Understanding Obsessive Compulsive Disorder
Obsessive-Compulsive Disorder (OCD) is a mental health condition where the brain gets stuck in a cycle of unwanted thoughts and repetitive behaviours. These thoughts can feel upsetting, scary, confusing, or impossible to ignore. Despite what people often say, OCD is not just about being neat, organised, or liking things a certain way. It can be exhausting, time-consuming, and have a major impact on daily life.
OCD affects around 2% of Australians at some point in their lives.
It often begins in adolescence and is frequently missed for years because people try to hide or manage it on their own.
OCD is highly treatable, especially when the right support is provided.
What OCD Actually Is
OCD is made up of two parts that work together:
Obsessions
Obsessions are unwanted thoughts, images, or urges that keep showing up in your mind. They might:
Feel scary, upsetting, or disturbing
Create anxiety, doubt, or discomfort
Seem important even when you know they don't make sense
Feel completely opposite to the kind of person you are
Compulsions
Compulsions are behaviours or mental acts you feel driven to do in order to reduce the anxiety caused by the obsessions. They might include:
Checking
Washing
Repeating actions
Counting
Mentally reviewing events
Repeating phrases in your head
Asking others for reassurance
Compulsions usually make you feel better for a short time, but they also keep OCD going.
The OCD Cycle
OCD often follows a repeating pattern:
Obsessive thought → Anxiety or discomfort → Compulsion → Temporary relief → Obsessive thought returns
For example, someone might think: “What if I left the door unlocked?”
They feel anxious, check the door several times, feel relieved briefly, and then later the doubt returns.
The more the compulsion is repeated, the more the brain learns that the thought is important or dangerous. OCD is maintained by the search for certainty or relief from uncertainty.
Intrusive Thoughts
Intrusive thoughts are thoughts that pop into your mind without you wanting them there. Everyone experiences them - they are a normal part of how the brain works. You might suddenly think things like, “What if I embarrass myself?”, “What if something bad happens?”, or “What if I accidentally hurt someone?” Most people notice the thought and move on without attaching meaning to it.
In OCD, the difference is:
Certain thoughts get “stuck”
The brain treats them as important or dangerous
You feel like you need to do something to feel better or “fix” the thought
The problem is not the thought itself. It is the meaning and attention OCD attaches to it.
Common OCD Themes
OCD can attach itself to almost anything. Common themes include:
Contamination: fear of germs, illness, dirt, or contamination
Harm: fear that you might accidentally harm yourself or someone else
Checking: repeated checking of locks, appliances, schoolwork, or messages
“Just right”: needing things to feel a certain way or be done perfectly
Religious or moral: worries about being a bad person or doing something wrong
Sexual or relationship: doubts about relationships, feelings, or attraction
Existential: questions about reality, existence, or meaning that feel hard to let go of
The theme itself is not what makes it OCD. The cycle is what keeps it going.
What Helps Treat OCD
Exposure and Response Prevention (ERP)
ERP is the most effective treatment for OCD. It involves gradually facing situations that trigger OCD while resisting the urge to do the compulsion.
For example:
Touching something you think is contaminated and not washing straight away
Leaving the house without repeatedly checking the lock
Allowing uncertainty without seeking reassurance
This helps your brain learn that anxiety naturally reduces over time without compulsions, and that feared outcomes often don’t occur (or are tolerable even when uncertainty remains). ERP is done gradually with a therapist so it feels challenging but manageable.
Other Helpful Supports
Cognitive Behaviour Therapy (CBT) to understand how thoughts, feelings, and behaviours interact.
Acceptance and Commitment Therapy (ACT) to help you respond differently to difficult thoughts.
Medication (SSRIs) for some people, discussed with a GP or psychiatrist.
Family support to help reduce reassurance and behaviours that may unintentionally maintain OCD.
What Doesn't Help (Even Though It Feels Like It Does)?
Some things feel helpful in the moment but actually strengthen OCD over time:
Repeatedly acting out compulsions
Constantly seeking reassurance
Avoiding situations that trigger anxiety
Trying to suppress or force intrusive thoughts away
These strategies reduce anxiety short-term but strengthen OCD over time.
Getting Help
OCD can feel overwhelming, but it is very treatable. If you think you might be experiencing OCD, talking to a parent, trusted adult, GP, school wellbeing staff member, or psychologist can be a good first step.
Not all psychologists are trained in OCD treatment, so it can help to ask whether they have experience with ERP. A GP can also provide a Mental Health Care Plan, which may reduce the cost of psychology sessions.
Recovery does not mean never having intrusive thoughts again. It means learning that you do not need to respond to them with compulsions.
HELPFUL RESOURCES
KIDS HELPLINE
1800 55 1800
Free counselling 24/7 for young people 5-25.
LIFELINE
13 11 14 / lifeline.org.au
24/7 crisis support and suicide prevention
ANXIETY RECOVERY CENTRE VICTORIA
1300 269 438 / arcvic.org.au
Victorian-based support and information specifically for OCD and anxiety disorders.
IOCDF
International OCD Foundation — therapist directory, family resources, lived-experience stories.
HEADSPACE
Mental health support for young people 12-25 across Melbourne.
REACHOUT
Online support and stories from young people with OCD and anxiety.
