By Miriam Aliberti —

Emma climbed into the roller coaster seat. She clicked the safety bar into place. Her palms were sweaty with anticipation. She loved roller coasters and this one was a triple loop! Then the thought came – What if something bad happens?  She turned her head and looked at the boy in the seat behind her. Then she turned and looked at him again and again and again. His face wrinkled up in confusion. Why did this girl keep flipping her head back and forth to look at him? She counted 8, 9, 10. Finally, she could stop.  It was embarrassing. Something in her head told her she had to look at the boy behind her ten times or someone might fall off of the roller coaster. Then something in her head told her to tap the seat belt ten times and touch her nose five times. Emma did everything her brain was telling her to do because she didn’t want anyone to get hurt. She knew it wasn’t logical but she couldn’t stop worrying that it might happen anyway. Emma has a psychological condition called OCD.

What is it?

Obsessive-Compulsive Disorder is a mental health issue that involves obsessions and compulsions. Obsessions are thoughts that just won’t go away. The thought repeats over and over in the person’s mind causing anxiety and distress that can sometimes become extreme. These thoughts cause fear or the sense that something is “just not right.” The thoughts can be an image, memory, idea, impulse or other annoying thinking that the person does not want and can’t control. Compulsions are the behavior that the brain tells the person they must do to make the anxiety go away and make things okay again. A compulsion is a thing that you do such as washing your hands, touching something multiple times, or checking the door to make sure its locked even though you know you have already locked it. Some people only have obsessions or compulsions but most people have both. OCD can become severe and get in the way of school, work, and relationships. Many people with OCD have characterized it as a big bully that just won’t leave you alone.

What OCD is not

Most of us can relate to occasionally having obsessions. Maybe you can’t help thinking about something mean that someone said to you and your mind keeps wandering back there. Maybe you like to color coordinate the clothes in your closet or check to make sure the iron was turned off a couple of times. These thoughts and behaviors alone would not be labeled as OCD. True OCD is a disorder that can make it very difficult to have a normal lifestyle. The thoughts won’t go away until you perform the behaviors that your brain says are necessary to make the anxiety, fear, and negative feelings go away. Sometimes a person with OCD will feel like something bad is going to happen to them or someone they love if they don’t complete the compulsive behavior. This can be very upsetting and a lot of work. The requirements of the OCD begin to take more and more time and cut into other stuff like homework and fun with friends. Some people quit hanging out with their friends because the OCD makes them do things that can be pretty awkward. How do you explain that you have to line up your sour patch kids according to color before you can eat them or that you are lagging behind because you have to touch every crack in the sidewalk three times before you can cross it? True OCD causes feelings of fear, worry, and the sense that something is very wrong even when there is no reason to feel that way. It’s normal to worry that someone you love will get in a car accident or that you answered a question wrong on your math test. These types of thoughts don’t necessarily mean you have OCD. Most people can think those things but then forget about it and move on. Someone with OCD gets hung up on the thought and can’t complete a task. They will often spend an hour or more of each day worrying about a thought or doing a behavior to relieve the stress caused by the thought. Some people say they are “sooo” OCD because they are very clean or very organized but OCD is much more than that. My friend Christina has struggled with OCD since 5th Grade. One story she tells is about a time when she had a handwritten paper due. She finished her paper right after school but then her brain told her that she needed all of her A’s to be perfect. She stayed up until 2:00 a.m. erasing over and over until there were holes in the paper where the A’s used to be. Her brain was telling her something bad would happen if she did not make all of the A’s just right. She felt responsible to fix all of the A’s so that nothing bad would happen to the people around her. Now 22 years old, she says “I wish people wouldn’t say I’m so OCD. It minimizes how hard it is to live with OCD and makes it seem like no big deal.

Who gets OCD?

OCD is more common than you would think. If you suffer from OCD, you are not alone. According to the book Talking Back to OCD “One in 200 young people suffers from obsessive-compulsive disorder.” That means there is a good chance you know someone right now who struggles with OCD.

What causes OCD?

Researchers don’t know for sure exactly what causes OCD but there is some evidence to show that it may be related to chemical irregularities in the brain. Tamar Chansky, Ph.D. states in her book Freeing Your Child From OCD that “In OCD, the part of the brain that filters information is not functioning properly, causing certain thoughts to get stuck which should just be forgotten.” It is also believed that OCD has a genetic component which means that the chance of a person having OCD is increased if a family member has OCD. Believe it or not, occasionally illness can cause OCD in children. One form is called PANDAS and according to the National Institute of Mental Health it can show up suddenly after a bout of strep throat.

How do I know if I have it?

It is important to know that only a professional person like a psychologist, psychiatrist, specially trained nurse or therapist can accurately diagnose OCD.  It may be time to consult a professional if obsessions and/or compulsions make it difficult to get through your day normally, when it starts taking a lot of time out of your day, makes you not want to hang out with friends, or makes you unhappy.  If the doctor or therapist believes a person has OCD, they may give them a test called the Y-BOCS. It is used as a rating scale for OCD and is considered quite reliable for determining the severity of the disorder. Some people are relieved to finally know what is happening and to be able to name the problem. They are then able to obtain treatment and get support. Talking with others who have a shared understanding can feel really good.

What are the signs and symptoms?

Most people who have OCD will sense that something is wrong but may not know or understand what is happening to them. They may feel embarrassed to tell anyone the thoughts they are having. The OCD might tell them not to say anything or something bad might happen. Here is a list of some of the more common signs and symptoms of people with OCD provided by the National Institute of Mental Health:

Obsessions are repeated thoughts, urges, or mental images that cause anxiety. Common symptoms include:

  • Fear of germs or contamination
  • Unwanted forbidden or taboo thoughts involving sex, religion, and harm
  • Aggressive thoughts towards others or self
  • Having things symmetrical or in a perfect order

Compulsions are repetitive behaviors that a person with OCD feels the urge to do in response to an obsessive thought. Common compulsions include:

  • Excessive cleaning and/or handwashing
  • Ordering and arranging things in a particular, precise way
  • Repeatedly checking on things, such as repeatedly checking to see if the door is locked or that the oven is off
  • Compulsive counting

These are just a few of the types of symptoms commonly seen in patients. The disorder can affect everyone differently and OCD symptoms can change or come and go often worsening under stressful conditions. Many OCD patients say that they noticed symptoms in childhood but OCD can also begin in the teenage years or even adulthood.

What do I do about it?

Once a person understands what is happening to them, the hard work and magic can begin. The sooner a person with OCD gets help, the better. OCD can worsen if left untreated. Research and treatment for OCD continue to improve and many treatments are highly effective allowing OCD to become very manageable. If you have OCD, it’s reassuring to know it’s possible to get back to a normal life! A clinician will help you decide the best treatment methods which may include types of psychotherapy and or medication. Listed below are some of the most widely used and effective treatments for OCD:

CBT (Cognitive Behavioral Therapy) – This type of therapy is based on thinking about your thoughts. If thoughts are seen as negative and scary, the body and brain will react with fear or anxiety. The idea behind CBT is to change the pattern of thinking that is creating the problem and helping the brain to sort through the thoughts in a more appropriate way. It’s kind of like reprogramming a computer or giving your brain new software.

ERP (Exposure Response Therapy) – This type of therapy helps someone to stand up to OCD. It helps the person to learn how to do the opposite of what the OCD says to do. This means not doing a ritual at all or doing it differently than the OCD says such as washing the hands 5 times instead of the 20 times requested by the OCD. The OCD gets weaker as the person gets stronger and says NO to the OCD.


Many people can get control of their OCD with just psychotherapy but sometimes a little help from medication is needed if it is too difficult or scary to complete the therapy. The medication can make it easier to begin therapy and is sometimes only needed for a short while. The International OCD Foundation suggests that the most effective medication prescribed for OCD is something called an SRI (Serotonin Reuptake Inhibitor). This medication helps to balance out the brain chemistry and make it easier for some people to follow through on treatment.

If you think you or someone you know might have OCD, don’t be afraid to ask for help. Lots of people have OCD. Sometimes it can feel good to know what is happening with you and to talk with other people who are experiencing the same or similar issues.

Help and Resources for OCD


OCD Support Group of the Valley

Treatment Centers


The Gateway Institute

Informative Websites

International OCD Foundation

NIMH (National Institute of Mental Health)

NAMI (National Alliance on Mental Illness)


Books about OCD

Talking Back to OCD: The Program That Helps Kids and Teens Say “No Way” –and Parents Say “Way to Go” by John S. March and Christine M. Benton

Freeing Your Child from Obsessive-Compulsive Disorder: A Powerful, Practical Program for Parents of Children and Adolescents by Tamar Chansky

The Mindfulness Workbook for OCD: A Guide to Overcoming Obsessions and Compulsions Using Mindfulness and Cognitive Behavioral Therapy by Jon Hershfield, MFT, Tom Corboy, MFT