Obsessive-compulsive disorder (OCD)

Everyone has been heavily preoccupied by a particular thought at one point or another. Usually, the thought goes away and life goes on. It can also happen to anyone to instinctively repeat certain gestures, such as checking that the door is indeed locked after removing the key from the lock. These are normal things.

However, such situations appear amplified in importance to people with obsessive-compulsive disorder (OCD). Someone with OCD feels invaded by uncontrolled and repetitive thoughts crossing their mind despite their desire or will. They are unable to stop having these thoughts even with the knowledge that they are senseless. These thoughts become obsessions. For instance, the person may be afraid that they have forgotten to switch the stove off while knowing that it was indeed shut. They may also be fearful of catching a disease by touching everyday objects, such as a door handle for example.

Thereafter, the person may also have compulsions. They may feel compelled to repeat certain actions to drive the obsession out of their mind or to reduce their anxiety. For instance, they could wash their hands repeatedly, sometimes to the point of harming themselves, in order to avoid contamination or catching a disease. They can also repeat formulas, count objects, or ask others to do so, in order to reduce the risk of a negative experience.

The person may experience a lot of psychological distress due to their obsessions and compulsions, which cause them to waste a lot of time every day, complicating their routine and daily activities. They have a hard time taking care of professional, social and family responsibilities.

People in such situations recognise their thoughts and behaviours are irrational, exaggerated or bizarre, but they cannot control themselves.

In most cases, obsessive-compulsive disorder develops gradually.

Someone with obsessive-compulsive disorder may simply have obsessions, compulsions only, or a combination of both.

Obsessions and compulsions become more frequent or more intense over time.

Examples of obsessions

Common obsessions include intense fear of the following:

• Contaminating oneself through contact with an object or a substance
• Losing self-control or getting angry
• Forgetting something important, for example to turn off the stove or to lock the front door
• Forgetting or losing an item, a credit card for example

Having sexual thoughts that completely consume the mind is also a known obsession.

Examples of compulsions

Some of the most common compulsions include:

• Washing one’s hands repeatedly, sometimes to the point of harming oneself
• Taking several showers daily
• Cleaning the house nonstop
• Ensuring repeatedly that electrical appliances have been turned off
• Verifying several times that doors are locked before stepping out or going to bed
• Spending a significant amount of time perfecting the organisation and storage of cabinet contents
• Compelling oneself to take the same route to work every day and to cross the street at exactly the same spot

A person may spend several hours a day on their compulsions.

Do not wait until you are unable to perform your usual activities in order to consult. If you have symptoms of obsessive-compulsive disorder, you can contact organisms and associations working with anxiety disorders. You can receive information, help and support from them.  

However, consult your family doctor or another health professional if you experience one of the following situations:

• Repetitive thoughts consume your mind, causing you distress and anxiety
• You feel obligated to repeat gestures and actions without being able to control yourself
• You have difficulty to accomplish your activities and fulfilling social, professional and family responsibilities

A health professional can assess whether or not you have an obsessive-compulsive disorder or another health problem with similar symptoms. To be properly assessed, it could be necessary to conduct a physical exam or laboratory tests. You will be proposed a treatment plan that is adapted to your needs.

If you have suicidal thoughts and fear for your safety, or that of people around you, see the page Recognizing signs of distress and preventing suicide. You will find further information on available help and resources.

Obsessive-compulsive disorder is an illness that can be treated. There are known treatments available to treat this disorder. Treatments allow people affected to regain control of their lives and daily activities. The earlier an affected person consults with a doctor, the better their chances of recovery.

In most cases, obsessive-compulsive disorder is treated effectively through psychotherapy, medication, or a combination of both treatments.

Psychotherapy sessions

Experts generally recommend cognitive behavioural therapy to treat obsessive-compulsive disorder. This form of psychotherapy aims to change the individual’s thoughts and problematic behaviour, and replaces them with thoughts and responses appropriate to reality. When necessary, it makes it possible to discuss past events to help understand the origin of current problems and to find solutions for them.

Anti-anxiety medication

Different medicines can be used to treat obsessive-compulsive disorder, including antidepressants and anxiolytics. Read the page with information about anxiety disorders to learn more about recommendations for taking medication.

The condition of someone with obsessive-compulsive disorder can worsen if it is not taken seriously.

Among other things, people with obsessive-compulsive disorder often end up feeling inadequate. They know their behaviour is irrational and that it affects their lives.

Certain symptoms associated with obsessive-compulsive disorder can also lead to depression if they are not treated quickly enough. These include fatigue, sleeping difficulties and headaches in particular. Depression frequently accompanies obsessive-compulsive disorder.

People with obsessive-compulsive disorder can also develop a problem with alcohol dependency. They often try to control their anxiety by drinking alcohol and doing drugs.

Conflicts can also arise with close relations, who do not always understand the behaviour of the person affected. These conflicts impact the daily life of the individual and their family, in addition to promoting the isolation of the person affected.

If you have symptoms of obsessive-compulsive disorder, you can act now. Advice on maintaining good mental health will help you change certain lifestyle habits. These changes will help you eliminate factors that worsen or maintain your obsessive-compulsive disorder.

Obsessive-compulsive disorder does not have a clearly identified cause. It is a combination of many factors that result in the onset of symptoms of this disorder. These factors can be biological, hereditary, individual or environmental. Read the information page on mental disorders to learn more about the risk factors of mental disorders.

Obsessive-compulsive disorder affects women as much as it does men.

It usually appears in early adulthood, but it can also occur in children.

Most people with obsessive-compulsive disorder are also affected by other mental disorders, depression and social phobia in particular.

Information and support resources

Following resource are available for getting help or further information on obsessive-compulsive disorder:

• Relief – Quebec Anxiety, Depressive and Bipolar Disorder Support Association 
• Phobies-Zéro 
  Helpline: 1 866 922-0002) (in French only)
• Association des médecins psychiatres du Québec  (in French only)

Care and services resources

To receive care or services, or to find a psychotherapist with whom you feel comfortable, contact one of the following resources:

• Your family doctor
• Your integrated health and social services centre (CISSS) or your integrated university health and social services centre (CIUSSS)
• The Ordre des psychologues du Québec