Obsessive Compulsive
Disorder (OCD)
FACT SHEET 37
WHAT IS OCD?
Anxious thoughts can influence our behaviour and this is helpful
at times. For example, the thought  I may have left the oven on
leads to the behaviour of checking the oven and keeping things
safe. However, once the thought becomes obsessive (recurring)
it can influence unhealthy patterns of behaviour that can cause
difficulties in daily functioning. The obsession or persistent
thought  I have left the oven on , can lead to repeated checking.
For someone with the anxiety disorder known as Obsessive
Compulsive Disorder (OCD), either obsessions (thoughts,
ideas, images that cause distress) or compulsions (acts
performed to alleviate the distress or neutralise the thought),
or both, are present.
Compulsive behaviours or rituals are often performed in the
hope of preventing obsessive thoughts or making them go away.
" performs repetitive, often seemingly purposeful, ritualistic
Performing these compulsions provides only temporary relief,
behaviours (compulsions) in order to reduce distress or
and not performing them markedly increases anxiety. People
neutralise the thought.
with OCD often think that unless they carry out these ritualistic
behaviours, dire consequences will follow, such as the death of a
In addition, obsessions, whether thoughts, ideas or images and
loved one. Even though they know such thoughts are irrational,
compulsions share the following features:
they are difficult to dismiss and cause much distress.
" repetitive and unpleasant with at least one obsession or
People with OCD often experience feelings of intense shame
compulsion recognised as excessive or unreasonable
about their need to carry out these compulsions. These
" persisting symptoms for at least one hour a day or
feelings of shame can exacerbate the problem. Shame and the
significantly interfering with normal functioning
consequent secrecy associated with OCD can lead to a delay in
diagnosis and treatment. It can also result in social disability (for
" the person tries to resist them, however, at least one
example, children failing to attend school or adults becoming
obsession or compulsion is not resisted
housebound). Shame can also be associated with unwanted
" the person derives no pleasure from the obsessive thought
thoughts or images (also known as intrusive thoughts) that
or compulsive act. There may be initial relief from the
enter the mind of the person with OCD and cause distress,
compulsion, but this passes.
leaving the person obsessing about the thought. For example,
" the obsessions or compulsions cause distress or interfere
 What if I hurt my child? These thoughts are out of character
with the person s day-to-day functioning, for example, work,
and therefore cause much distress as the person struggles
social life, school, and are disabling.
with what it means about them as a person to be thinking
this way. Some people with OCD seem to infer that a morally
" the person considers that the obsessions and compulsions
unacceptable thought is on par with the action. As a result, their
do not occur exclusively within episodes of depression.
anxiety increases when these problematic thoughts arise.
It s important to note that this is only a guide to recognising
OCD. For a diagnosis, talk to a health professional.
SIGNS AND SYMPTOMS OF OCD
People with OCD may also experience other mental health
A person may have OCD if he/she:
issues including depression, other anxiety disorders, an eating
" has recurrent, persistent and unwanted thoughts, impulses
disorder and/or alcohol or substance-use problems.
or images (obsessions) that cause distress. These are not
just excessive worries about daily life.
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Obsessive Compulsive
Disorder (OCD)
FACT SHEET 37
COMMON OBSESSIVE THOUGHTS AND HOW COMMON IS OCD AND WHO
COMPULSIVE BEHAVIOURS EXPERIENCES IT?
Issues that commonly concern people with OCD and result in Close to 3 per cent of Australians experience OCD in their
compulsive behaviour include: lifetime and approximately 2 per cent in a 12 month period.1
OCD can occur at any time in life and children as young as six
" Cleanliness/order: Obsessive hand-washing or household
or seven may have symptoms, although symptoms seem to
cleaning to reduce an exaggerated fear of contamination
develop fully for the first time in adolescence.2
is common. An obsession with order or symmetry is also
common, with an overwhelming need to perform tasks or
WHAT CAUSES OCD?
place objects, such as books or cutlery, in a particular place
and/or pattern.
OCD is thought to develop as a result of a combination of
genetic and environmental factors. A number of factors may
" Counting/hoarding: Some people with OCD repeatedly
increase the risk of developing OCD. These include:
count items or objects, such as their clothes or pavement
blocks when they are walking, or hoard items such as junk
" Family history: People with OCD often have a family history
mail and old newspapers.
of the disorder or other mental health problems.
" Safety/checking: Some people with OCD have obsessive
" Biological factors: OCD has been linked to several
fears about harm occurring to either themselves or others
neurological factors and irregular levels of serotonin (a chemical
which can result in compulsive behaviours. For example,
that transmits messages between brain cells) in particular.
some people repeatedly check whether the stove has been
Research into chemical, structural and functional changes
turned off or that windows and doors are locked. Others may
or abnormalities in the brain continues.
repeatedly retrace a route they have driven in their car to
" Social factors: People may be more at risk if they experience
assure themselves that they have not had an accident with
a stressful major life change, such as the birth of a child, the
a pedestrian, cyclist or other driver; even though they know
breakdown or loss of a close relationship or moving house
they have not been involved in a collision.
or job.
" Sexual issues: Some people with OCD have an irrational
" Psychological factors: People with certain personality traits,
sense of disgust concerning sexual activity. For example,
such as being excessively neat, highly organised or placing a
some people may become preoccupied with unwanted
great deal of emphasis on morality and responsibility, may be
thoughts about engaging in sexual activity with children or
more at risk.
animals, violent sexual behaviour or their sexual orientation.
" Environmental / learned behaviours: Some experts suggest
Without treatment, people who experience these obsessions
that OCD may develop as a result of learned behaviour. Direct
may become increasingly anxious about such thoughts, even
conditioning (e.g. developing a washing compulsion after
though they know they bear no relation to their own sexual
contracting a disease from contact with an animal) and learning
inclinations and are irrational.
by watching the behaviour of others e.g. parents.
" Religious/moral issues: Some people with OCD have
religious or moral anxieties and may, for example, feel a
WHAT TREATMENTS ARE AVAILABLE?
compulsion to pray a certain number of times a day or to such
an extent that it interferes with their work and/or relationships. OCD is treatable and seeking treatment is the first step towards
recovery. There are two main types of effective treatments for
OCD; psychological therapy and medication.
1 Australian Bureau of Statistics. (2008). National Survey of Mental Health and Wellbeing: Summary of Results,
2007 (4326.0). Canberra: Australian Bureau of Statistics.
2 Heyman, I., Mataix-Cols, D., Fineberg, NA. (2006). Clinical review: Obsessive-compulsive disorder.
British Medical Journal. 333(7565): 424 29.
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Psychological therapy Medication
Cognitive Behaviour Therapy (CBT) is the most commonly While psychological treatment is usually the first choice for the
used therapy for people with OCD and can be conducted in treatment of OCD, medication may also be helpful and has
group sessions, but the treatment of OCD is usually delivered been found beneficial, particularly for OCD.
individually.
Antidepressants may be prescribed to treat anxiety and
Cognitive behaviour therapists work closely with people to depressive disorders. Talk to your doctor for more information
develop a shared understanding of thinking and behavioural and see beyondblue Fact sheet 11  Antidepressant
difficulties. Therapists can assist people to uncover unhelpful medication.
and unrealistic ways of thinking. They can help a person to
The Therapeutic Goods Administration (Australia s
move closer to more helpful and realistic ways of thinking.
regulatory agency for medical drugs) and manufacturers of
Cognitive behaviour therapists also have techniques that
antidepressants do not recommend antidepressant use for
help minimise the distress associated with obsessions. By
depression in young people under the age of 18. For more
minimising the distress associated with the obsession, the
information see beyondblue Fact sheet  Antidepressants for
thought pattern is broken down and occurs less frequently.
the treatment of depression in children and adolescents.
Therapists may also examine how an individual s way of thinking
Although fluvoxamine and sertraline have been approved for
prompts negative behavioural patterns, exacerbating and
treating Obsessive Compulsive Disorder in this age group, close
prolonging the OCD and reinforcing the fear. Then behavioural
monitoring by a medical professional is recommended.
tasks, such as exposure tasks, are carried out by the person to
Benzodiazepines: These anti-anxiety and sedative drugs
enable a return to more helpful behaviours. Graded exposure
are used to relieve anxiety and aid sleep. They are, however,
is the term that is commonly given to this series of exposure
addictive and so are only useful for a short period of time (two
tasks as the person is gradually exposed to the situation that
or three weeks) or if used intermittently. Benzodiazepines
is feared. For example, a person with an obsessive thought
can be difficult to stop taking, and if a person has become
about burning down the house may feel compelled to check
dependent, withdrawal symptoms may be quite severe.
all electrical equipment before leaving a room  a ritual which
A common withdrawal symptom is high anxiety, which
may be even more time-consuming and more exhausting if the
paradoxically can worsen the problem and make it difficult
person plans to leave the house. Over time, the therapist may
to assess whether current anxiety is related to the OCD
provide strategies which enable the person to check fewer
or a result of long-term use of the Benzodiazepines.
pieces of equipment in fewer rooms less often, so the person
See www.reconnexion.org.au for more information and talk
gradually learns to reduce the anxiety and manage his/her
to your doctor.
particular obsessions and compulsions.
If you decide that you wish to stop taking your medication, it is
Another effective part of CBT is Psycho education. This relates
crucial that you discuss this with a health professional before
to education regarding the symptoms of anxiety and why they
taking any action.
occur. For example, people tend to be less fearful of symptoms
if they are informed about the human physiological response
HELPING YOURSELF TO RECOVER
to fear. People react to the threat of imminent danger with an
acute stress response, commonly known as the fight-or-flight
FROM OCD
response, during which the brain releases hormones such as
Once a person with OCD is receiving treatment, the process
adrenaline that prepare the body for action. Understanding this
of recovery can be different for each individual. Recovery can
process may assist the person in understanding the importance
involve ups and downs; some days are easier than others. For
of breathing and relaxation techniques, as well as the benefits of
more information see beyondblue Fact sheet 15  Recovery.
aerobic exercise. Often, breathing and relaxation strategies
The following tips may help:
are also taught to minimise physical symptoms of anxiety and
manage stress in general.
" Talk to your doctor about referral to a mental health
professional who specialises in treating anxiety disorders.
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" Self-monitor: It can be useful to keep a diary of the frequency,
HOW TO HELP SOMEONE RECOVER
intensity and types of unwelcome thoughts (obsessions)
FROM OCD
you have. Resist completing rituals (compulsions) as much
Family and friends can play an important role in helping people
as possible. If the need to carry out compulsions becomes
recover, as well as helping themselves to cope with the person s
stronger, let your treating health professional know.
condition. Some ways in which to do this include:
" Practise letting go and putting things into perspective.
" Encourage the person to seek help. Assist the person to
Don t feel you must relentlessly meet unrealistic standards.
find out about available services and offer to accompany the
Focus on successes rather than failures and don t be too
person to the consultation.
hard on yourself.
" Acknowledge that the person has a disorder and that he/
" Try to reduce your stress in general. Practise relaxation
she is not just  being difficult ; the anxiety is a very real and
techniques such as breathing and muscle relaxation.
distressing experience.
Relaxation techniques can provide quick relief from anxiety
and, if practised regularly, can also reduce anxiety and stress
" Don t argue with the person or try to stop the person from
in general. For more information on relaxation techniques see
participating in what seems to you like illogical behaviour. Often
beyondblue Fact sheet 6  Reducing stress.
the person realises it is illogical, but still feels compelled to act
in this way. During treatment, there may be a role for you in
" Recognise triggers  Consider which situations or
helping the person with OCD to resist the completion of rituals.
circumstances make you feel anxious or increase your stress
levels (for example, too much caffeine, excessive workload,
" Don t involve yourself in the person s compulsions. Helping a
going to staff meetings or to the shops). Then try to develop
person with OCD to carry out the compulsions only makes it
strategies to confront situations, rather than avoiding them in
more difficult for the person to recover.
order to manage and minimise general stress and anxiety.
" Avoid giving reassurance. The person with OCD needs to
" Set some realistic and small goals for yourself to manage
confront his/her fears without constant reassurance.
stress better, for example, walking three times a week,
" If appropriate, offer practical support, such as helping the
joining a yoga class and eating regular meals.
person to practise relaxation techniques.
" Develop some  self statements that you find reassuring. For
" To encourage the person, acknowledge any gains he/she
example,  This is not my responsibility ,  Maybe it s time to
makes, no matter how small.
take a breath ,  Good enough is sometimes good enough .
" Work with the person to re-establish a daily routine that
" Make time for pleasurable activities. Set aside time to do
includes enjoyable and/or relaxing activities.
enjoyable things, such as reading, gardening or listening to
music, and seeing family and friends. For more information " Encourage the person to maintain a healthy lifestyle.
see beyondblue Fact sheet 8  Keeping active and
" Don t expect too much too soon; recovery can take a while
Fact sheet 15  Recovery.
and there may be some ups and downs.
" Maintain a healthy lifestyle; get regular exercise, have
" Find emotional support for yourself  dealing with and caring
adequate sleep, eat a balanced diet and limit your intake
for a person with OCD can be difficult at times. You may
of alcohol and other stimulants, such as caffeine to reduce
need support too. This may involve attending a support
anxiety. For more information, see beyondblue Fact Sheet 7
group, individual, couple or family counselling, or educational
 Sleeping well, Fact sheet 8  Keeping active, Fact
sessions. For more information see beyondblue s free
sheet 9  Reducing alcohol and other drugs and Fact
booklet A Guide for Carers available from the website
sheet 30  Healthy eating for people with depression,
or call 1300 22 4636 (local call cost).
anxiety and related disorders.
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Lifeline
WHERE TO FIND HELP
13 11 14
A General Practitioner (GP) is a good person with whom to
24-hour counselling, information and referral (local call cost)
discuss your concerns in the first instance. A GP can conduct
or arrange for any medical tests that are deemed necessary
Mensline Australia
and can make a referral to a mental health professional. It is
1300 78 99 78
recommended that you go to your regular GP or another GP in
Support for men especially those with family and relationship
the same clinic as they have access to your medical records.
problems
However, if you don t have a regular GP or clinic, a list of GPs
with expertise in treating mental health issues is available at
Suicide Call Back Service
www.beyondblue.org.au by clicking on Find a Doctor or Other
1300 659 467
Mental Health Practitioner, or call the beyondblue info line on
Free telephone support for people at risk of suicide, their carers
1300 22 4636 (local call cost).
and those bereaved by suicide
Psychiatrists are doctors who specialise in mental health. They
Relationships Australia
can make medical and psychological assessments, conduct
1300 364 277
medical tests and prescribe medication. Some psychiatrists use
www.relationships.com.au
psychological treatments such as Cognitive Behaviour Therapy
Support for people with relationship problems
(CBT) and Interpersonal Therapy (IPT). IPT is a structured
program with a specific focus on improving relationships.
Facing Anxiety
Psychologists, mental health nurses, social workers
www.mentalhealth.asn.au/ada
and occupational therapists with mental health training
Information on anxiety disorders, related resources and
specialise in providing non-medical (psychological) treatment for
support groups
people with depression, anxiety and related disorders.
Anxiety Network Australia
A rebate can be claimed through Medicare for psychological
www.anxietynetwork.com.au
treatments if the person has a mental health problem and is
Information on anxiety disorders, related programs, workshops,
referred by a GP, psychiatrist or paediatrician to a psychiatrist,
courses and stories from people living with these disorders
registered psychologist, social worker or occupational therapist
in mental health. This rebate can be claimed for part of the cost Anxiety Recovery Centre
of up to 12 individual consultations and 12 group sessions in a
www.arcvic.com.au
calendar year. To find a list of health professionals who provide
Information about anxiety disorders, their management and
psychological treatment for which a Medicare rebate can be
links to other services
claimed go to www.beyondblue.org.au and click on Find a
Climate.tv  interactive e-health
Doctor or other Mental Health Practitioner.
www.climate.tv
Developed by medical experts, this is a self-management
MORE INFORMATION
system for people with depression and anxiety.
beyondblue: the national depression initiative
CRUfAD Clinical Research Unit for Anxiety and Depression
To find out more about depression, anxiety and related disorders
call the beyondblue info line 1300 22 4636 (local call cost)
www.crufad.org
or visit the website www.beyondblue.org.au
Information about anxiety and its management
Youthbeyondblue
E-Couch
www.youthbeyondblue.com
www.ecouch.anu.edu.au
beyondblue s website for young people  information about
Evidence-based information about emotional problems
depression and anxiety and how to help a friend
(including anxiety) and strategies to help you prevent problems
and understand yourself better
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Obsessive Compulsive
Disorder (OCD)
FACT SHEET 37
headspace: National Youth Mental Health Northern Territory
Foundation Top End Association for Mental Health
1300 780 081
www.headspace.org.au
www.teamhealth.asn.au/about.html
Mental health information for young people
Queensland
MoodGYM
Panic Anxiety Disorder Association QLD
www.moodgym.anu.edu.au
[phone]
Online psychological therapy
www.anxietyqld.org.au
Multicultural Mental Health Australia
South Australia
[phone]
www.mmha.org.au Anxiety Compulsive and Eating Disorders
Provides mental health support for Australians from culturally-
Association (ACEDA)
diverse backgrounds
(Incorporating Obsessive Compulsive Disorders Support Service)
[phone]
Reconnexion
www.aceda.org.au
1300 273 266
www.reconnexion.org.au
Tasmania
Psychology services for people experiencing anxiety and
Mental Health Council of Tasmania
depression and tranquilliser dependency
[phone] / 1800 808 890
www.mhct.org
STATE-SPECIFIC SERVICES
Victoria
ACT
ADAVIC (The Anxiety Disorders Association of Victoria)
Mental Health Foundation
www.adavic.org.au
[phone]
Information about Obsessive Compulsive Disorder, Panic
www.mhf.org.au
Disorder, Social Phobia, Agoraphobia, Generalised Anxiety
Information about anxiety, depression, schizophrenia and
Disorder, depression and support services
bipolar disorder in the Australian Capital Territory
Western Australia
New South Wales
Anxiety Self Help Association
Facing Anxiety Support & Information
[phone]
1300 794 992
www.cnswa.com/asha/
www.mentalhealth.asn.au/ada
Other beyondblue anxiety information material available:
beyondblue Fact sheet 21  Anxiety Disorders
beyondblue Fact sheet 31  Post-Traumatic Stress Disorder
beyondblue gratefully acknowledges the contribution
beyondblue Fact sheet 35  Generalised Anxiety Disorder
of Reconnexion in the development of this fact sheet.
beyondblue Fact sheet 36  Panic Disorder
beyondblue Fact sheet 37  Obsessive Compulsive Disorder
© beyondblue: the national depression initiative, 2009.
beyondblue Fact sheet 38  Specific Phobias
PO Box 6100, Hawthorn West VIC 3122
beyondblue Fact sheet 39  Social Phobia
T: [phone]
beyondblue info line 1300 22 4636
beyondblue wallet-size information card  Anxiety Disorders
F: [phone]
beyondblue envelope-size information card  Anxiety Disorders
E: [e-mail]
W: www.beyondblue.org.au
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