The Complete Guide to Understanding, Diagnosing and Treating (2025)
It is estimated that 4% of Portuguese suffer from OCD - 1 in 25. But given the difficulties associated with diagnosis, it's possible that the number is higher. Is OCD a collection of manias?
Have you ever spent the whole day with a song in your head that you can't stop humming?
Now imagine that instead of a song, what you can't get out of your head is a thought negative, absurd and distressing. Imagine that the only way to relieve this anxiety is to repeat a specific action, such as washing your hands for 10 minutes.
Does it seem exaggerated? For those who suffer from OCD - Obsessive-Compulsive Disorder - this is a daily reality.
Many texts and articles have already been written about OCD, offering a general idea of what the disorder is and how it manifests itself.
This article is not just an introduction to this pathology - represents an in-depth journey into the knowledge of OCD, from the introduction to this disorder to the concrete steps we can take to reduce its impact, or even overcome it.
🧭 Table of Contents
- 1. 🧠 What is OCD?
- 2. 🔄 Difference between OCD and common manias
- 3. 🧩 Types of OCD
- 4. 📋 Most common symptoms of OCD
- 5. Causes and risk factors
- 6. 🔍 The diagnosis of OCD
- 7. 🧒 OCD in children and adolescents
- 8. Impact of OCD on daily life
- 9. 💊 How is OCD treated?
- 10. When to seek professional help
- 11. 🛠️ How to deal with OCD in everyday life?
- 12. Myths and truths about OCD
- 13. ⚠️ OCD and other comorbidities
- 14. 🧾 OCD vs OC personality disorder: what's the difference?
- 15. 📚 Resources and support available in Portugal
- 16. Conclusion
- 17. ❓ FAQ's about OCD (Obsessive-Compulsive Disorder)
What is OCD?
Obsessive Compulsive Disorder (OCD) is an anxiety disorder characterised by the presence of obsessions (unwanted and persistent thoughts) e compulsions (repetitive behaviours, physical or mental, that the person feels the need to perform).
Unlike simple manias or superstitions, OCD interferes with significantly the quality of life and the social, professional and personal functioning of the individual.
Difference between OCD and common manias
We all have our own habits and behavioural traits, but at first, habits don't cause us deep suffering in the course of our routine.
Checking that the door is locked, washing your hands, having a ritual before falling asleep, correcting the position of an object. We call these common and functional behaviours habits. The need for a footballer to step out onto the pitch on the right foot is called mania, superstition.
But when we talk about OCD, we're talking about pathological behaviour. What does this mean? That these are behaviours that go out of our rational controlwhich are excessiveand cause deep anguish and anxiety. In the vast majority of OCD cases, patients perceive obsessions as illogical. Alongside this, there is a clear and unsuccessful desire to put an end to obsessions.
Here's a simple comparison:
Features | Common Mania | TOC |
Frequency | Occasional | Repetitive, daily |
Impact on life | None or minimal | High, cause of suffering |
Control over the act | Easy to stop | Difficult or impossible to avoid |
Associated emotion | Tranquillity | Anxiety, disgust, guilt... |
Types of OCD
There are many different manifestations of OCD. Here are some of the most common:
- Verification Obsessionsobsession with safety (gas, doors, appliances...)
- Contamination Obsessionsexcessive fear of germs, "dirt"
- Obsessions of Symmetry and Orderneed for perfect organisation (switches in a specific position, successive breaks in work to organise elements...)
- Sexual Obsessionsunwanted sexual obsessions
- Obsessions associated with violence: constant violent thoughts and urges
- Moral/Religious Obsessions: constant obsession with not failing to fulfil any convictions or structuring guiding principles
- Identity Obsessionsobsessions related to doubts about identity
- Obsessions of Responsibility: constant obsession with not failing to fulfil orders and/or obligations
- Compulsive accumulationdifficulty discarding objects, even worthless ones
Each of these types can vary in intensity and impact, and many people have a combination of these standards.
Most common symptoms of OCD
Here are some of the most common symptoms reported by OCD patients:
- Intense anxiety
- Fear
- Repulsion
- Anguish
- Feelings of guilt
- Tension
- Tremors
- Increased heart rate
- Cold sweats
- Alertness and hyper-vigilance
- Insomnia
Causes and risk factors
Although there is no single cause found for the onset of OCD, there are several factors associated with its development:
- Geneticsfamily history
- Chemical changes in the brainreduced serotonin levels
- Environmentrigid upbringing, trauma or continuous stress
- Acquired behavioursassociation between thoughts and rituals, with positive reinforcement over time
The diagnosis of OCD
The diagnosis is made by a doctor psychiatrist or clinical psychologist through:
- Structured clinical interviews
- Observation of symptoms and duration (minimum 1 hour per day)
- Criteria DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) or ICD-11 (International Classification of Diseases, 11th revision)
It is important in the diagnostic process rule out other conditions. Generalised anxiety, depression, psychotic disorders or autism spectrum disorders deserve special attention from the professional guiding the process.
Important Note:The diagnosis of OCD is often hampered by natural tendency to hide behaviours related to the disorder. It is very important, in consultation, that the patient describe as accurately as possible the symptoms, and the contexts in which they appear.
OCD in children and adolescents
In younger age groups, OCD can manifest itself differently. Here are some examples to watch out for:
- Repeating long rituals before going to sleep ⟶ non-completion causes anxiety and inability to fall asleep
- Excessive fears → not overcome with any help
- Difficulty separating from parents → profound changes in behaviour, deep anxiety
Early identification is essential to prevent damage to physical, cognitive, emotional and social development.
Impact of OCD on daily life
This disorder can be especially challenging, compromising various areas of everyday life, such as the following:
- Professionalconstant delays, reduced productivity...
- Socialisolation, difficulty maintaining friendships...
- Family: tension with family members who don't understand the disorder...
- Mental healthemotional exhaustion, low self-esteem, depression...
How is OCD treated?
OCD is treatable, especially with a combination of:
- Cognitive Behavioural Therapy (CBT)Exposure Technique with Response Prevention (ERP)
- Medicationselective serotonin reuptake inhibitors (SSRIs)
- Complementary therapies: mindfulness, meditation, psychoeducation
- Neurotherapy: Transcranial Magnetic Stimulation (complemented by the Neurofeedback)
These methods are often applied as complementary in the treatment cycle. At NeuroPsyque, we mostly use the Psychotherapy (ERP) and Neurotherapy as pillars of OCD treatment.
The choice of treatment depends on the severity, the individuality of the patient and the history of response to previous treatments.
The role of psychotherapy in treatment
Psychotherapy is a key element in the treatment of OCD. As we've seen, the most effective approach is CBT with ERPwhere the patient is gradually exposed to their obsessions, avoiding realising the compulsion. Over time, this reduces the anxiety associated with obsessive thinking.
Other approaches include:
- Acceptance and Commitment Therapy (ACT)
- Psychodynamic psychotherapy
- Group therapy
A close therapeutic relationship based on trust is essential for success.
Medicines used for treatment
The most commonly used drugs include
- SSRISfluoxetine, sertraline, escitalopram
- Tricyclicsclomipramine (in some cases)
- Anxiolyticswith limited use due to the high risk of addiction
Pharmacological treatment requires time (6 to 12 weeks) in order to take effect, and must be closely monitored by a doctor.
When to seek professional help
Many people live with OCD symptoms for years before seeking support. It's important to be aware of signs that indicate the need for professional help:
- Behaviours or thoughts interfere with work, studies or personal relationships.
- The time spent with obsessions and compulsions exceeds one hour a day.
- There is intense emotional distress or a feeling of loss of control.
- Symptoms worsen over time, even with attempts at control.
If you identify with these 4 points, you should consult a psychologist or psychiatrist, which is the first step to starting an effective treatment plan adapted to your case.
How to deal with OCD in everyday life?
We know it's very important to be monitored by specialised professionals, but outside the doctor's office, what can we do to improve our quality of life in the face of this condition? Here are a few particularly important practices and principles that help deal with OCD on a daily basis:
- Establish a structured daily routine
- Take time out every day for moments of relaxation, however brief, in order to lighten the mental load - read a book, practise breathing techniques, etc?
- Reduce stress with moderate-intensity physical activity
- Learn about OCD and its manifestations, and about mental health practices
- Avoid excessive consumption of content that can cause anxiety
- Avoid isolation and talk about problems with someone you trust
Face-to-face or online support groups are also excellent resources for sharing knowledge and emotional support.
Myths and truths about OCD
There are many myths associated with OCD, and it is essential to fight the stigma associated with the disorder. Here are some common myths:
Myth | Truth |
"OCD is liking everything tidy" | OCD is a serious disorder - it's not a personality trait and should be monitored by specialised professionals. |
"People with OCD are dangerous" | People with OCD are more likely to suffer in silence than to cause harm to others. |
"OCD is very rare" | It affects around 2-3% of the world's population. |
"It's impossible to cure OCD" | With proper treatment, symptoms can be effectively controlled, greatly reducing the impact on day-to-day life. |
OCD and other pathologies
OCD rarely occurs in isolation. It is often associated with other mental health conditionssuch as:
- Major depression
- Generalised anxiety
- Eating disorders
- Obsessive-compulsive personality disorder (OCPD)
- Autism spectrum disorders
- Tourette's Syndrome
The presence of associated pathologies can make diagnosis and treatment difficultThis requires a multidisciplinary approach.
OCD VS OC personality disorder: what's the difference?
The main difference between OCD and PPOC is the acceptance of the symptoms as pathological or normal, respectively.
While a patient with OCD recognises behaviour as pathological (egodystonic) and tries to treat them, the patient with COPD tends to regard obsessive behaviour as normal (egosyntonic)and condemn those around them for not adopting them. Patients with POCD tend to have extreme rigidity faced with the idea of changing patterns of obsessive-compulsive behaviour.
It is extremely important that signs of TOC and PPOC are evaluated by specialised professionalswith experience in diagnosing these pathologies.
Resources and support available in Portugal
In Portugal there are a few institutions and resources for those living with OCD:
Resource | Description |
SNS - National Health Service | Free or subsidised access to psychology and psychiatry consultations |
Telephone support for mental health issues: 808 24 24 24 | |
University Hospitals | Units specialising in obsessive-compulsive disorders |
Support organisation for patients and families | |
Support organisation for patients and families |
At NeuroPsyque we treat patients with OCD through a approach moulded to the individual, integrated between specialities such as Neurology, Neuropsychiatry and Psychotherapy, which allow us to offer you the greater expectation of eliminating the suffering caused by this disorder.
We have the most specialised equipment and specialists in therapies such as NeuroFeedback and Transcranial Magnetic Stimulationwhich have proved central to the treatment of OCD. Book your appointment with us!
Conclusion
OCD (Obsessive Compulsive Disorder) is a serious disorder, but with the potential for a favourable prognosis when approached correctly. Knowing the symptoms, seeking professional support and applying self-care strategies can radically transform the lives of people affected by this condition.
Information, social support and appropriate treatment are fundamental pillars for a more balanced and happier life. If you have OCD or suspect you have it, if you have someone close to you who faces this condition, remember: specialised help and support is essential to overcome this condition.
At NeuroPsyque, we work to give our patients the best possible expectation of improvement, using all the resources at our disposal. Book your appointment with us! See you soon!
FAQ about OCD (Obsessive Compulsive Disorder)
1. Can OCD be cured?
OCD doesn't have a definitive "cure", but the symptoms can be very well controlled with therapy, medication, and therapies such as the Transcranial Magnetic Stimulation (TMS), to the point where the symptoms no longer disable everyday life.
2. Can OCD get worse over time?
Yes, without proper treatment, symptoms can intensify and become more disabling.
3. What causes OCD?
OCD is influenced by genetic and environmental factors (by experience). Chemical changes in the brain and positive reinforcements associated with specific behaviours are also important factors.
4. How does the mind of an Obsessive-Compulsive work?
The mind of a person with Obsessive-Compulsive Disorder (OCD) is dominated by intrusive and repetitive thoughts, called obsessions, which generate anxiety and deep, disabling discomfort.
5. What is the difference between obsessions and compulsions?
Whereas obsessions are characterised by uncontrollable thoughts, compulsions make up the acts that the person with OCD feels compelled to perform.
6. Is medication mandatory in the treatment of OCD?
No. Not always. Some cases are treated only with Psychotherapy e Neurotherapy.
7. How do I know if what I have is OCD or just a mania?
The difference lies in the impact: if the thoughts or behaviours cause suffering or negatively interfere with daily life, it could be OCD.
8. OCD or Obsessive-Compulsive Personality Disorder?
The difference lies in the acceptance of symptoms that damage different areas of life as being pathological, negative, in the case of OCD, or as an integral part of the personality, positive and natural, in the case of POCD.
9. Can children have OCD?
Yes, it's common for the first symptoms to appear in childhood or adolescence.
10. Is there any risk in using neurotherapy to treat OCD?
In the face of pharmacological therapies, the Neurotherapy is an effective alternative with a very low incidence of side effects.
11. Are there any support groups in Portugal for people with OCD?
Yes, there are associations and groups in person and online that offer support and share experiences.
