Obsessive-compulsive disorder (OCD) is an anxiety disorder that is manifested in a variety of forms, but it is most commonly characterized by a subject's obsessive, distressing, intrusive thoughts and related compulsions (tasks or "rituals") which attempt to neutralize the obsessions. It is important to distinguish OCD from other types of anxiety, including the routine tension and stress that appear throughout life. A person who shows signs of infatuation or fixation with a subject/object, or displays traits such as perfectionism, does not necessarily have OCD.

OCD is placed in the anxiety class of mental illness, but like many chronic stress disorders it can lead to clinical depression over time. The constant stress of the condition can cause sufferers to develop a deadening of spirit, a numbing frustration, or sense of hopelessness. OCD's effects ones day-to-day life (particularly in its substantial consumption of time) and can produce difficulties with work, finances and relationships. OCD is different from behaviors such as gambling addiction and overeating as people with these disorders typically experience at least some pleasure from their activity; OCD sufferers do not actively want to perform their compulsive tasks, and experience no pleasure from doing so.

Most OCD sufferers are aware that such thoughts and behavior are not rational, but feel bound to comply with them to fend off feelings of panic or dread. Because sufferers are consciously aware of this irrationality but feel helpless to push it away, untreated OCD is often regarded as one of the most vexing and frustrating of the major anxiety disorders.

Equally frequently, these rationalizations do not apply to the overall behavior, but to each instance individually; for example, a person compulsively checking their front door may argue that the time taken and stress caused by one more check of the front door is considerably less than the time and stress associated with being robbed, and thus the check is the better option. In practice, after that check, the individual is still not sure, and it is still better in terms of time and stress to do one more check, and this reasoning can continue as long as necessary.

In an attempt to further relate the immense distress that those afflicted with this condition must bear, the following example is commonly used. Implore yourself not to think of pink elephants. The point lies in the assumption that most people will immediately create an image of a pink elephant in their minds, even though told not to do so. The more one attempts to stop thinking of these colorful animals, the more one will continue to generate these mental images. This phenomenon is termed the "Thought Avoidance Paradox”, and it plagues those with OCD on a daily basis, for no matter how hard one tries to get these disturbing images and thoughts out of one's mind, feelings of distress and anxiety inevitably prevail.

To be diagnosed with Obsessive-Compulsive Disorder, one must have either obsessions or compulsions alone, or obsessions and compulsions, according to the DSM-IV-TR diagnostic criteria:

Obsessions are defined by:

a) Recurrent and persistent thoughts, impulses, or images that are experienced at some time during the
disturbance, as intrusive and inappropriate and that cause marked anxiety or distress.

b) The thoughts, impulses, or images are not simply excessive worries about real-life problems.

c) The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them
with some other thought or action.

d) The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her
own mind, and are not based in reality.

e) The tendency to haggle over small details that the viewer is unable to fix or change in any way. This
begins a mental pre-occupation with that which is inevitable.

Compulsions are defined by:

a) Repetitive behaviors or mental acts that the person feels driven to perform in response to an
obsession, or according to rules that must be applied rigidly.

b) The behaviors or mental acts are aimed at preventing or reducing distress or preventing some
dreaded event or situation; however, these behaviors or mental acts either are not connected
in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.

In addition to these criteria, at some point during the course of the disorder, the sufferer must realize that his/her obsessions or compulsions are unreasonable or excessive. Moreover, the obsessions or compulsions must be time-consuming (taking up more than one hour per day), cause distress, or cause impairment in social, occupational, or school functioning. OCD often causes feelings similar to that of depression.

The typical OCD sufferer performs tasks (or compulsions) to seek relief from obsession-related anxiety. To others, these tasks may appear odd and unnecessary. But for the sufferer, such tasks can feel critically important, and must be performed in particular ways to ward off dire consequences and to stop the stress from building up. Examples of these tasks would be repeatedly checking that one's parked car has been locked before leaving it; turning lights on and off a set number of times before exiting a room; repeatedly washing hands at regular intervals throughout the day.

Symptoms may include some, all, or perhaps none of the following:

Repeated hand-washing.

Specific counting systems — e.g. counting in groups of four, arranging objects in groups of three,
grouping objects in odd/even numbered groups, etc. One serious symptom which stems from this is
"counting" your steps, e.g. you must take twelve steps to the car in the morning.

Perfectly aligning objects at complete, absolute right angles, etc. This symptom is shared
with OCPD and can be confused with this condition unless it is realized that in OCPD it is not
stress-related.

Having to "cancel out" bad thoughts with good thoughts. Examples of bad thoughts are:
i) Imagining harming a child, and having to imagine a child playing happily to cancel it out.
ii) Sexual obsessions, or unwanted sexual thoughts. Two classic examples are fear of being
homosexual or fear of being a pedophile. In both cases, sufferers will obsess over whether or not they
are genuinely aroused by the thoughts.

A fear of contamination; some sufferers may fear the presence of human body secretions such as
saliva, sweat, tears, or mucus, or excretions such as urine or feces. Some OCD sufferers even
fear that the soap they're using is contaminated.

A need for both sides of the body to feel even. A person with OCD might walk down a sidewalk
and step on a crack with the ball of their left foot, then feel the need to step on another crack
with the ball of their right foot. Also, if one hand gets wet, the sufferer may feel very uncomfortable
if the other is not.

There are many other possible symptoms, and one need not display those above to suffer from OCD. Furthermore, possessing the symptoms above is not an absolute sign of OCD.

Community education have placed the prevalence between 1 and 3%, although the prevalence of clinically recognized OCD is much lower, suggesting that many individuals with the disorder are unaccounted for clinically. The fact that many individuals do not seek treatment may be due in part to stigma associated with OCD.

People who suffer from the separate condition obsessive-compulsive personality disorder are not aware of anything abnormal about themselves; they will readily explain why their actions are rational, and it is usually impossible to convince them otherwise. People who suffer from OCPD tend to derive pleasure from their obsessions or compulsions, while those with OCD do not feel pleasure but are ridden with anxiety.

OCD is ego dystonic, meaning that the disorder is incompatible with the sufferer's self-concept. Because disorders that are ego dystonic go against an individual's perception of his/herself, they tend to cause much distress. OCPD, on the other hand, is ego syntonic meaning the individual accepts that the characteristics displayed as a result of this disorder are compatible with his/her self-image. Ego syntonic disorders understandably cause no distress. This is a significant difference between these disorders.

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