Understanding obsessive compulsive disorder (OCD) can feel complicated, especially when there’s so much misinformation about the condition. You might find yourself questioning if you have OCD, unsure whether your thoughts and behaviors match what you’ve heard about it—like the common misconception that OCD is just about being neat or having compulsions around cleaning. Or maybe you’re trying to have a better understanding of the experiences of a loved one who lives with the condition. Either way, getting a true sense of what OCD feels like is crucial, not only for recognizing whether it might be part of your life, but also for offering empathy and support to those who struggle with it.
Part of what makes OCD difficult to grasp is that the condition often looks different from what people expect. There are numerous TV shows and movies that show OCD as a quirk or downplay the serious mental toll it can take, making people assume it’s less of a serious condition than it is. Whether you’re looking for clarity about your own feelings or trying to relate to someone else’s, understanding how OCD feels helps bridge the gap between the condition and the people it affects.
Let’s explore what it really feels like to have OCD, why OCD thoughts feel so real, and what can be done to get relief from OCD symptoms.
What is OCD?
OCD is a mental health condition that involves experiencing repetitive intrusive thoughts, images, or urges known as obsessions. To relieve the distress and anxiety the obsessions cause, people with OCD engage in repetitive behaviors or mental rituals called compulsions. These compulsions offer temporary relief, but make the cycle of obsessions and compulsions worse over time.
OCD isn’t as rare as you might think—it affects about 1 in 40 people. Dr. Patrick McGrath, Chief Clinical Officer at NOCD, shares that people with OCD often know and understand their actions and thoughts aren’t always rational. “Instead of focusing on school, work, family, friends, health or recreation, people with OCD end up spending their time and energy on compulsions. Most of them know this behavior is illogical, but this doesn’t convince their brain that it can take a break and stop seeking certainty all the time,” he explains.
While OCD can make certain parts of life challenging, with the right treatment and support, it’s possible to manage your OCD and prevent it from taking over your life.
Intrusive thoughts
A key component of OCD is the presence of intrusive thoughts, which are known as the “obsessive” part of the disorder. These unwanted thoughts, however, can manifest in many forms beyond just words in your mind. Intrusive thoughts may appear as distressing images, ideas, or memories, often leading to feelings of OCD paranoia and heightened anxiety.
Intrusive thoughts can be about a wide range of topics, including germs or contamination, morality, a need for symmetry or order, or even disturbing scenarios of harm. Sometimes, depending on the subject, these thoughts can cause groinal responses—an involuntary physical sensation in the genital area that can happen even when the thoughts are unwanted.
People with OCD might experience overwhelming OCD feelings of terrible events happening in critical moments. “Imagine being in an interview for your dream job, only to suddenly fear that you’ll receive terrible news, like a terminal diagnosis,” said Dr. McGrath. Or imagine meeting a new baby and fearing that you might lose control and harm the child. “While most people would dismiss these thoughts as irrational or bizarre, someone with OCD may feel that these intrusive thoughts are real possibilities,” he explained. This can lead to engaging in mental or physical rituals to “protect” against the thoughts. Unfortunately, the more you try to suppress or neutralize these thoughts, the more you get stuck in the cycle
Examples of intrusive thoughts, images, urges, sensations and memories
Intrusive thoughts are personal and can look different for each individual—while one person might experience intrusive urges, another might keep seeing disturbing images. It’s also important to note that you may experience more than one form of intrusion at the same time. “Your intrusive thoughts may show up in just one form, or in a mishmash of forms,” shares Dr. McGrath.
Here are some of the ways these intrusions can appear:
- Intrusive thoughts: These show up as highly charged statements that flood your mind.
- Example: Feeling contaminated after touching a public bathroom door.
- Example: Feeling contaminated after touching a public bathroom door.
- Unwanted images: Your intrusive thoughts may appear as extremely vivid images or mini-movies playing on the screen of your mind.
- Example: A scene popping into your mind where you murder your family with a knife.
- Example: A scene popping into your mind where you murder your family with a knife.
- Unwanted sensations: Perhaps you have noticed a sensation somewhere in your body that gives you pause. Something that felt out of context or caused you to worry about what it meant that you felt it,” says Dr. McGrath.
- Example: A sudden irregularity in your heartbeat while you are sitting on the couch watching TV.
- Example: A sudden irregularity in your heartbeat while you are sitting on the couch watching TV.
- Unwanted ideas: These intrusive thoughts tend to show up as “What if?” questions that seem to come out of nowhere.
- Example: Thinking, “What would happen if I pushed this person into oncoming traffic?”
- Example: Thinking, “What would happen if I pushed this person into oncoming traffic?”
- Unwanted memories: “This is a particularly sneaky trick that OCD tries to play, because it can root itself in something that actually happened,” Dr. McGrath explains. The real-life basis of an idea makes it seem like a more real problem for you to pay attention to, even though it is still an intrusive thought.
- Example: Recalling over and over the time you made a social blunder in elementary school.
- Example: Recalling over and over the time you made a social blunder in elementary school.
- Unwanted urges or impulses: Sometimes intrusive thoughts aren’t verbal or visual but more physical. “You may feel an urge to do something or act out in some way that is inconsistent with who you are as a person and the values you hold,” explains Dr. McGrath.
- Example: Standing on a roof deck and suddenly having the urge to jump.
Intrusive thoughts, images, sensations, ideas, memories, and urges can manifest in many different ways and no two people’s experiences with OCD are exactly the same.
Whether you experience just one form or a combination, it’s important to remember that these thoughts and urges do not reflect who you are or your values. Intrusive thoughts may feel real and deeply unsettling, but they are just that—intrusions. Recognizing them for what they are is the first step toward managing their impact.
What is it like to have OCD?
One of the best ways to understand what OCD feels like is by looking at real-life examples of how it can latch onto daily life. Dr McGrath provides an example: “Imagine you’re a 12-year-old kid, and you’ve just gotten home from school. You’re ready to breeze through your homework so you can go hang out with your friends, but your mom reminds you that you need to clean your room first,” he explains. “You know you won’t be able to convince her otherwise, so you start tidying up quickly, just wanting to get it over with. But then, a thought hits you: My sister is going to die unless I do this right.”
“Suddenly, the panic sets in,” says Dr. McGrath. “Your mind starts racing: If I don’t fold everything perfectly, it’ll be my fault if something happens to her. Your stomach feels sick, you’re getting dizzy, and you feel like you just have to tell someone about the thought. But you know it sounds crazy, so you don’t. Instead, you start over, determined to get it right. You fold your green shirt, then the blue one, and finally the red one—thinking, If I don’t get this right in two tries, she’s going to die. The fear becomes unbearable, and you begin again, caught in a cycle of dread.”
This isn’t some extreme or rare case. Dr. McGrath says it’s a real example adapted from a patient’s story, giving a glimpse of what it is like to have OCD. In this case, the intrusive thought and obsession is, “My sister is going to die unless I do this right.” Mental and physical distress coincides with the obsession, until it becomes seemingly unbearable. Then, to protect the sister and get rid of distress, the compulsion kicks in: folding the clothes in a certain way to somehow “protect” the sister. Of course, there’s no actual link between folding clothes and someone’s wellbeing, but OCD creates a logic that feels painfully real, convincing the person that they must act.
Most people with OCD know their behavior is illogical, but this doesn’t convince their brain that it can take a break and stop seeking certainty all the time. That’s why explaining to someone with OCD that their actions are irrational probably isn’t doing them any good. They already know this—in fact, their frustration at not being able to control their thoughts and compulsions despite knowing that they are irrational is itself a source of distress.
OCD can wreak havoc on every part of someone’s life. It doesn’t help that the people around them misunderstand their symptoms, calling them control freaks, neat freaks, obsessive, or “sort of OCD.” As it turns out, people with OCD don’t really want control (in the form of neatness, or cleanliness, or whatever else). They feel like they need control because their mind is constantly telling them things aren’t alright, and because lacking control leads to overwhelming distress.
Why OCD feels so real
For people without OCD, intrusive thoughts might pop up every now and then, but they don’t linger. These individuals have the mental filter to dismiss them, confident that the thought doesn’t mean anything.
But for those with OCD, that filter isn’t working. When an intrusive thought arises, intense fear and anxiety follow, triggering a fight, flight, or freeze response. “This is why OCD feels so real. There is a very real process taking place in your brain. The problem is that it is a faulty alarm; there is no actual danger,” says Dr. McGrath. The mind screams that action is necessary, but the situation doesn’t warrant it.
OCD hijacks your brain’s alarm system, convincing you that danger is looming, even when there’s none. You’re left feeling all the panic of an imminent threat that simply isn’t there.
How to manage your OCD: effective treatment
OCD can be very overwhelming. The intrusive thoughts and ritualistic behaviors people perform for relief can interfere with daily life, making even simple tasks feel like enormous challenges.
The good news is that there is a clinically proven treatment that can help: exposure and response prevention (ERP) therapy. In ERP, you’ll work with a trained therapist to face your fears in a gradual, supportive way. You’ll identify the thoughts and triggers that provoke your anxiety and, instead of turning to compulsions, you’ll learn to sit with the discomfort until it fades naturally.
This process may sound difficult, but ERP is designed to help you slowly build confidence and break the cycle of OCD. With the right guidance and support, you can learn to manage your symptoms and live a life where OCD no longer controls you.
“In time, most people find that their anxiety decreases and their intrusive thoughts become much less problematic. Sometimes, those intrusive thoughts even fade into the background,” says Dr. McGrath.
Bottom line
If you, or someone you are close to, has OCD, there is hope. With the right treatment, like ERP therapy, you can take meaningful steps toward managing your symptoms and regaining control. Taking that first step might feel scary, but it’s a courageous choice that will lead to lasting change.