Common OCD Themes: You’re Not Alone

People with OCD typically struggle for 14-17 years before landing proper help. 14-17 YEARS! OCD creates all of these “what ifs” in our minds that often make us question reality. “What if I’m actually going crazy?” In our society, people commonly identify with OCD as if having it is a cool thing. We hear those around us talking about how “they are sooo OCD” because they like to be organized or wash their hands a tad more than the average person. Listening to others speak of OCD in such a nonchalant way can cause us to feel even more lonely. 

What’s worse than people not getting it? People thinking they understand when they don’t. People passing OCD off as if it’s no big deal. I want to help end this misconception. I want people to better understand OCD themes so those who struggle and their families gain the respect they deserve for bearing this indescribable weight. Below are common OCD themes. Can you relate?


Sure, people who struggle with contamination may wash their hands a lot or clean more often. But it is far more than that. It’s waking up every morning washing their hands until they feel just right. And feeling just right may not happen until hand wash #47, 55 minutes later, having to start over each wash if just one thing was out of order from the routine. Failing to wash their hands just right day after day results in bleeding hands and after the bleeding has stopped, looking raw and cracked. Fear of contamination results in taking scalding hot showers for 3 hours every morning and night to decontaminate. These folks often feel like they can’t go anywhere in public because they have no control over others. Just the thought of door handles, public bathrooms, or shaking people’s hands can send these folks into a panic attack. Sometimes, the fear of getting sick or passing an illness along to someone else is enough to send them into spiral. 

Harm OCD 

Harm OCD is not one that is commonly known, yet comes in a close second to the number of contamination cases I see. Why? Because these thoughts are not exactly ones that someone struggling is proud of, especially if they haven’t learned that these thoughts are a symptom of OCD. Harm thoughts often include thoughts of hurting a loved one, fear of stabbing Dad with a steak knife, fear of throwing a baby off a balcony. Even scarier yet, OCD makes you believe that the possibility of committing these horrendous acts of crime is just a matter of time before it happens. So folks struggling try to avoid anything that can remotely resemble a weapon or the person the thoughts are targeting. They even tend to avoid cutting up vegetables for dinner. They see horror video clips in their mind, where they can’t stop picturing murdering the person they care most about. Notably, people with Harm OCD are typically the sweetest people in the world. They are not actually going to harm a soul. How do I know? Well people who follow through on harmful acts are not those who panic at the very thought of following through. The people who harbor these thoughts are petrified by them, they hate every part of the experience, and sometimes they fear this possibility so much that it drives them to think that maybe the solution is harming themselves to avoid the possibility of harming someone else.

“Just Right” OCD 

“It just doesn’t feel right.” Folks who experience this theme can’t explain why things don’t feel right to themselves or others. Things just need to feel right to them; otherwise, it feels like they need to do it over and over again until it feels “just so”. Unlike other OCD themes, “just right” doesn’t necessarily have anything to do with fearing something bad will happen. It just FEELS like you have to. Sometimes, hand washing can be mistaken for contamination OCD or for ordering/ symmetry OCD. “Just right” OCD has no logic to it’s thoughts. People who carry this theme may just be doing things over and over so they feel capable of moving on to other parts of their day. This person may feel incapable of getting to school or work on time. Maybe they even miss school or work entirely because they got caught up in a routine. “Just right” OCD stalls people’s daily lives until the “perfect” feeling arrives. 

Scrupulosity (Religious or Moral OCD)

Scrupulosity is defined by a person experiencing moral or religious obsessions, typically causing them to feel like a terrible person. These individuals are overly concerned that they may act or have already acted in a sinful or morally obstructive way. They may experience excessive guilt or worry about whether or not they are following through on religious or moral teachings, being loyal to their higher power (e.g. God), blasphemy, sin, morality, right and wrong, thoughts of curse words, etc. They may feel the need to confess their thoughts, pray excessively, or repeatedly imagine sacred images or scripture in efforts to neutralize the thoughts. What’s most frustrating is that OCD targets this part of their life that is so highly valued. Worse yet, they cannot enjoy the religious or spiritual community due to the intrusive thoughts. Many times, it is helpful for therapists to speak with members of the clergy to gain a clear understanding of what is morally expected in their religious or spiritual community. Scrupulosity is often not in line with typical practices in their religion, causing significant confusion and distress. 

Relationship OCD 

This type of OCD is INCREDIBLY frustrating to the person experiencing it. Oftentimes, a person in a very loving and committed relationship will begin to have doubts about whether or not they should be with their partner. It is hard to depict OCD thoughts from personal thoughts. Those who experience this may find themselves constantly and relentlessly checking in with themselves and their partner about the strength and value of the relationship. Folks may feel guilty about their uncertainty within the relationship so they confess to their partner. When OCD first begins to creep up, the sufferer’s partner often reassures them in their confidence regarding their relationship. As time goes on, partners become frustrated with the constant uncertainty and doubt about the OCD sufferer’s ability to commit, thus leaving the relationship in turmoil. 

Order and symmetry 

Everything has a place. Orders and systems are there for a reason. Rules have a purpose. For those with order and symmetry OCD, when things are out of place, anxiety spikes through the roof. Sometimes, magical thinking occurs where folks with this theme fear that if they do not keep to order or symmetry, something bad will happen. These individuals are fully aware that their fears are irrational, that one thing out of place does not cause harm to people they love. And yet, they can’t help but to abide by OCD’s made up rules just in case. 

Unwanted sexual thoughts 

This is as petrifying as it sounds. This may include incest, pedophilia, intrusive thoughts of being a different sexual orientation than you are or want to be, or any other intrusive sexual thought. One myth I want to bust right now is that people with unwanted sexual thoughts do not act on them. They live in constant fear because of them. Imagine loving your nephew and having thoughts of being sexually attracted to him. Imagine thoughts of having sex with your mom over and over. Imagine being happily married, yet having this excruciating doubt that you’re actually attracted to the opposite sex even when you’ve always been sure of your sexual orientation. A very common symptom of this type of OCD is frequently feeling sexually aroused when confronted with a trigger, which tricks sufferers even more so into believing the thoughts. I want people to know this is common and not indicative that the thoughts will come true. So what do people with this type of OCD do? They avoid, avoid, avoid as much as possible. They try to escape anything that triggers the thoughts to go off. They constantly check in with bodily sensations to ensure they do not feel aroused and consequently, may end up feeling unwanted arousal. They seek reassurance from others often and confess their thoughts or on the flip side, keep these thoughts secret for years. Their life becomes much smaller because soon enough, everything triggers them. 

Obsessions related to perfectionism

Perfectionists often do well in school, in the workplace, with organization and order, and with making plans. All good qualities. When someone experiences OCD perfectionism, it most likely feels like success… until it feels debilitating. Perfectionism causes severe all or nothing thinking. People either want to complete the task at hand absolutely perfectly with no flaws in sight, but this requires checking upon checking, rewriting, rereading, redoing. It takes hours and hours, and it never actually feels perfect. Sooner or later, people find themselves feeling too overwhelmed to complete a task when trying to measure up next to “perfect”. It’s exhausting and feels impossible, so people stop trying altogether. A person’s bedroom may go from immaculately clean to a pig-sty. Students may go from having straight As to getting Ds and Fs on tests and assignments because it’s too draining to study or complete homework. Those working may stop completing projects or stay home from work altogether. The key is striving for excellence, not perfection, but for those with perfectionism OCD, it feels like an endless loop. 

Obsessive fears of losing control/ “going crazy” 

Excessive fears about becoming possessed, having a psychotic break, becoming a mass murderer and enjoying it. All are intrusive thoughts under this theme’s umbrella. Folks experiencing this are terrified. They do everything possible to prevent their fears from occurring. These folks often check to make sure they are not seeing things. I’ve seen many avoid horror films, haunted houses, things related to halloween…not because they just aren’t interested. Because, “what if engaging in these activities increases my chances of going crazy?” Anything that reminds them of losing control in some way can cause mass amounts of anxiety. 

Postpartum OCD

New moms and dads want nothing more than a healthy baby and to raise their child to be a respectful, happy, successful, and giving person. New parents dream of being able to come home from the hospital and spend joyous time with their family. Many of us have heard that this can be a struggle for some mothers. Postpartum anxiety and postpartum depression are struggles our society is familiar with, but postpartum OCD is not so widely known. This affects new mothers mostly, but new fathers can be affected too. Tormentingly, parents may have intrusive thoughts of hurting their baby, killing their baby, sexually abusing their baby, or emotionally damaging their baby. Due to how scary and real these thoughts may feel, parents avoid their newborn and then feel guilty for the disconnection. Imagine the guilt, shame, and distress during the precious first few months of a baby’s life. 

Health OCD 

It starts with one sensation in their body. Perhaps a few more pop up. The person with OCD begins to research on WebMD and strings together a diagnosis that reflects some symptoms they’ve had. The next thing they know, they are spending hours a day researching symptoms and searching for answers, excessively checking sensations in their body, asking for reassurance from everyone they are close to, especially their doctors. These folks may be afraid they have a serious illness or disease like cancer. Receiving confirmation from medical professionals that they do not have their feared illness is important, yet every time they get confirmation, it doesn’t feel like enough. Second, third, fourth, and fifth opinions feel needed. OCD convinces sufferers that it is FACT that something is wrong. And how petrifying does it sound to truly believe with all your heart that something is seriously wrong but the doctors can’t figure it out? These folks fear that if they cannot obtain certainty and confirmation from professionals, that something truly bad will happen. 


I’m thinking that if you’ve read this, you either have OCD yourself, are generally an anxious person, or know someone you struggles with this beast. I hope reading these themes has helped you understand that OCD is far more complex than having to turn light switches on and off or washing your hands pretty often. OCD has the potential to ruin lives and unfortunately has so powerfully and negatively affected countless lives already. While it can take on different masks for those OCD affects, it can have similar negative impacts. OCD often affects the entire family. OCD draws in family members to participate in rituals and reassurance. It often ends up interfering with people’s ability to go to school or work. This illness affects appetite, sleep habits, energy levels, and after suffering for awhile, people with OCD may also be affected by depression as well. Those with OCD may retreat from social events or spending time with friends and relationships altogether. When severe, it has caused people to stay bed or house ridden.

If you know anyone else who can benefit from learning a bit more, please share this with them. I’ve had way too many clients tell me that they’ve had these symptoms for years and years not knowing what it was or what to do about it. So let’s help everyone we can get connected with knowledge and help as soon as possible.