Distorted physical sensations can be a common — but distressing — symptom of OCD. Although they may feel real, approaching them like any other OCD-related obsession can help.
Obsessive-compulsive disorder (OCD) is a chronic mental health condition that requires treatment. Its symptoms include obsessions (intrusive thoughts, feelings, or images) and compulsions (repetitive behaviors used to try to reduce the anxiety brought on by obsessions).
Sometimes people with OCD experience obsessions as distorted physical sensations. When obsessions are felt physically, it can be harder for people with OCD to resist acting on compulsions.
But no matter what form OCD obsessions may take, people with this condition can learn to manage them with the help of therapy, medication, and self-care techniques.
Although obsessive-compulsive disorder cancause new physical sensations, it often exacerbates or focuses on common physical sensations that are already there.
For example, someone with OCD might become hyperaware of their heartbeat. You may find it difficult to focus on anything else about the sound or physical sensation of your heartbeat. Or, you might worry that there’s something wrong with your heartbeat, or that the sound is louder than it usually is.
Some people with OCD may start to experience physical sensations that aren’t actually there.
For example, someone with contamination OCD could start having the physical sensation that their hands are dirty. They might be able to “feel” 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 OCD can include:
- being hyperaware of the need to urinate
- not being able to stop focusing on your own breathing
- feeling like there is something crawling on their skin
- not being able to stop keeping track of how often you’re blinking
- seeing or imagining floating dots in front of your eyes
- burning sensations
- an obsessive need to itch
- hearing voices
- a need to vomit
- a groinal response
- smelling something that isn’t there, like gasoline
These types of physical sensations can be tricky to address, precisely because they tend to be based on some physical sensation that may actually be there.
But these sensations are still considered OCD obsessions. And, like all OCD obsessions, they often lead to compulsions.
For example, someone who feels dirt on their hands might try to clean it off repeatedly. Someone who feels that their heartbeat is irregular could ask others repeatedly 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 sort of disturbing, unwanted, or intrusive thought or urge that causes someone to feel anxiety or distress.
Some intrusive thoughts that could be associated with OCD physical sensations include:
- “My hands are dirty. Everyone who shakes my hand will get sick.”
- “If I don’t blink enough, then I’ll go blind.”
- “Was that a dot I just saw? Do I have a brain tumor?”
- “Do I smell gas? Did I leave the stove on?”
- “That spot on my arm won’t stop itching. Did I get bit by a poisonous bug?”
- “I had a sensation in my groin. Does that mean I’m turned on?”
- “What if I throw up and then someone slips on the vomit and dies?”
- “If I don’t get up to go to the bathroom, then I might wet the bed.”
These thoughts may sound outrageous to people who don’t live with OCD. But for people with OCD, these thoughts are all too real. And, they may seem even more real when they’re accompanied by physical sensations.
For those living with this condition, anything can be a trigger, and therefore anything could become an intrusive thought.
People with OCD might have intrusive thoughts about topics ranging from turning into a pedophile to poisoning their family, which could be triggered by just about anything.
Intrusive thoughts themselves are a common human experience, and research from 2014 shows that most people have them from time to time.
The difference is that people with OCD often respond to these thoughts with compulsive behaviors to try to reduce anxiety.
Physical sensations in OCD are sometimes called “quasi-hallucinations,” which are a feature of psychosis.
Hallucinations are when people see, hear, smell, or feel something that’s not actually there. They’re a common symptom of psychotic disorders such as schizophrenia.
But OCD isn’t considered a psychotic disorder.
One of the differences between OCD sensations and psychotic hallucinations is insight. People with OCD tend to have more self-awareness about their symptoms than people with psychosis.
In other words, someone with OCD may logically understand that the physical sensations and thoughts they’re experiencing aren’t based in reality.
The person who “feels” dirt on their hands may know that, logically, their hands are clean. But they might still continue to have anxiety about the possibility that their hands aren’t clean, and physical sensations may come along with that fear.
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People with psychotic disorders, on the other hand, may not have as much insight into their symptoms. People experiencing psychosis of this kind often fully believe their hallucinations are real.
Researchers and experts still don’t know exactly what causes OCD. Research from 2018 shows that there are several factors that can increase your chance of having OCD, including:
- neurological differences
- brain chemistry
- environment and life events
Experts know even less about what causes physical sensations in certain people with OCD, but not in others.
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But it’s important to remember that an association doesn’t prove causation. In other words, experts don’t yet know what comes first: The physical sensations or these other factors.
Living with OCD with intrusive physical sensations can be challenging. But there are ways to cope with these uncomfortable feelings.
A healthcare or mental health professional can work with you to find the best treatment plan for your symptoms, often involving a combination of:
Like all mental health conditions, it may take time and effort to find what works best for you.
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 sensations. It also teaches relaxation and other coping strategies to help manage these thoughts and sensations.
Instead of reacting compulsively, you’re taught how to allow these obsessions to be present. This helps your brain to learn to stop reacting to obsessions.
Certain types of antidepressant medications have also been found to be effective for people with OCD.
Only a doctor can prescribe medications. It’s important to follow the guidelines provided by a doctor or pharmacist and take only as prescribed.
Self-care strategies can’t replace professional therapy or medication, but they can be helpful.
Try these tips to cope with OCD and accompanying physical sensations:
- Resistant Compulsions: Try to resist responding to physical sensations with a compulsion. Remember that compulsions may bring you short-term relief, but often keep you locked in the obsession-compulsion cycle.
- Support groups: Consider joining a self-help or support group. The International OCD Foundation has a list of OCD support groups near you.
- Relaxation techniques: Try evidence-based relaxation techniques such as deep breathing. Although these strategies may not make OCD physical sensations go away, they can help you quench the anxiety that they may cause.
If you want more tips, you can check out our page on how to manage your OCD at home.
Although physical sensations may feel very real to someone living with OCD, they’re no different than any other OCD obsessions.
And, just 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 to feel 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 begin, you can check out Psych Central’s guide to finding mental health support.