What Are the Warning Signs of OCD?

Medically Reviewed on 10/5/2022
What Are the Warning Signs of OCD
Warning signs of OCD may include obsessively washing hands or repeating certain actions over and over

Obsessive-compulsive disorder (OCD) is a mental illness that can cause a person to feel compelled to engage in repetitive behaviors.

Warning signs of OCD are different for everyone, but the most common include:

  • Obsessively washing hands
  • Repeating actions over and over
  • Counting in certain patterns
  • Silently repeating words or phrases
  • Arranging items to face the same way
  • Feeling nervous about certain things in their environment
  • Unwanted thoughts, including aggression or sexual or religious subjects

However, some people with OCD may have other symptoms, such as excessive cleaning or hoarding. Others may be obsessed with the idea that they have a disease or an infection even though they do not.

What are the main symptoms of OCD?

Experts have divided symptoms of obsessive-compulsive disorder (OCD) into specific categories:

Symmetry symptoms

Symmetry OCD is often diagnosed at an early age. People with these symptoms feel an urge to keep everything in order, symmetry, or perfection. They tend to spend hours positioning objects perfectly and may write or rewrite lists repeatedly. 

Failure to keep things in order can make the person feel stressed and anxious. They may also have a fear that unorganized things may cause unrelated harm to them or their loved ones. Some examples of symmetry symptoms include:

  • Keeping things in symmetrical order
  • Obsessively making sure everything on their desk is neat 
  • Making labels on the cans in the pantry face the same way
  • Leveling all wall hangings

Common obsessions of symmetry OCD include:

  • Constantly worrying that something bad will occur if an object at home or work is uneven (pillows on a bed or books in a bookcase)
  • Intense anxiety over asymmetry
  • Extreme need for stability, such as placing items symmetrically or walking with the same pressure on each foot

Common compulsions of symmetry OCD include:

  • Writing a set number of words on each line on a page and keeping words directly symmetrical
  • Rewriting words and letters until there are no noticeable flaws or asymmetries in handwriting
  • Arranging clothes or shoes in a specific manner in the closet
  • Avoiding areas having symmetrical geometric shapes, so they don’t feel constrained to trace the edges with their eyes

Contamination symptoms

People with these symptoms are constantly worried about being contaminated with dirt or germs, causing them to perform various compulsive actions to combat their fear and anxiety. Examples of contamination symptoms include:

  • Fear of germs or dirt
  • Bathing or washing hands repeatedly
  • Refusing to touch doorknobs or shake hands 
  • Cleaning items frequently

Common obsessions seen with contamination OCD include:

  • Extreme fear of getting “contaminated” by touching certain substances or items in particular places
  • Obsessive fears about sticky residue, grease, or dirt on body or clothing
  • Obsessive fears about HIV, blood, cancer, bodily fluids, feces, or urine
  • Extreme fear of being coughed or sneezed on
  • Fear of wearing clothes that have been contaminated with anything
  • Fear of spreading contaminants around the house, car, personal belonging,s or bedroom

Common compulsions associated with contamination OCD include:

  • Repeatedly washing and cleaning (washing hands, disinfecting, etc.)
  • Excessive and ritualized showering that may be time-consuming
  • Avoiding public spaces
  • Avoiding touching other people
  • Changing clothes often or discarding clothes or other items that have become contaminated
  • Seeking reassurance that they have not been contaminated

Unacceptability symptoms

Unacceptability symptoms are characterized by intrusive, aggressive, sexual, or religious thoughts. People exhibiting these symptoms may neither agree with their symptoms nor act to reverse them. These intrusive thoughts can cause:

Some examples of unacceptability symptoms include:

  • Hurting loved ones
  • Causing harm to strangers
  • Repeating something mentally
  • Saying something aloud

Common obsessions of unacceptability symptoms include:

  • Intense fear of committing a dreaded action or acting on an undesirable yearning
  • Fear of contamination 
  • Fear of committing a sin or engaging in profane behaviors
  • Constantly suspecting their sexual orientation 
  • Fear of harming themselves or others

Common compulsions of unacceptability symptoms include:

  • Impulsively repeating a ritual to reduce their anxiety
  • Checking themselves or others to ensure that everyone is safe
  • Ruminating (continually thinking the same thoughts)
  • Seeking reassurance from others
  • Intense desire to perform a task perfectly
  • Avoiding objects, places, or people that can trigger intrusive thoughts
  • Constantly praying while doing other tasks

Harm symptoms

These symptoms are characterized by the fear of hurting themselves or their loved ones. People with these symptoms may experience a mental image of violence against themselves or others. As a coping mechanism, they may avoid the situation or person that triggers these symptoms. Some examples of harm symptoms include:

  • Fear of hurting yourself or your loved ones
  • Constantly checking on your loved ones

Common obsessions associated with harm symptoms include:

  • Fear that one day they may hurt a loved one or themselves
  • Fear of executing a violent act or giving in to a violent desire
  • Worry about committing an impulsive act, such as stabbing or killing someone
  • Worry about committing suicide before hurting someone
  • Anxious about falling unconscious and harming someone without even knowing

Common compulsions associated with harm symptoms include:

  • Compulsively checking themselves and others to confirm they didn’t harm anyone
  • Avoiding people or situations that may trigger the fear
  • Seeking reassurance from others to make sure no harm was done
  • Mentally rewinding memories to make sure no harm was done
  • Avoiding knives, pens, or other sharp objects to prevent harming someone

Hoarding symptoms

Hoarding symptoms are characterized by having difficulty letting things go. People with these symptoms tend to collect things that have no value and are useless. 

Common obsessions associated with hoarding symptoms include:

  • Difficulty organizing things 
  • Strong positive feelings (joy, delight) when acquiring new items 
  • Strong negative feelings (guilt, fear, anger) related to getting rid of items 
  • Beliefs that things are “valuable” or “useful” even when other people consider them useless
  • Feeling responsible for objects and sometimes thinking of inanimate objects as having feelings 
  • Denying the problem even when the clutter interferes with their life

Compulsions associated with hoarding symptoms include:

  • Difficulty getting rid of items
  • Collecting things to form clutter in home, office, car, or other spaces
  • Inability to resist free items, such as sugar packets from restaurants 
  • Buying things because they are a “bargain” 
  • Not allowing family or friends in the home due to shame or embarrassment 


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How is OCD treated?

Treatment of obsessive-compulsive disorder (OCD) may include:

  • Psychotherapy: Involves exposing the person to their obsession and helping them learn ways to resist their urge to perform compulsive rituals
  • Medications: Antidepressants approved by the FDA to treat OCD include:

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Medically Reviewed on 10/5/2022
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