It isn't unusual to check the front door to make sure it is locked before going to bed or to check the stove to make sure it is off before heading out the door. If you have obsessive-compulsive disorder (OCD), though, you might have the need to check things repeatedly or a certain number of times. You do this in an attempt to stop, or find relief from, intrusive thoughts and feelings of anxiety.
For example, you might believe that your house is going to burn down if you don't check your stove 10 times. You might need to check the front door four times before you are able to go to bed. It can be hard to know whether your behaviors are quirks of your personality or if they are something more serious.
Obsessions are unwanted, intrusive ideas, urges or images. Compulsions are the responses to obsessions, usually in the form of repetitive behaviors. The following are nine common obsessions/compulsions/rituals associated with OCD.
Hand washing - This is frequently driven by a fear of germs or contamination and includes the frequent use of hand sanitizers. Some people must wash their hands a certain number of times or in a certain way to try to reduce feelings of anxiety. If you worry excessively about germs and contamination, even after you have washed your hands, you might want to talk to a mental health professional.
Repeatedly checking - Checking and rechecking is the most common type of compulsion among those with OCD. It involves checking, and rechecking, behaviors to attempt to alleviate fears that something terrible is going to happen unless you check and recheck. Many people develop a ritual of checking something a certain number of times.
Excessive organization - You organize things to the point of over-organizing. You like things neat, tidy and symmetrical. Some people organize their refrigerators alphabetically, their closets by color. They buy things only in pairs or always have items in even numbers. They spend enormous amounts of time making sure their life has order and are keenly aware and agitated if the order is upset.
Ruminating about relationships - You constantly go over every aspect of your relationships - romantic, friendships, family, coworkers. You replay interactions in your mind, looking at every remark and comment, trying to find hidden meanings in what others say or reviewing what you have said, sure you said something wrong. While many people analyze their relationships and are at time insecure about romantic interests, those with OCD replay these thoughts as if "stuck in a loop."
Needing reassurance - Seeking reassurance is sometimes a way to avoid obsessive thoughts and rituals. For example, if you ruminate about your relationship, you might constantly ask your partner for reassurance that he or she loves you. If you are a hand washer, you might ask for reassurance after touching a shopping cart or shaking someone's hand. If you find yourself asking the same questions over and over, it might be a sign of OCD.
Fear of violence - Many people have thoughts of violence - either happening to them or inflicting violence on others. Usually, these thoughts are fleeting and are dismissed without a problem. For those with OCD, the thoughts can replay in a loop. You might think these thoughts make you a bad person or be convinced that something terrible might happen. If you find yourself avoiding situations because of an unfounded fear or checking repeatedly to avoid a perceived terrible outcome, it could be a sign of OCD.
Counting - Some people count as they go about daily activities. For example, you might count how many steps from your desk to your car. You might find that you must always end on an even number and be concerned something bad is going to happen if you end on an odd number. You might take smaller steps or take a few extra steps to be sure you get to your car with an even number of steps.
Cleaning - Similar to hand washing, excessive cleaning usually stems from a fear of germs and contamination. You clean your house excessively and become agitated when your children invite friends over, needing to clean every surface they touched during their visit. Like hand washing, your anxiety is eased for a short while but returns more intensely.
Sexual thoughts - People with OCD often have intrusive sexual thoughts. They might imagine themselves being sexually inappropriate with co-workers, neighbors, or people on the street. They might have thoughts about someone of the same sex and worry excessively that they are gay (or vice-versa.) They might worry that they are going to sexually molest a child. As with other types of intrusive thoughts, the thought becomes stuck in a loop.
"What is Obsessive-Compulsive Disorder (OCD)? Date Unknown, Staff Writer, National Institute of Mental Health
"What You Need to Know About Obsessive Compulsive Disorder," Date Unknown, Staff Writer, International OCD Foundation