Obsessions are thoughts that one can't get out of their head. No matter how hard one tries, the unwelcome thoughts return. Common subjects are germs/contamination, doubting that something was done, orderliness/organization, fear of impulsive behavior (saying something inappropriate/doing something terrible), fear of having terrible thoughts.
One way to cope with the anxiety caused by obsessive thoughts is to take action. These actions can get out of control and interfere with life in a negative way. The thought and action are not necessarily connected in logic. Now they are called "compulsions." Here are some examples:
- If someone is afraid of germs, they might start cleaning and sterilizing things constantly (more than the average person would) as well as refuse to touch anything in a public place or shake hands with anyone. They might also start washing/scrubbing their hands many times a day.
- A person who doubts might start checking things over and over and over. Ten minutes later, the doubt returns and they have to check again. It's as if they don't remember or trust their memory. Did I lock the door? Did I close the garage door? Is the stove turned off? Did I put something away? Did I turn on/turn off something?
- People who obsess on orderiless and organization can't stand anything out of place. Everything has a place. No paperclip can sit outside of the official paperclip box. The lamp is not allowed to be an inch out of place on the tabletop. Couch cushions have to be just so. These people might also fixate on a certain type of thing that is out of place everywhere they go. Imagine walking to work and having to pick up every piece of trash (no matter how small) found on the street.
- Some people with OCD are afraid of their own impulses to say something inappropriate (vulgarity, insults, lies, hoaxes) and so they avoid going places and being with people. It's like being afraid of suddenly being overcome with Tourrette's Syndrome when one doesn't even have it in the first place. Some people are afraid of doing something inappropriate, dangerous or worse. Again, these people isolate themselves to protect others.
- Fixation on words, phrases or repeated actions are another way to deal with the anxiety. Some people will say certain words or phrases over and over until they "feel better."
- Hoarding is another OCD compulsion. Suffers might keep something for a reason that seems logical to them but it gets out of control and becomes extreme. Imagine keeping an empty jar because it would be good for storage. Compare that to someone who has accumulated hundreds of jars, none of them used, to be saved for a future, possible use. There are also people who hoard animals to the point of their homes becoming filthy and they are unable to afford to feed and provide proper veterinary care for their pets.
- Some people become obsessed with negative parts of their body. They scrub or wash or pluck to the point of causing damage to their appearance and/or health.
- Scrupulosity is an religious expression of OCD that goes way back into history. A person focuses on their religion, or a certain aspect of their religion, way too intensely and loses sight of the big picture. Clergy in many faiths have been helping their members with this problem for hundreds of years. This is not to be confused with being religious and devout. This is a situation of extreme religion when even the leader says there is a problem.
Psychiatry and psychology have come a long way in the past 50 years. Now there are ways to deal with the anxiety. OCD can't be cured, but it can be managed and it's impact on life lessened . There are many anxiety medications available. There is also Cognitive Behavior Therapy (CBT) to help people react and deal with anxiety.