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Obsessive-compulsive disorder (OCD) is characterized by two major symptoms: obsessions and compulsions. Some patients experience one component more strongly than the other.

Obsessions are recurrent persistent and unpleasant thoughts or impulses that a person cannot control. These thoughts may appear once in a while or may be almost constant, crowding the mind and preventing a person from concentrating on other tasks. Typical obsessions include fear of dirt or contamination; excessive concern with order, symmetry and exactness; constant thoughts of specific sounds, images, words or numbers; fear of harming a loved one; and fear of thoughts considered evil or sinful.

Compulsions are repetitive behaviors that a person engages in and cannot control. A patient engages in compulsions as a means of relieving obsessive thoughts, even though this action may seem irrational to the person and others. For example, people who are obsessed with a fear of germs may wash their hands compulsively to combat this fear. In other cases, the compulsive act is not as clearly associated with the obsessive thought. Many people also develop rules to follow that help control anxiety in the midst of obsessive thoughts, such as touching objects a specific number of times or counting to a certain number. In some cases, performing the compulsion does indeed relieve the anxiety, but only temporarily.

Typical compulsions include excessive washing of hands, repeatedly checking doors to make sure they are locked or checking to make sure appliances are turned off, keeping items arranged in a certain order and hoarding items such as coupons.