10 ocd themes explore the hidden side of obsessive‑compulsive disorder that isn’t about spotless surfaces or perfect order. Obsessive‑compulsive disorder (OCD) is a “mental health condition where distressing, intrusive thoughts (obsessions) trigger repetitive behaviors (compulsions) aimed at reducing anxiety or preventing something bad from occurring.” When most people think of OCD, they picture immaculate closets, color‑coded lists, and the quirky detective monk on TV. Those portrayals miss the reality: OCD can hijack any cherished value, from family to faith, through terrifying, unwanted thoughts.

10 OCD Themes: What You Need to Know

1 Postpartum

“I’m going to kill my baby,” thinks a new, loving, happy mother. Once she has this thought, panic and fear take over. Why would she think that? She wants this child and loves it with her entire being. The thought persists, and she wants to make it go away because it isn’t true. She decides that the only way she will hold her child is if her partner is present. It works, but only for a while. Soon, she refuses to hold her child because she fears her thoughts might come true. If she doesn’t touch the baby, she can’t kill it. Her fear, however, does not subside, and to worsen her experience, she is not bonding with the child she loves the way she wants to.

Such is an example of what it could be like for someone with postpartum OCD (pOCD), based on examples of the disorder provided by the International OCD Foundation.

Someone with pOCD may experience intrusive, unwanted thoughts about harming or losing their child, so they engage in compulsions or rituals such as avoidance or reassurance‑seeking, hoping to get rid of the thoughts. Still, the cycle usually worsens the person’s experience rather than helps it. Without proper understanding and treatment, it can drive the sufferer further away from that which they truly love: their family.

2 Incest

Many OCD themes revolve around taboo or even violent subjects that bring immense distress to the person who has them. One such theme is “incest OCD.” When someone experiences incest OCD, they are plagued with thoughts like “What if I’m sexually attracted to my father?” or “What if I touched my sister sexually once and I don’t remember?” or “What if my desire to be around my family is proof that I’m actually sexually attracted to them?”

These thoughts can be worsened by what’s called a “groinal response,” which is a physical reaction in the genitals that feels similar to arousal, as it can include twitching, tingling, lubrication, or even an erection. The difference is that these symptoms are rooted in hyper‑awareness and not true sexual arousal.

Someone with incest OCD will have such a deep fear of sexual attraction toward family members that they will avoid contact with those people, spend hours researching similar experiences on Google or Reddit for reassurance, reviewing memories, checking for groinal responses, or confessing their thoughts to others to abdicate themselves of guilt.

Someone with incest OCD does not care about their house being clean or how many times they wash their hands—they simply no longer wish to be terrified of their own bodies and their own families.

3 Pedophilia

Since OCD loves to latch onto the taboo and go against someone’s values, sexual themes are prominent in the OCD community. However, one is especially upsetting: pedophilia OCD.

Someone who experiences pedophile‑themed OCD is the complete opposite of an actual pedophile. These people experience horrible, unwanted thoughts about doing sexual harm to children and spend so much time and energy on compulsions in an attempt to make the guilt, fear, shame, and anxiety go away.

They live in fear, believing they are the worst kind of human out there.

Thoughts include, “Did I look at that child for too long? Why did I do that? Does that mean I am aroused by them? Am I sexually attracted to children? Am I a creep? Am I a pedophile? Am I going to accidentally one day inappropriately touch a child? Why am I thinking these thoughts? Is it because I actually want to? Is it because I secretly like it?”

To an outsider, it seems rather obvious that this person does not feel attraction toward children, is not a pedophile, and will not become one. However, to the individual with OCD, these thoughts are real, terrifying, and urgent, and they must be dealt with immediately so that those fears do not come true.

Someone with OCD may avoid walking or driving past schools or playgrounds, therefore taking too long to get to work. They may not visit nieces and nephews or isolate themselves from their own children. They may do excessive research, confess their thoughts, or even go so far as to watch pornography just to see if they become aroused.

This particular theme comes with a great deal of shame, guilt, self‑hatred, and embarrassment. Thanks to inaccurate portrayals of OCD and social misunderstandings, people with this form of OCD and other subtypes with stigmatized themes, help is often not sought out by those who may need it most.

4 Sexual Orientation

Sexual orientation OCD (SO‑OCD) is the obsessive need to know for certain your sexuality, who you’re attracted to, and your sexual identity. Most people do question their sexuality from time to time. Others have stories of grappling with it, like finding the right time or the right way to come out as gay, for example. However, someone with SO‑OCD is completely ensnared in a quest to know beyond all doubt exactly who they are and who they are attracted to, to the point that their lives can become completely disrupted.

Take Teagan, for example. She is a young woman whose testimonial for Rogers Behavioral Health is a prime example of what SO‑OCD, and OCD in general, can put someone through. She writes, “I saw a TikTok that said, ‘If you get butterflies when looking at the same gender, sorry… you’re gay.’ Most people would hear this and either laugh or just move on without even questioning themselves, but not me and my doubt‑infested thoughts. This sent me into a spiral like I’d never been in before… I could no longer see the world or who I was the same. I began having multiple, intense panic attacks back‑to‑back… I just ‘NEEDED’ to know if I was gay… like NOW!!”

Fears of ruining relationships, lying to oneself, not knowing one’s own identity, possibly facing stigma or ostracization by “coming out,” or not loving one’s current partner if they find out they are not of that orientation can drive someone with SO‑OCD to time‑consuming and distressing compulsions.

Reality and fear tend to get blended with OCD, and when that begins to attack your own sense of identity, that’s frightening.

5 Suicide

One of the most difficult themes of OCD to talk about and treat is suicidal OCD. While all thoughts of suicide should be treated with the utmost care and concern, there is a subtype of OCD that is actually driving the person to do the opposite of taking their own life.

Suicidal OCD is different from true suicidal ideation in that the thoughts of self‑harm are unwanted and terrifying, and the distress the thoughts cause leads to extreme measures to prevent suicide—not act on it.

Suicidal OCD can manifest in many ways. It could be something like driving on an overpass and picturing yourself swerving your car over the edge or seeing a train and imagining yourself jumping in front of it. However, the thought fills you with fear and shock because you don’t want to do those things. Similarly, if you are going through a distressing time, you may think, “I don’t want to be here anymore,” which is immediately followed by shock, distress, fear, and panic because, again, the thought is not actually true.

Someone in these scenarios may avoid bridges, trains, roads, windows, and balconies. They may also avoid knives or guns, get rid of their weapons—knives, guns, and ammunition—or confess their thoughts to someone so they can make sure they don’t actually do it. They may question themselves and wonder if these thoughts are normal, if others have them too, and if they are actually likely to harm themselves.

These behaviors are meant to eliminate the thoughts and feelings because the person does not want them. Again, however, all thoughts of this nature ought to be treated with the utmost seriousness and case, as all cases are unique to the individual.

This section of this list is only meant to highlight the existence of a distressing category of obsessive‑compulsive order that is a real experience that goes far beyond the quirkiness of a color‑coded list.

6 Harm

Harm OCD is a broad theme that can include harm to oneself or others and can be a horrifying experience for someone with the disorder.

Someone with any variation of harm OCD might think things like: “What if I push this person in front of a car?” If they are feeling angry, they might think, “I should just stab them,” and then immediately be overcome with panic and ask themselves, “Why did I just think that?” If they are feeling distressed, sad, or frustrated, they might think about harming themselves and then freak out about having that thought in the first place.

Someone cutting vegetables might look at the knife and think about killing someone with it. A new mother might think about throwing her child down the stairs. They may fear they are a serial killer in the making, fear they are possibly self‑harming or suicidal, or worry that they might “snap” and do something to themselves or others.

The media has taken this subtype and run with it in the wrong direction, making it a stigmatized subtype and furthering the misunderstanding of this serious mental illness.

Trap (2024) is a horror film that portrays a killer with obsessive‑compulsive disorder and makes a connection between those urges and his kills. The film has faced criticism for its inaccurate and dangerous portrayal of the mental health condition because those with harm OCD are the least likely to do harm. In fact, they are those who highly value kindness, care, and safety.

7 Death

The fear of death is commonplace and persistent. Even those who do not actively “fear” death likely experience it when confronted with it. After all, our brains are hardwired to survive and resist death.

Unlike the normal discomfort and fear of death, this subtype of obsessive‑compulsive disorder takes it to an entirely new level. Someone with death OCD grapples with obsessive intrusive thoughts about their own death, the process of dying, death coming to loved ones, and the afterlife. These fears are accompanied by compulsions, such as asking for reassurance that you won’t die, excessive research about illnesses or the afterlife, or avoiding certain images, movies, places, or objects that remind you of death or the afterlife.

For example, someone with intense death‑related OCD may fear that they will suddenly die. To mitigate the fear, they may ask their spouse, “Do you think I’m going to have a heart attack?” They may avoid driving to prevent a car accident. They may also avoid hospitals or driving past cemeteries and funeral homes. One writer shared her story and said she avoided imagery and mentions of the Devil because she associated it with the afterlife.

It’s also not uncommon for those suffering from OCD to engage in magical thinking. This is when superstitious thoughts take hold, and you believe that your thoughts, anxieties, and triggers are causally related to external events. For example, someone with OCD may see a Halloween costume of the Devil and interpret it as a “sign” or an omen that their death is nigh. They may have a dream in which a loved one dies, and they will live in extreme anxiety, believing their dream is a prophecy.

When this happens, compulsive behaviors once again set in and can take over a person’s life.

8 Religious Scrupulosity

There is one subtype of OCD that somewhat incorporates superstition, and that is religious or moral scrupulosity OCD. Someone suffering from scrupulosity OCD has unwanted and pervasive fears around morality and religion.

Fears of doing something “wrong,” not being “pure” enough, not practicing religion perfectly, sinning, death, divine punishment, and possession, as well as obsessions with rituals, sacrifice, and doctrine, take over the lives of those who grapple with scrupulosity OCD. Subsequently, they engage in compulsions and rituals to help mitigate the intrusive, relentless thoughts. Examples include prayer, confession (to a religious leader or a loved one), rituals done to perfection or until they feel “just right,” hyper‑awareness of behavior, scanning memories or monitoring thoughts for sins, and avoiding places or events that could trigger these thoughts or lead something “bad” happening.

This particular category of OCD can be particularly distressing, as our religion (or ethics, if you are not “religious”) plays a part in our day‑to‑day lives. Concerns with how we treat our partners, whether we made the “right” decision, or if we honored our god(s) with genuine, correct reverence are daily engagements. When our thoughts and actions become so rigid and full of anxiety, it can be difficult to know where healthy practice ends and self‑sabotage begins.

That blurred line between anxiety and reality is difficult for anyone, regardless of which part of your life it affects.

9 Relationship

With OCD, all themes stem from levels of uncertainty, unpredictability, or an overall lack of control. Most OCD thoughts tend to stem from slim possibilities or have little to no evidence to substantiate them. With harm OCD, for example, the person knows that they will not cause another harm at the end of the day. Someone with incest OCD ultimately knows that their thoughts are not real—even if it takes a lot of work to get there. The anxiety that these thoughts cause is ultimately proof that they are egodystonic, meaning they go against the person’s values and identity.

Relationship OCD, however, is considered to be an especially challenging subtype of OCD.

Someone with ROCD constantly experiences doubts about their relationship. This typically manifests in romantic relationships but could latch onto any important relationship.

ROCD sows seeds of doubt about your love for your partner, their love for you, infidelity, the strength of the relationship, whether or not it’s worth your time, your partner’s flaws, attraction, and ability to handle conflict. While some relationship doubts are normal, someone with OCD cannot tolerate these doubts or questions, leading to chronic, intense anxiety, depression, panic, or paranoia about themselves, their partner, and/or their relationship.

This can lead to compulsions like researching relationship topics on Google or Reddit, asking others constantly for advice or reassurance (including from their partner), confessing their thoughts to their partner (including fears about cheating or not loving them), checking for “signs” that everything is okay (or not), or testing yourself or your partner by flirting with others—just to see how you or they feel, so you can “make sure.”

This subtype of OCD can be particularly painful due to the potential to sabotage healthy relationships by responding to problems where none exist or to stay in unhealthy relationships by writing your doubts off as ROCD.

Considering that OCD usually latches onto that which you value or want the most, someone with ROCD has the potential to be isolated and distressed, given that they feel constant anxiety and doubt. That anxiety is present whether they are single or in a relationship or whether that relationship is working for them or not.

It creates a cloud of doubt and loneliness so profound that even that which you love the most feels unsafe and contaminated.

10 Meta (Do I Even Have OCD?)

The kicker of all OCD subtypes just might be what is called meta OCD. This theme focuses on the disorder itself, questioning whether your spirals and behaviors are even OCD at all.

What if this isn’t OCD? What if I’ve been lying to myself or my therapist, and we’ve got it all wrong? What if I’m doing my treatment wrong? What if I’m stuck like this forever? What if I missed something?

The OCD begins to attack the individual, their treatment, their progress, and their reality, which can completely sabotage their treatment and overall wellness.

Compulsions associated with this theme include going to multiple therapy appointments or avoiding them, excessively researching OCD or taking quizzes, ruminating or other mental compulsions, or asking others for reassurance.

This theme is sneaky, as it can develop after someone has begun treatment for their OCD with another theme, thus proving to be another obstacle for them to tackle in therapy. Fortunately, meta OCD is not uncommon and can be handled just like any other theme.

Obsessive Compulsive Disorder is known in popular media as that problem that people who are really, really picky and phobic about cleanliness have. Unfortunately, this is not even close to what OCD actually is. Most people have huge misconceptions about OCD, helped by shows like Monk, which have made them think that being perfectionist, anal-retentive, or overly habitual is what being OCD is all about.

There are multiple types of OCD, and it is certainly much more complicated and difficult to deal with than TV makes it look. For those who suffer from OCD, watching popular media depicting it is basically just one extended cringe fest. Below we will go over some of the lesser known facts about OCD and bust some of the misconceptions.

10. Adrian Monk From The Hit TV Show Is Not A Good Example Of OCD

The hit TV show Monk is famous for its depiction of a detective with severe OCD. However, the truth is that OCD is probably one of the few disorders that the character actually doesn’t have. Monk is depicted as having phobias of almost everything, which isn’t really what OCD is about at all. And he is also depicted as being very cleanly and overly picky about little things, but that isn’t really OCD either. He is a grab bag of so many different symptoms with so little congruity that it is amazing anyone can claim he has any one particular disorder at all.

For many who suffer from OCD, this depiction is hurtful because it makes light of the disease without properly explaining how it works at all. It is described as wacky and he is shown to be anal retentive and extremely hard to please and work with, but this is also not representative of OCD either. While Tony Shaloub is a great actor, and does his best to provide a sensitive performance, the show falls totally flat in terms of any kind of realism.

9. Many Sufferers Of OCD Suffer In Complete Silence

Many people like to think of OCD as a very public disease. Those with OCD will constantly perform little rituals that show how “crazy” and “wacky” they are to everyone around them. These rituals, like touching a doorknob many times, are often played for laughs in popular media – while the person with actual OCD feels great shame at what they are doing. While some who suffer from OCD do things like this, many of them actually don’t. It is often depicted like that because it is easy to show that on TV, but many who suffer from OCD suffer almost entirely in their own heads.

Much of OCD actually stems from persistent bad thoughts that keep occurring, often of a sexual or violent nature and involving friends or loved ones. Normal people would simply feel disgusted by the thought and move on, but those with OCD obsess over it and feel great shame. That means many with OCD will create mental rituals they go over to push the bad thoughts away. For this reason, many who have OCD are completely invisible in their suffering, totally dealing with it within their own heads.

8. Making Light Of OCD Makes It Harder For Sufferers To Get The Help They Need

The constant jokes about OCD may be funny to those who make them, but to those with OCD, it makes it harder to get the help they need, and it can also be very hurtful. People saying “I am so OCD” because they don’t like their vegetables to touch their mashed potatoes – those people are anal-retentive – and others who make light of it by making jokes about touching doorknobs or what have you, are making things much harder for those who truly suffer.

When you are an object of ridicule, especially if you are one who mostly suffers in your own head, then you are unlikely to come out to others as needing help – this is on top of the fact that there is already a stigma behind going to see mental health professionals. Those who joke about OCD should think twice about what they are doing. OCD is a disease marked almost entirely by great feelings of shame, and the mockery only makes those with it feel even more ashamed about what they do. At the very least, if someone is going to joke about OCD, they should get a better understanding first of what it actually is.

7. OCD Is Characterized By Persistent Unwanted Thoughts That Won’t Go Away

Like we mentioned earlier, OCD isn’t really about not wanting your peas to touch your chicken, or being really obsessed with making sure your shirt is tucked in perfectly and not a lock of hair is out of place. There is a disorder for this when it is taken to an extreme, but that is not Obsessive Compulsive Disorder. Obsessive Compulsive Disorder is characterized by extremely disturbing thoughts that pop into people’s heads involving usually things of a sexual or violent nature and often involving friends and family.

While even normal people have weird thoughts like this pop into their heads now and again, the difference is that a normal person just moves on, knowing that they don’t associate with such things. However, someone with OCD feels guilty that they had the thought at all, and starts obsessing that there is something wrong with them because they had the thought. Trying not to think about something makes you think it all the harder, which makes the sufferer feel even more guilt on top of that previous guilt. Those with OCD will then do physical or mental rituals to distract themselves when the thought or thoughts try to intrude again, so they can avoid the guilty and horrible feelings. Some people will get caught up in their physical ticks to the point they hardly think about the thing they are trying to avoid thinking about anymore. Instead, they just feel a vague sense that something horrible will happen if they don’t keep the rituals up – that horrible thing generally being that the thoughts pop back up again. The best way for an OCD person to deal with this is to reassure themselves that they shouldn’t feel guilty, and not try so hard to forcibly push the thoughts away.

6. Being Incredibly Cleanly, Germaphobic Or Picky About Food Touching Is Not OCD

As we talked about earlier, being OCD is not the same thing as being really picky and cleanly. Those people are often called “anal-retentive”, but there is also a clinical term for people who take being super cleanly and neat and on the ball to the complete extreme. This disorder is called obsessive compulsive personality disorder, and is quite distinct from OCD. This disease, which is closer to one of the diseases that the character on Monk actually has, is characterized by someone who has to not have their food touching, always has to have perfectly pressed clothes, and combed hair, etc.

Oftentimes this person had a stricter upbringing, or had some event happen that shook their feeling of security. Those who have OCPD (obsessive compulsive personality disorder) are doing what they do to make the world continue to feel right, but their reasons tend to be much different. They aren’t really dealing with bad thoughts or specific feelings of doom if they don’t keep everything just so. Instead, they just have a really strict regime of keeping everything they way they wish, because in general, it gives them a feeling of safety and security. While both fall under anxiety disorders and both have obsession involved, that is as close as they actually get to each other. When many people say OCD, they really mean OCPD.

5. For Many People, OCD Takes On Religious Connotations

There is also a special form of OCD known as scrupulosity, which may or may not involve the trademark intrusive thoughts. Those with this issue deal with a special religious version of OCD. Essentially, they become so obsessed with following the rules of religion to the letter that it makes it very hard for them to properly live their daily lives. One sufferer spoke of how, when studying for her Bat Mitzvah, she was so worried about pork fumes that she was scrubbing her hands constantly red raw. She would say her prayers over if she had to and ignore people to make sure she said them just right.

This is something a lot of OCD sufferers who are religious deal with, and the sad thing is they are more likely to suffer alone because they are so afraid of how people will judge them if they tell them what they are dealing with. These people tend to be very afraid of making any religious mistake and being punished or being in disfavor with their God of choice. Unfortunately this can be a very tricky form of OCD to deal with, because the sufferer can even think that intrusive thoughts are actually being influenced by demons, making the whole thing even more complicated.

4. Those With OCD Are Often Suffering From A Lot Of Guilt About Their Unwanted Thoughts

The truth is that at its heart, OCD is almost entirely about guilt. Whether it is guilt at what you did that you fear a deity will punish you for, guilt about the thoughts you had, or guilt about something you did wrong, or any kind of guilt. Those with OCD have a short circuit in the brain wherein when they feel guilty about something, they will start obsessing over it constantly in order to make themselves feel better and try to reassure themselves. Unfortunately, because their reason they are seeking assurance is because of guilt, and the feeling is strong, they will invariably make themselves feel even guiltier.

Those with OCD will then go to their go to rituals when it all becomes too much, and the obsessing has started to make things worse. Now they will try to push away all thoughts about the thing that is bothering them, in an attempt to improve how they feel. Those with OCD will often also feel guilt at how poorly they manage their own symptoms, which only decreases their sense of self-worth even more. This is why it is so important that people understand what the disease is and don’t make light of it as much. It is already something that tends to wear down and batter those who suffer from it, so mocking them and making light of their suffering only makes it harder for them to cope.

3. People With OCD Are Hyper Aware Of Their Problems And Very Embarrassed By Them

Let’s be clear: while people with OCD are often a laughingstock, especially on TV, it is not funny to them at all. Those who suffer (like this author) are hyper aware of the things that they do. If it is currently a physical ritual, they try to hide the fact that they do it from others, because it is insanely embarrassing when others find out. If it is a mental ritual, it is much easier to hide, but they are still very, very aware that they are doing it, and feel shame even as they are performing their rituals in order to avoid more guilt.

So while it may be often depicted as someone who doesn’t really understand just how “crazy” they are, the truth is that many people who are mentally unhealthy, except for those with delusional disorders, are well aware of their mental problems and how crippling they are. In fact, they are probably much more aware of the issue and how it is affecting them than you, the casual observer, could ever be. The best way to deal with it is sensitivity, like any disorder, and if comedy is to be done, the comedian should at least take the time to properly understand what they are joking about so they can give it a proper treatment. If you want to help someone who you think has OCD, the best thing you can do is be someone they can talk to about anything – be their guilt free zone where you can get them talking and assure them that they don’t need to feel guilty all the time.

2. Persistent OCD Symptoms Can Lead To Depression And Other Mood Disorders

As you might imagine, having OCD can be very, very frustrating. Sufferers will go through bouts where they are doing better than other times, and sometimes worse. However, overall, it is a chronic problem that can be difficult to manage on an ongoing basis. You can be going well, and then something happens that triggers a thought from a horrible episode and you are doing terrible again. A life event happens that is extremely awful and you can find yourself relapsing when you had made a lot of progress. Constantly feeling guilty about horrible thoughts and trying to repress them is incredibly difficult to deal with on an ongoing basis and so many people who suffer from OCD end up with other mood disorders.

Roughly three out of four people with OCD end up with depression as well, because of how depressing it is to deal with the chronic issue of OCD. It is hard to feel good on an ongoing basis and feel good about yourself when you are constantly either feeling guilty or obsessing about thoughts or actions in an attempt to avoid feeling guilty, or guiltier. The worst part is, the rational part of the OCD sufferers brain knows that their feelings of guilt are completely irrational, but try as they might, they can’t just turn those thoughts off. In a way, the constant feelings of guilt are just as much an obsession as the rituals themselves.

1. People With OCD Can Get Better At Controlling The Problem But There Is No Cure

There are many ways to treat OCD, and to help those who suffer with it, but the truth is that there is no known cure. No one is sure if it has a genetic component or not, but there is some belief that it runs in families. Regardless of how it comes, once it is there, it is there to stay. Those with OCD will never completely cure their dilemma, and will have to deal with the issue to some degree or another for the rest of their lives.

However, this doesn’t mean everything is grim. While it may always be a problem lurking in the background, those with OCD, if they do the right things or seek the right treatment, can ameliorate the symptoms to some extent. Images may still pop into your head, but accepting and acknowledging that they are they, but there is no reason to feel guilty about them, and then practicing taking a breath and moving on, can help the sufferer deal better with their issue. Forcing yourself to break a ritual now and then, and then reminding yourself afterwards that nothing bad happened is another way you can help break yourself of the more debilitating symptoms.

Most of all, it is about practicing letting go instead of obsessing over things and allowing yourself to feel guilt if necessary, but then move on and force yourself to stop worrying about it. Nothing will cure someone with OCD, there is no magic bullet. But with many mental health disorders, with the right treatment, those with OCD can still at least live a relatively happy and normal life.