Obsessions vs. Compulsions: Understanding Both Halves of OCD

You check the lock one more time. You know you locked it, and you even remember doing it. Still, the thought won’t leave you alone: What if I didn’t? What if someone breaks in because of me? So you check again. For a moment, you feel better, until the doubt returns.

That sequence illustrates something important about obsessive-compulsive disorder (OCD). Obsessions and compulsions are two different things, but they can work together to create a frustrating cycle that becomes increasingly difficult to interrupt.

At Oasis Health and Wellness in Nashville, Tennessee, Monique Watson, PMHNP-BC, and the team help people understand what’s driving that cycle and find ways to reduce its control over everyday life.

Obsessions are the unwanted thoughts

We casually say we’re “obsessed” with a television show, hobby, or favorite food, but an OCD obsession is very different. Obsessions are recurring, intrusive thoughts, images, or urges that you don’t want and find difficult to control. They may create intense anxiety, fear, disgust, uncertainty, or doubt.

Someone with OCD might experience persistent fears about contamination or illness, accidentally hurting another person, making a serious mistake, or something terrible happening to someone they love. Other obsessions may involve a need for symmetry or for things to feel “just right,” or unwanted sexual, violent, religious, or morally troubling thoughts.

Having an intrusive thought doesn’t mean you want it to happen or intend to act on it. In fact, people with OCD often find these thoughts so upsetting precisely because they conflict with their values and desires.

Compulsions are what you do in response

If an obsession creates distress, a compulsion is an attempt to make that distress go away. Compulsions are repetitive behaviors or mental acts you feel driven to perform, even when you recognize that they don’t truly solve the problem.

You might wash excessively, repeatedly check locks or appliances, arrange objects until they feel “right,” count certain things, repeat particular words, or continually ask other people for reassurance. 

However, compulsions aren’t always visible. You might silently repeat a phrase, replay a conversation over and over in your mind, pray repeatedly to neutralize an unwanted thought, or mentally retrace events to make sure you didn’t do something wrong.

You can struggle significantly with OCD without the people around you noticing a single ritual.

How the OCD cycle keeps going

Suppose an intrusive thought suddenly pops into your head: What if I left the stove on? The thought produces anxiety, so you return to the kitchen and check. When you see that the stove is off, your anxiety drops.

The problem is that the relief doesn’t necessarily last. Because checking made you feel better, your brain can learn to seek the same reassurance the next time doubt appears. Soon you may feel compelled to check twice, then five times. Perhaps you begin taking a picture of the stove before leaving home, or find yourself turning around halfway to work just to make absolutely certain.

Compulsive behaviors may provide temporary relief from distress, but they don’t resolve the underlying obsession. Over time, the cycle can become increasingly disruptive.

When does it become OCD?

Almost everyone experiences an intrusive thought occasionally. You may also double-check the front door before leaving or wonder whether you unplugged the curling iron. Those experiences alone don’t mean you have OCD.

The difference lies largely in the extent of distress and disruption the thoughts and behaviors cause. According to the International OCD Foundation, OCD symptoms may consume more than an hour each day, cause significant distress, or interfere with activities and relationships that matter to you.

If rituals routinely make you late, intrusive thoughts keep you from concentrating, or you avoid people, places, or activities because of your fears, it’s worth seeking professional help.

Breaking the cycle starts with understanding it

OCD can occur alongside anxiety, depression, and other mental health conditions, so getting an accurate diagnosis matters. At Oasis Health and Wellness, we begin with a comprehensive psychiatric evaluation to better understand your symptoms, including the particular obsessions and compulsions affecting your life.

From there, we develop a personalized treatment plan. Depending on your needs, care may include medication management, education and coping strategies, ongoing monitoring and treatment adjustments, and coordination with other healthcare professionals. We also provide convenient telehealth appointments throughout Tennessee.

If unwanted thoughts and repetitive rituals are consuming your time or interfering with work, relationships, or everyday life, call our office at 615-282-8312 or book an appointment online today. Understanding the cycle can be an important first step toward loosening its grip.