OCD Treatment

This is one of the most recognised forms of OCD. People fear dirt, germs, bodily fluids, chemicals or illness, and may wash their hands until they crack and bleed, shower for hours, clean excessively, or avoid touching door handles, money or other people.

Some fear becoming ill themselves, while others fear passing contamination to loved ones, especially children or elderly parents. Over time, the rituals can take over the household, with family members asked to follow strict cleaning rules, change clothes on entering the house or avoid certain rooms.

People with checking OCD are troubled by doubts that they have left something unsafe or caused harm, such as leaving the gas on, the door unlocked, or hitting someone while driving. They check repeatedly, sometimes dozens of times, yet the doubt returns as soon as they walk away.

Checking can make people late, keep them awake at night, and lead them to avoid responsibilities such as locking up or driving. Some people take photos or ask others to check for them, which keeps the doubt alive.

In religious OCD, sometimes described as waswasa, a person is tormented by doubts about purity, faith or sin. They may repeat ablution or prayers many times, fear their worship is invalid, or experience blasphemous thoughts that horrify them because they go against their deepest beliefs.

These thoughts are not a sign of weak faith. In fact, they cause such distress precisely because the person cares so much about their faith. Many people with religious OCD feel deep shame and avoid telling anyone, while their worship, which should bring peace, becomes a source of fear and exhaustion.

Some people experience intrusive thoughts or images of harming others, acting inappropriately, or thoughts that clash with their values. Because these thoughts are so upsetting, people may avoid knives, children, driving or being alone with loved ones, and constantly question whether they are a bad person.

People with this type of OCD are not dangerous. The thoughts are unwanted and distressing precisely because they are the opposite of what the person wants. There is no evidence that people with OCD act on these thoughts. New mothers sometimes experience such thoughts about their baby and need reassurance and specialist support rather than fear.

Some conditions are closely linked to OCD, and we also assess and treat:

• Hoarding disorder, great difficulty discarding possessions
• Body dysmorphic disorder, preoccupation with a perceived flaw in appearance
• Hair pulling and skin picking, repetitive behaviours that cause damage
• Tic disorders, which often occur alongside OCD
• Health anxiety, constant fear of having a serious illness
• OCD in children and teenagers, often with rituals involving parents
• Perinatal OCD, intrusive fears about a baby during pregnancy or after birth
• OCD with depression, which is common and needs treating together

OCD can also be confused with anxiety, depression or psychosis, which is why a careful specialist assessment is so important. Getting the diagnosis right ensures you receive the specific treatment OCD needs.