OCD: Symptoms, Causes, Diagnosis, and Treatment

Katie Rapkoch, CHPC

Published on

July 3, 2024

Updated on

January 17, 2024

Medically reviewed by

Ben Ahrens, HHP

Everyone experiences fear, anxiety, and obsessive thoughts every so often—perhaps before an interview or when going through a breakup. The fear and anxiety are present for a certain amount of time and then fade away when the perceived threat is reduced or eliminated. In people with obsessive-compulsive disorder (OCD), however, fear, anxiety, and obsessive thoughts are frequent, persistent, and debilitating and can severely disrupt their everyday lives. OCD is a mental illness that affects approximately 2 percent[1] of the general population. This disorder is characterized by repeated, anxiety-provoking thoughts, urges, or mental images, referred to as obsessions. In response to these obsessions, OCD sufferers engage in repeated behaviors, called compulsions, in an effort to relieve or neutralize their anxiety. People with OCD often recognize the irrationality of their thoughts and behaviors, yet still feel an irresistible drive to perform their compulsions. The most well-known example of OCD is frequently washing one’s hands due to fear of contamination, although OCD presents in numerous ways. Neurologically speaking, OCD is brain circuitry gone awry. The obsessive, unrelenting thoughts and compulsions occur due to dysfunction in the brain’s limbic system and structures related to the limbic system. The good news is that this faulty circuitry can be rewired thanks to neuroplasticity—the brain’s ability to reorganize itself by forming new neural pathways. In this article, we’ll be covering everything you need to know about OCD, including how re-origin, a neuroplasticity-based treatment program, can help you eliminate the dysfunctional brain patterns and re-establish normalcy and balance. OCD is also commonly referred to as:

  • Compulsive behavior
  • Obsessive-compulsive behavior
  • Obsessive-compulsive syndrome
  • Obsessive compulsion
  • Obsessive thoughts
  • Intrusive thoughts

Symptoms of OCD

As described above, OCD involves obsessions and compulsions. Obsessions, which manifest in the form of thoughts, images, or impulses, occur over and over again and feel outside of the person’s control. They are typically accompanied by intense and uncomfortable feelings such as fear, disgust, doubt, or a feeling that something just isn’t “right.” Everyone has obsessive thoughts every once and a while, but the difference is that in people with OCD, intrusive thoughts, images, or urges are extremely persistent and trigger extreme anxiety that gets in the way of day-to-day functioning. Like a needle getting stuck on a record, OCD causes the brain to get stuck on a particular thought, image, or urge, unable to switch gears. Common obsessions in OCD include[2]:

  • Contamination: Fear of being contaminated with germs, disease, bodily fluids, environmental contaminants, or household chemicals.
  • Unwanted sexual thoughts or images: Forbidden or perverse sexual thoughts, images, and urges about oneself or others, questioning one’s sexual orientation, sexual obsessions that involve children, incest, or aggressive sexual behavior.
  • Losing control: Fear of acting on an impulse to harm oneself or others, fear of blurting out obscenities or insults, fear of violent images in one’s mind.
  • Harm: Fear of a loved one getting hurt or dying, fear of harming others because of not being careful enough, fear of being responsible for something terrible happening.
  • Perfectionism: Obsession with cleanliness, order, or exactness.
  • Health: Concern with getting a physical illness or disease or feeling like you have an illness that doctors haven’t been able to find/diagnose.
  • Magical thinking: Superstitious ideas about lucky/unlucky numbers, black cats, certain colors, stepping on cracks, etc.

An individual with OCD may have only one obsession or have many obsessions at once. The obsessions of an individual tend to reflect topics that they deeply care about. For example, an elementary school teacher who adores children is more likely to experience unwanted sexual or violent thoughts about children, whereas someone who is very health conscious is more likely to experience an obsession about contracting or having a disease. In other words, OCD obsessions are the opposite of what a person believes in, wants, or would do—that’s what makes them so disturbing and frightening. Obsessions also tend to center around things that people can’t be 100 percent certain of, which feeds the cycle. In response to obsessions, OCD sufferers engage in compulsions, which are repeated behaviors, rituals, or thoughts that a person uses with the intention of neutralizing, counteracting, or making their obsessions go away. In many cases, OCD sufferers will spend hours each day engaging in their compulsions. Examples of compulsions include[2]:

  • Washing and cleaning: Washing or cleaning oneself, one’s house, or one’s belongings excessively or in a certain way.
  • Mental compulsions: Mental review, excessive praying to prevent something from happening, counting while performing a task to end on a “good,” “right,” or “safe” number.
  • Checking: Checking that you didn’t harm yourself or others, checking that nothing terrible has happened, checking multiple times that you turned off an appliance.
  • Repeating: Repeating routine activities such as going in and out of doors or turning lights on and off, repeating body movements such as tapping, touching, or blinking, repeating certain words, phrases, or sentences.
  • Reassurance seeking: Constantly asking friends, family, strangers, or people on the internet for advice or reassurance.
  • Avoidance: Avoiding anything that triggers obsessions.

Keep in mind that the above lists of obsessions and compulsions are not exhaustive. OCD manifests in many different ways and just because your obsession or compulsion isn’t listed above doesn’t mean it’s not related to OCD. Additionally, OCD often co-occurs with other limbic system disorders, including depression, general anxiety disorder, fibromyalgia, post-viral fatigue, and multiple chemical sensitivities.

Causes and risk factors of OCD

What causes the brain to get stuck in these dysfunctional patterns? According to the Mayo Clinic[3], OCD is thought to develop due to a combination of changes in brain function, learning from watching family members with the disorder, and possibly genetics. re-origin’s neuroplasticity-based program is right in line with what’s currently understood about OCD. We believe that OCD is the result of an impairment in a part of the brain called the limbic system[4] and structures related to the limbic system. The limbic system is not only involved in your behavioral and emotional responses, but it also drives your primal fight/flight/freeze response. This is confirmed by functional imaging studies[5] that consistently report hyperactivity in the orbitofrontal cortex, anterior cingulate cortex, and caudate nucleus of patients with OCD. The problem seems to be that the smooth, efficient filtering and shifting of thoughts and behaviors are disrupted by dysfunction in these parts of the brain. A limbic system impairment, such as OCD, can arise when someone experiences a traumatic physical or emotional event while their chronic stress load is already high. The combination of stressors essentially overwhelms the brain, changing the circuitry in the limbic system. When the limbic system becomes impaired in this way, its protective mechanisms fire more rapidly and inappropriately. It continuously sends out alarm signals making the sufferer feel like something is always wrong, even when there truly is no danger. These faulty neural pathways ultimately become conditioned, meaning they get stuck in a vicious loop of obsessive thought, anxiety, compulsive behavior, and temporary relief. OCD can affect people of all ages, however, it typically presents before age 40. Some risk factors that may make one more likely to develop the disorder include:

  • Having a high chronic stress load
  • Experiencing traumatic or stressful life events (contracting a virus, getting in an accident, experiencing an emotional event, childbirth, etc.)
  • Experiencing traumas or stressful events in close succession
  • Experiencing trauma in childhood
  • Having a relative who suffers from OCD

How is OCD diagnosed?

OCD is most commonly diagnosed by a psychiatrist. They will conduct a physical exam and psychological evaluation, which entails discussing the patient’s thoughts, feelings, symptoms, and behavior patterns. A diagnosis of OCD may be made if a person is experiencing any of the following:

  • The presence of obsessions and compulsions
  • Obsessions and compulsions that are time-consuming or cause significant distress or impairment in social, occupational, or other important settings
  • Symptoms cannot be better explained by another health issue

How is OCD treated?

Traditional treatment of OCD generally involves a specific type of psychotherapy called exposure response prevention (ERP) and/or psychiatric medications. Let’s go over what these two approaches entail:

Exposure response prevention (ERP)

ERP is a component of cognitive behavior therapy (CBT) that involves gradually exposing oneself to feared obsessions through words, imagery, or physical objects and resisting the urge to perform your compulsions. As the sufferer improves, the exposures increase in terms of how challenging they are. ERP works by teaching the brain that the thoughts, images, and urges are safe and not to be feared, thereby switching off the part of the brain that’s over-firing. Over time, this releases the need to practice compulsions as frequently, or eliminates the desire to perform compulsions altogether.

In many ways, ERP is similar to re-origin’s program. They both work to rewire the brain and override the faulty programming and use incremental training to gradually decondition the brain to its triggers. Unlike re-origin which is self-directed, however, ERP requires the help of a mental health provider. Appointments can be pricey, making it inaccessible to many people due to cost.


Certain antidepressant medications are often used in conjunction with ERP therapy. These can help control the obsessions and compulsions of OCD and make therapy more productive. The downsides are that antidepressants don’t address the root neurological cause of the dysfunction. When people start to wean off antidepressants, their obsessions and compulsions often start up again. This class of medications also comes with a long list of potential side effects and many people have difficulty discontinuing use.

How we approach OCD

OCD occurs when the limbic system becomes traumatized due to experiencing a physical or emotional trauma while your stress load is already high. When in this impaired state, the limbic system repeatedly sends out inappropriate alarm signals to warn of danger, leading to obsessions and compulsions.

The good news is that these symptoms are temporary and can be reversed. At re-origin, we focus on addressing the root cause of OCD: an impaired limbic system. We believe that interrupting faulty neural pathways in the brain and calming the overactive threat-response system are the keys to permanent and full recovery from OCD.

Through re-origin, you learn how to adopt the perspective of the “curious observer,” separating yourself from the obsessions and learning to see them as nothing more than a symptom of a glitch in your brain. Then, using specific neurocognitive exercises, you can systematically work to create new, healthy neural pathways and get back to a place of safety and balance where normal thought processes and reactions can resume.

re-origin’s approach does not chase or mask symptoms, but rather works to rewire the part of the brain that is causing the dysfunction (the limbic system), resulting in long-lasting recovery. The program is easy to follow, self-directed, cost-effective, and takes just minutes a day to implement.

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How to live and cope with OCD

At re-origin, we believe that nobody should have to live or cope with OCD. We want you to eliminate your obsessions and compulsions and re-establish peace and happiness. Our program involves applying an easy-to-follow, five-step neurocognitive technique to override and rewire faulty conditioning in the brain and create new, functional neural pathways.

The key to overcoming OCD lies in applying our techniques and being persistent in your efforts. With dedication and repetition, you can create new, anxiety-free neural pathways in your brain. Learn more about the re-origin program with a free trial at re-origin.com/freetrial.

A Final Word from re-origin

OCD can be extremely debilitating, frightening, and confusing. It can make you question the very truth of who you are and what you believe in. If you’re suffering from this disorder, it’s important to understand the following:

  • You did not cause this.
  • Your inability to manage is not a reflection of your strength.
  • Your obsessions are not a reflection of who you are as a person or your reality.
  • You’re not going insane. Your persistent, scary thoughts and feelings are simply the result of faulty transmissions in a malfunctioning brain.
  • This condition is not permanent—you can undo the faulty wiring in your brain and make a full recovery with the help of re-origin.

No one should have to live with OCD—and thankfully, you don’t have to! With our proprietary neuroplasticity training program, you can learn to undo the underlying cause of your obsessions and compulsions, putting an end to the symptoms you’re experiencing once and for all.


What is OCD in psychology?
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OCD, which stands for obsessive-compulsive disorder, is a mental health disorder in which people experience recurring, unwanted thoughts, ideas, images, or urges (obsessions) that make them feel driven to do something repetitively (compulsions).

What causes obsession?
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Most people have obsessive thoughts at some point in their lives, but that does not mean that everyone has OCD. In OCD, circuitry in the brain is malfunctioning, making sufferers think that there is danger when there really isn’t any. These glitches in the brain (faulty neural pathways) are what cause the obsessions. In order for a diagnosis of OCD to be made, the cycle of obsessions and compulsions must be so extreme that it consumes a lot of time and gets in the way of everyday life.

What triggers OCD?
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OCD tends to arise when someone experiences an emotional or physical trauma while their stress load is already high. This causes the limbic system to go into a maladaptive state that triggers a cycle of obsessions and compulsions. What triggers a person’s compulsions is unique to the individual. It could be certain words, places, images, thoughts, people, experiences, or objects.


Katie Rapkoch, CHPC