OCD: More Than Being Tidy. Signs, Myths and Treatments That Work

“I’m so OCD about my desk” isn’t what OCD is. Obsessive-compulsive disorder is a serious mental health condition involving unwanted, distressing thoughts (obsessions) and repetitive behaviours or mental rituals (compulsions) that can take hours a day. It’s very treatable.

Imagine being a new nurse terrified that you’ve given the wrong medicine, even though you checked. You go back to check again, and again, and again. At home you replay every shift. The thought “what if I harmed someone?” won’t leave. You’re exhausted and ashamed. This isn’t conscientiousness; it may be OCD.

Common obsessions and compulsions

• Fear of contamination, with excessive washing or cleaning
• Fear of causing harm, with repeated checking
• Need for symmetry or “just right” feelings, with arranging or repeating
• Unwanted intrusive thoughts, often violent, sexual or religious, which the person finds horrifying
• Mental rituals such as counting, praying or reassurance-seeking

Having intrusive thoughts doesn’t mean you want to act on them. In OCD, they cause distress precisely because they go against the person’s values.

Treatments that work

• CBT with exposure and response prevention (ERP): gradually facing fears without carrying out compulsions
• Medication: SSRIs, often at higher doses than for depression
• A combination of both for more severe OCD

But why don’t people get help sooner?

Many people hide OCD for years out of shame about their thoughts. Healthcare providers who treat OCD hear these thoughts all the time and understand them. Reaching out early can give you back hours of your day.

Sources: US National Institute of Mental Health (OCD), NHS (Obsessive compulsive disorder), NICE guideline on OCD and body dysmorphic disorder, International OCD Foundation. This guide is for general information and does not replace advice from your own nurse, doctor or mental health professional.