What are the physical sensations of OCD?

Distorted physical sensations can be a common — but distressing — symptom of OCD. Although they may seem real, approaching them like any other OCD-related obsession can help.

Obsessive-compulsive disorder (OCD) is a chronic mental illness that requires treatment. Its symptoms include obsessions (intrusive thoughts, feelings, or images) and compulsions (repetitive behaviors used in an attempt to reduce anxiety caused by obsessions).

Sometimes people with OCD experience obsessions in the form of distorted physical sensations. When obsessions are felt physically, it can be more difficult for people with OCD to resist compulsions.

But whatever form OCD obsessions take, people with the condition can learn to manage them with the help of therapies, medications, and self-care techniques.

Although obsessive-compulsive disorder cancause new physical sensations, they often exacerbate or focus on common physical sensations that are already present.

For example, a person with OCD might become hyperaware of their heartbeat. You may find it difficult to focus on anything other than the sound or physical sensation of your heartbeat. Or, you might be worried that there is something wrong with your heartbeat or the sound is louder than it usually is.

Some people with OCD may begin to experience physical sensations that are not actually there.

For example, a person with contaminated OCD might begin to have the physical sensation that their hands are dirty. They might be able to “smell” dirt and grime on their hands, even though they can’t see it.

This type of physical sensation with OCD is more common than you might think.

Other examples of physical sensations in the TOC may include:

  • being hyper-aware of the need to urinate
  • not being able to stop focusing on your own breathing
  • feel like there’s something crawling over their skin
  • not being able to stop keeping track of how often you blink
  • seeing or imagining floating dots before your eyes
  • burning sensations
  • an obsessive need to itch
  • hear voices
  • a need to vomit
  • a groin response
  • smell something that is not there, like gasoline

A study 2017 found that people who had more of these distorted physical sensations had a harder time controlling their compulsive behaviors.

These types of physical sensations can be difficult to process precisely because they tend to be based on a physical sensation that may actually be there.

But these feelings are still considered OCD obsessions. And, like all OCD obsessions, they often lead to compulsions.

For example, someone who feels dirt on their hands may try to clean them repeatedly. Someone who feels their heartbeat is irregular might repeatedly ask others to check their heartbeat.

For some people with OCD, physical sensations are linked to intrusive thoughts – also called obsessions in OCD.

Obsessions can be any kind of disturbing, unwanted, or intrusive thoughts or urges that cause someone to feel anxious or distressed.

Some intrusive thoughts that could be associated with physical sensations of OCD include:

  • “My hands are dirty. Anyone who shakes my hand will get sick.
  • “If I don’t blink enough, I’ll go blind.”
  • “Was that a point I just saw? Do I have a brain tumour?
  • “Do I smell gas? Did I leave the stove on?
  • “This spot on my arm keeps itching. Have I been bitten by a poisonous insect? »
  • “I had a feeling in my groin. Does that mean I’m on? »
  • “What if I vomit and someone slips on the vomit and dies?”
  • “If I don’t get up to go to the bathroom, I risk wetting the bed.”

These thoughts may seem outrageous to people who are not living with OCD. But for people with OCD, these thoughts are all too real. And, they can feel even more real when accompanied by physical sensations.

Triggers

For those living with this condition, anything can be a trigger, and therefore anything can become an intrusive thought.

People with OCD can have intrusive thoughts about things ranging from child molestation to poisoning their family, which can be triggered by just about anything.

Compulsive behaviors

Intrusive thoughts themselves are a common human experience, and 2014 research shows that most people have them from time to time.

The difference is that people with OCD often react to these thoughts with compulsive behaviors to try to reduce the anxiety.

The physical sensations in OCD are sometimes called “near-hallucinations, which are a hallmark of psychosis.

Hallucinations occur when people see, hear, smell, or feel something that isn’t actually there. They are a common symptom of psychotic disorders such as schizophrenia.

But OCD is not considered a psychotic disorder.

Insight

Insight is one of the differences between OCD sensations and psychotic hallucinations. People with OCD tend to be more aware of their symptoms than people with psychosis.

In other words, someone with OCD can logically understand that the physical sensations and thoughts they experience are not based in reality.

The person who “smells” the dirt on their hands can know that, logically, their hands are clean. But they may still continue to have anxiety about their hands not being clean, and physical sensations may accompany this fear.

According to a paper 2013people with OCD may immediately realize that their obsessive thoughts, images, or impulses are “excessive and rationally unjustified.”

People with psychotic disorders, on the other hand, may not have as much knowledge about their symptoms. People with this type of psychosis often fully believe that their hallucinations are real.

Researchers and experts still don’t know exactly what causes OCD. 2018 research shows that there are several factors that can increase your chances of having OCD, including:

  • genetic
  • neurological differences
  • brain chemistry
  • environment and life events

Experts know even less about what causes physical sensations in some people with OCD, but not in others.

The discoveries of a 2015 study suggest that people with OCD who experience sensory obsessions may have certain brain changes and differences, such as increased gray matter volume in the left sensorimotor cortex.

Experts have also related OCD physical sensations at a lower level of insight and self-awareness. In other words, if you are more prone to irrational thoughts, you may experience more physical sensations.

But it is important to remember that an association does not prove causation. In other words, experts don’t yet know which comes first: physical sensations or these other factors.

Living with OCD with intrusive physical sensations can be difficult. But there are ways to deal with these uncomfortable feelings.

A medical or mental health professional can work with you to find the best treatment plan for your symptoms, often involving a combination of:

As with all mental health issues, it can take time and effort to find what works best for you.

Therapy

Therapy is often a first-line treatment for OCD. The “gold standard” of treatment for OCD is exposure and response prevention (ERP).

ERP is a specific type of cognitive behavioral therapy (CBT) that invites you to intentionally trigger intrusive thoughts and feelings. It also teaches relaxation and other coping strategies to help manage these thoughts and feelings.

Instead of reacting compulsively, you are taught to allow these obsessions to be present. This helps your brain learn to stop reacting to obsessions.

Medication

Certain types of antidepressant medications have also been shown to be effective for people with OCD.

Only a doctor can prescribe medication. It is important to follow directions provided by a doctor or pharmacist and take only as prescribed.

Self-care

Self-care strategies cannot replace professional therapy or medication, but they can be helpful.

Try these tips for coping with OCD and the physical sensations that come with it:

  • Resist the compulsions: Try to resist responding to physical sensations with a compulsion. Remember that compulsions can give you short-term relief, but often keep you locked into the obsession-compulsion cycle.
  • Support groups: Consider joining a self-help or support group. The TOC International Foundation has a list of OCD support groups near you.
  • Relaxation Techniques: Try evidence-based relaxation techniques such as deep breathing. Although these strategies won’t make the physical sensations of OCD go away, they can help you reduce the anxiety they can cause.

If you want more advice, you can check out our page on how to manage your OCD at home.

Although the physical sensations may seem very real to someone living with OCD, they are no different from any other OCD obsessions.

And, like any other obsession, they can keep you locked in an obsessive-compulsive cycle if you respond to them with compulsions.

There are evidence-based treatments for OCD that can help you get out of this cycle. With the right support, you can manage your OCD symptoms and start feeling better.

A doctor or therapist can work with you to find the best treatment plan, which often consists of therapy, medication, and self-care.

If you’re ready to get help but don’t know where to start, you can check out Psych Central’s guide to finding mental health support.

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