What are OCD Physical Sensations?

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

Obsessive Compulsive Disorder (OCD) is a chronic mental illness that requires treatment. The symptoms include obsessions (intrusive thoughts, feelings, or images) and compulsions (repetitive behaviors used to reduce anxiety caused by obsessions).

Sometimes people with OCD experience obsessions as 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 may take, people with this condition can learn to cope with it using therapy, medication, and self-care techniques.

Although obsessive-compulsive disorder cancause new physical sensations, often worsen or focus on general physical sensations that are already there.

For example, someone with OCD may become hyper-aware of their heartbeat. You may find it difficult to focus on anything other than the sound or physical sensation of your heartbeat. Or you may be concerned that there is something wrong with your heartbeat, or that the sound is louder than usual.

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

For example, someone infected with OCD may develop a physical sensation that their hands are dirty. They may 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 may include:

  • being hyperaware of the need to urinate
  • can’t stop focusing on your own breathing
  • feel like something is crawling on their skin
  • can’t stop tracking how often you blink
  • seeing or imagining floating dots before your eyes
  • burning feeling
  • an obsessive need to itch
  • hearing voices
  • a need to vomit
  • a groin reaction
  • smelling something that isn’t there, like gasoline

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

These kinds of physical sensations can be difficult to deal with precisely because they are usually based on a physical sensation that is possible.

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 may try to clean them repeatedly. A person who feels that their heartbeat is irregular may repeatedly ask others to check their heart rate.

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

Obsessions can be any distressing, unwanted, or intrusive thought or urge that causes a person to feel anxious or sad.

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

  • “My hands are dirty. Anyone who shakes my hand gets sick.”
  • “If I don’t blink enough, 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. Was I bitten by a poisonous beetle?”
  • “I had a feeling in my groin. Does that mean I’m excited?”
  • “What if I throw up and then someone slips on the vomit and dies?”
  • “If I don’t get up to go to the toilet, I might wet the bed.”

These thoughts can sound outrageous to people who don’t live with OCD. But for people with OCD, these thoughts are all too real. And they can seem 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 on topics ranging from turning into a pedophile to poisoning their family, which can be caused by just about anything.

Compulsive behavior

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 reduce anxiety.

Physical sensations in OCD are sometimes referred to as “quasi-hallucinations,” which is a hallmark of psychosis.

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

But OCD is not considered a psychotic disorder.

Insight

One of the differences between OCD sensations and psychotic hallucinations is insight. People with OCD generally have more self-awareness about 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 on reality.

The person who “feel” dirt on his hands may know that his hands are logically clean. But they may still be concerned about the possibility of their hands not being clean, and physical sensations may accompany that fear.

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

In contrast, people with psychotic disorders may not have as much insight into their symptoms. People who experience such psychosis often fully believe that 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 developing OCD, including:

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

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

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

Experts also have linked OCD physical sensations to 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 a connection does not prove causation. In other words, experts don’t yet know which comes first: the physical sensations or these other factors.

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

A health care 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 illness, 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” for OCD treatment is exposure and response prevention (ERP).

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

Instead of reacting compulsively, learn how to let these obsessions be present. This helps your brain learn to stop responding to obsessions.

medication

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

Only a doctor can prescribe medicine. It is important to follow the directions of a doctor or pharmacist and take only as directed.

self care

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

Try these tips for coping with OCD and associated bodily sensations:

  • Resist coercion: Try to resist responding to physical sensations with a compulsion. Remember that compulsions can bring you short-term relief, but often keep you locked in the cycle of obsession-compulsion.
  • 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. While these strategies may not make the physical sensations of OCD go away, they can help you reduce the anxiety they can cause.

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

While physical sensations can feel very real to someone with OCD, they are no different from 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 to feel better.

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

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