage or resist these compulsions. It can be difficult to work out whether something is a real issue with your relationship or a symptom of their OCD. And it can also be hard to not take things personally if their worries or doubts are about you.

Try to resist engaging in any compulsions, even if they’re about you. If you think someone’s distress could be due to OCD, try to delay any important conversations or arguments until they feel calmer. And take time out of the situation if you need to. Remember that your feelings and needs are important too.

Useful contacts

Beat

0808 801 0677 (England)
beateatingdisorders.org.uk
Offers information and advice on eating disorders, and runs a supportive online community. Also provides a directory of support services at HelpFinder.

Carers UK

0808 808 7777
advice@carersuk.org
carersuk.org
Advice and support for anyone who provides care.

Hoarding UK

info@hoardinguk.org
hoardinguk.org
Support for people affected by hoarding, including support groups.

Hub of Hope

hubofhope.co.uk
UK-wide mental health service database. Lets you search for local, national, peer, community, charity, private and NHS mental health support. You can filter results to find specific kinds of support.

Mind

Mind’s helplines provide information and support by phone and email.

Local Minds offer face-to-face services across England and Wales. These services include talking therapies, peer support and advocacy.

Side by Side is Mind’s supportive online community for anyone experiencing a mental health problem.

NHS Services Finder

nhs.uk/service-search (England)
Searchable database of NHS services.

NHS talking therapies self-referral

nhs.uk/service-search/mental-health/find-an-nhs-talking-therapies-service
Information about local NHS therapy services for certain mental health problems. You can self-refer (England only) but you must be registered with a GP.

OCD Action

0300 636 5478
ocdaction.org.uk
Information and support for people affected by OCD and hoarding, including online forums and local support groups.

OCD-UK 

01332 588 112
ocduk.org
Charity run by and for people with OCD.

Triumph Over Phobia (TOP UK)

topuk.org
Self-help therapy groups and support for those with OCD, phobias and related anxiety disorders.