Obsessive thoughts and compulsions

What is it?

Obsessive thoughts are intrusive, unwanted, and distressing ideas or images that repeatedly enter a person’s mind. Compulsions are repetitive behaviors or mental acts that a person feels driven to perform in response to these obsessions, often to reduce anxiety or prevent a feared event. This cycle can become time-consuming and significantly interfere with daily functioning.

Prevalence and statistics

• Obsessive-Compulsive Disorder (OCD) affects approximately 2–3% of the global population.

• Onset often begins in adolescence or early adulthood, though it can start in childhood.

• Up to 25% of people with OCD experience severe symptoms that impact daily life.

• OCD is equally common among men and women, though men tend to show symptoms earlier.

How to identify?

Emotional signs –

• Intense anxiety or distress when obsessions occur

• Feelings of shame or embarrassment about thoughts or rituals

• Fear that something bad will happen if rituals aren’t done

Physical signs –

• Repeated hand washing, checking, or arranging

• Tiredness from performing rituals for extended periods

• Physical discomfort due to repetitive behaviors

Behavioral signs –

• Avoiding situations that trigger obsessions (e.g., public places, dirty surfaces)

• Engaging in repeated rituals (e.g., checking doors, counting, repeating phrases)

• Increased time spent alone to perform compulsions without judgment

Cognitive signs –

• Persistent intrusive thoughts (e.g., fears of harm, contamination, or immoral behavior)

• Overestimation of threats or exaggerated sense of responsibility

• Difficulty dismissing irrational thoughts despite recognizing they’re not logical

Common themes involved in obsessions and compulsions -

• Uncertainty and checking

• Contamination and cleaning/ washing

• Sexual ideas

• Need for symmetry and perfection

• Repeated reassurances

• Assumed health issues

• Excess religious activity leading to unfavourable outcomes

• Repeated mental counting

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