Obsessions
These are unwanted ideas or impulses that repeatedly well up in the mind of the person with OCD. Persistent fears that harm may come to self or a loved one, an unreasonable belief that one has a terrible illness, or an excessive thought, such as, "My hands may be contaminated---I must wash them"; "I may have left the gas on"; or "I am going to injure my child." These thought are intrusive, unpleasant, and produce a high degree of anxiety. Often the obsessions are of a violent or sexual nature, or concern illness.
Compulsions
In response to their obsessions, most people with OCD resort to repetitive behaviours called compulsions. The most common of these are washing and checking. Other compulsive behaviours include counting (often while performing another compulsive action such as hand washing), repeating, hoarding, and endlessly rearranging objects in an effort to keep them in precise alignment with each other. These behaviours generally are intended to ward off harm to the person with OCD or others. Some people with OCD have regimented rituals while others have rituals that are complex and changing. Performing rituals may give the person with OCD some relief from anxiety, but it is only temporary.
Insight
People with OCD usually have considerable insight into their own problems. Most of the time, they know that their obsessive thoughts are senseless or exaggerated, and that their compulsive behaviours are not really necessary. However, this knowledge is not sufficient to enable them to stop obsessing or the carrying out of rituals.
Resistance
Most people with OCD struggle to "boss out" or banish their unwanted, obsessive thoughts and to prevent themselves from engaging in compulsive behaviours. Many are able to keep their obsessive-compulsive symptoms under control during the hours when they are at work or attending school. But over the months or years, resistance may waken, and when this happens, OCD may become so severe that time-consuming rituals take over the sufferer's lives, making it impossible for them to continue activities outside home.
Shame and Secrecy
OCD sufferers often attempt to hide their disorder rather than seek help. Often they are successful in concealing their obsessive-compulsive symptoms from friends and coworkers. An unfortunate consequence of this secrecy is that people with OCD usually do not receive professional help until years after the onset of their disease. By that time, they may have learned to work their lives--and family member's lives--around the rituals.
Long-lasting Symptoms
Most commonly, OCD is a lifelong condition. The symptoms may become less severe from time to time, and there may be long intervals when symptoms are mild or even absent, but for most individuals with OCD, the symptoms are chronic.