OCD Signs, Symptoms and Misconceptions

"I need everything lined up perfectly. I'm so OCD"

"My desk has to be organised or I can't focus."

"I hate it when things are out of place."

You may have heard people use "OCD" this way. It has become a common way of describing someone who likes things clean, organised or done in a particular way.

But obsessive-compulsive disorder (OCD) is not simply about being neat or particular.

For someone with OCD, certain thoughts can feel unwanted, upsetting and difficult to switch off. They may then feel driven to repeat certain behaviours or mental rituals to reduce the anxiety.

So how is OCD different from simply liking things a certain way?

What Actually Is OCD?

Obsessive compulsive disorder, or OCD, is a mental health condition involving obsessions, compulsions or both.

Obsession: are recurring and unwanted thoughts, images, fears or urges that can cause anxiety or distress.

For example:

• “What if I left the stove on?”
• “What if I accidentally hurt someone?”
• “What if I get sick from touching this?”
• “What if something bad happens because I made a mistake?”

The person usually does not want to have these thoughts.

They may even know the fear is unlikely, but the thought can still feel difficult to ignore.

Compulsions: Compulsions are actions or mental rituals someone feels they need to repeat, often to reduce the anxiety caused by an obsessive thought.

Examples include:

• Checking doors or appliances repeatedly
• Washing or cleaning excessively
• Counting certain objects or actions
• Arranging things until they feel “right”
• Repeating certain words in their head
• Asking for reassurance again and again

Doing the compulsion may temporarily help the person feel better.

But the anxiety often comes back. The cycle can look like this:

Unwanted thought → Anxiety → Compulsion → Temporary relief → Anxiety returns

This cycle can become difficult to break without support.

OCD Isn't Just About Cleaning

One of the most common OCD misconceptions is that everyone with OCD is extremely clean or organised. Some people with OCD do experience fears about germs or contamination.

But OCD can appear in many other ways.

"What if I left the stove on?"

Someone may check the stove once.   
Then twice.

Then go back again because they are still not completely certain.

"What if I get sick?"

Someone may wash their hands repeatedly, avoid touching certain objects or avoid public places because of fears about contamination.

"What if something bad happens if I don't do this?"

Someone may feel they need to count, repeat an action or perform a routine a certain number of times.

"What if I made a mistake?"

Someone may reread an email many times, repeatedly review a conversation in their mind or keep asking someone else for reassurance.

"Why can't I stop thinking about this?"

Some people experience intrusive thoughts that feel disturbing, upsetting or completely unlike something they would normally think.

They may spend a lot of time trying to understand why the thought appeared. Not all OCD habits are visible. Some compulsions happen completely inside a person’s mind.

What Causes OCD?

There is no single known cause of OCD.

Researchers believe several factors may play a role, including:

• Genetics
• What certain areas of the brain function
• Personality or temperament
• Stressful or difficult life experiences

OCD can also run in families, although having a family member with OCD does not mean you will develop it.

Stress may also existing OCD signs and symptoms feel stronger. Importantly, being organised careful or perfectionist does not cause OCD.

When Does "Just a Habit" Become Something More?

Most people have routines or habits.

You might check the door once before leaving home.

You may prefer to arrange your desk a certain way.

You might reread an important message before sending it.

These behaviours alone do not mean you have OCD.

It may be worth paying closer attention when the behaviour starts to feel difficult to control.

Some signs include:

• spending a lot of time checking or repeating things
• feeling very anxious if you cannot complete a ritual
• repeatedly asking other people for reassurance
• experiencing thoughts that feel intrusive or difficult to control
• avoiding places, people or situations because they trigger anxiety
• having routines that interfere with work, school or relationships
• knowing a fear may be excessive but still feeling unable to let it go

Can OCD Be Treated?

Yes, OCD can be treated, and treatment can help reduce the distress caused by obsessive thoughts and compulsive behaviours.

Depending on the individual, treatment may involve medication, psychological therapy or a combination of both.

Medication

Doctors may prescribe certain antidepressant medicines to help manage OCD symptoms. A commonly used group is called selective serotonin reuptake inhibitors (SSRIs). Another medicine called clomipramine may also be considered.

These medicines affect serotonin, a chemical in the brain that is involved in mood and other brain functions. It may take time to notice an improvement, and some people may experience side effects.

Your psychiatrist will recommend a suitable medicine and monitor how you respond to treatment.

Cognitive Behavioural Therapy

Cognitive behavioural therapy (CBT) can also be used to treat OCD, either on its own or together with medication. A specific form of CBT known as exposure and response prevention (ERP) is commonly used for OCD.

ERP helps a person gradually face situations that trigger their anxiety while learning to resist performing the usual compulsion. For example, someone who is afraid of contamination may gradually practise touching an object they consider unclean without immediately washing their hands.

With repeated practice and professional guidance, the person can learn that the anxiety can reduce even without carrying out the compulsion. Treatment is tailored to the individual, and a psychiatrist can recommend an approach based on the person’s symptoms and how much OCD is affecting their daily life.

When Should You Seek Help?

You do not need to wait until OCD signs and symptoms become severe before speaking to someone.

Consider seeking professional support if unwanted thoughts or repetitive behaviour:

• are causing significant anxiety
• take up a large amount of your time
• interfere with work or studies
• affect your relationships
• make you avoid everyday situations
• feel increasingly difficult to control

Seeking help does not mean your thoughts are "crazy". It also does not automatically mean you have OCD.

Other mental health conditions can also involve anxiety, repetitive thoughts or certain behaviours. A mental health professional can listen to what you are experiencing, assess your symptoms and help you understand what may be happening.

OCD Is More Than Being Clean or Organised

Being neat does not mean you have OCD. Enjoying an organised home does not mean you have OCD. OCD is different because unwanted thoughts and repetitive behaviours can become distressing, time consuming and difficult to control.

Recognising that difference can help reduce common OCD misconceptions and encourage people who are struggling to seek support. If intrusive thoughts or repetitive behaviours are affecting your everyday life, you do not have to simply put up with them.

A psychiatrist or mental health professional can help you understand what you are experiencing and discuss suitable treatment options.

At Nobel Psychological Wellness Centre, our Psychiatrists Dr Thong Jiunn Yew, Dr Zheng Zhimin and Dr Seng Kok Han, provide psychiatric assessment and support for mental health conditions including obsessive compulsive disorder.

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