OCD Brain vs. Normal Brain: Experts Explain the Difference

Learn about how OCD impacts the brain and helpful coping mechanisms.

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Obsessive-compulsive disorder (OCD) is a condition known for causing symptoms like excessive cleanliness, counting, and fear. But there’s so much more to OCD than what’s on the surface — it can also affect brain function. 

So what’s the difference between an OCD brain vs. a normal brain? Importantly, there’s no such thing as a normal brain, but a person living with OCD will experience obsessions and compulsions, says Charlie Health therapist Courtney Way, MA, LCAT. Read on to learn more about OCD symptoms, what you may see in the brain scan of someone with OCD, and the specific brain region involved in an OCD brain.

Causes of an OCD brain

According to Harvard Medical School, about 3% of people worldwide live with OCD. The disorder can develop starting as early as ten years old, with boys more likely to experience pediatric OCD. However, most people will typically have initial OCD symptoms by the time they turn 25 and rarely begin after 30.

OCD doesn’t have a single, identified cause. Researchers have found links to factors such as a person’s genetics and environment, including both the likelihood of a person developing OCD and how it will present. However, there’s no definitive answer about what causes OCD.

Each person’s experience living with OCD is unique, but there are certain patterns — externally and in the brain — that are often seen. With that said, here’s what you need to know about living with OCD.

Symptoms of an OCD brain

OCD is typically diagnosed through a psychological evaluation with a mental or behavioral health clinician, according to Harvard Medical School. Medical professionals will look at a person’s experience with obsessions and compulsions. Obsessions present as intrusive thoughts, while a compulsion is any continually repeated behavior, says Charlie Health therapist Tairesha Flemister, LMSW. Obsession and compulsions can prevent in ways such as:

Obsessions

• Fear of contamination or germs
• Fear of harming oneself or others
• Fear that others may be harmed
• Intrusive thoughts or images
• Extreme need for symmetry or exactness
• Persistent doubts, relating to many things, but sometimes through a lens of safety seeking, such as ‘Did I lock the door?’

Compulsions

• Excessive hand washing or cleaning
• Checking locks, appliances, or tasks repeatedly and not feeling safe unless it is done
• Counting, tapping, or repeating actions — usually as an attempt to self-soothe
• Arranging objects in a specific way
• Seeking repeated reassurance from others

These symptoms can negatively impact a person’s relationships, work or school responsibilities, and daily life, adds Flemister.

Brain differences in people living with OCD

An OCD brain might behave differently and even have indications on a brain scan. In brain imaging, some patients living with OCD might have greater activity in areas of their brain, such as the orbitofrontal cortex, anterior cingulate cortex, and basal ganglia, says Way. These parts of the brain network handle things such as detecting errors, making decisions, and forming habits.

The heightened brain activity can contribute to OCD symptoms. “This neurological imbalance forces the brain to perceive harmless thoughts as threats, creating intense anxiety and driving repetitive compulsions,” says Charlie Health group facilitator Nicole Lonano, M.S.

What OCD treatment looks like

Here are some therapist-approved ways to cope with OCD. 

1. Identify triggers

Do your OCD symptoms increase at certain times of day, in specific environments, or around  particular people? Pay attention to the things in your life that feel most triggering, says Lonano. That’s not to say they should necessarily be avoided, but being aware of them can provide greater clarity about your repetitive behaviors and provide an opportunity to target them with a certified mental health professional.

2. Reduce stress

Stress can fuel OCD and trigger symptoms. As much as you can, work to reduce stress in your life. Integrate preventative and coping techniques into your routine, such as regular movement, mindfulness practices, and other relaxation techniques. These steps can help reduce symptom severity and OCD brain activity.

3. Lean on support

A lot of shame can accompany OCD, bringing feelings of isolation or that you’re the only one who feels this way. Lean on trusted people in your life who will listen without judgment and support your well-being, says Flemister. Support groups can also be a wonderful, safe space to share your experiences and feel understood.

4. Try therapy

Working with a mental health professional can make a huge difference in coping with OCD. There are a few options you can try, including exposure and response prevention (ERP). This technique is a form of cognitive behavioral therapy (CBT) that “gradually helps people face anxiety triggers without performing compulsions,” says Flemister. It can help reduce compulsive behavior, anxiety, and any other OCD symptoms you might be experiencing.

CBT, on its own, can also prove helpful. A therapist can help you challenge harmful beliefs and create “healthier thought patterns,” adds Flemister.

5. Take medication

Medication is not required for everyone living with OCD. However, options such as selective serotonin reuptake inhibitors (SSRIs) can provide extra support and reduce symptoms of OCD, including depressive feelings, says Way.

How Charlie Health can help

If you or a loved one is struggling with obsessive-compulsive disorder or another mental health disorder, Charlie Health is here to help. Charlie Health is a virtual behavioral health provider delivering high-acuity treatment for kids, teens, and adults facing serious mental health conditions and substance use disorders. Our innovative treatment model combines clinical expertise, group connection, and measurement-based care to support long-term healing. With the right support, managing your mental health is possible. Fill out the form below to start healing today.