The useful question is not what the person does. It is what happens if they do not do it.
The distinction
Someone who likes things a certain way feels mildly irritated when they are not. Someone with obsessive-compulsive disorder feels dread, and performs the behaviour to discharge it. The behaviour is not a preference being expressed. It is a distress being managed.
A second difference: people with OCD generally recognise that the compulsion does not make sense. That recognition does not reduce the urge, and it adds a layer of shame that keeps people from disclosing it. Average delay to treatment for OCD is long, and this is why.
The part that surprises people
Much of OCD is invisible. Mental compulsions such as counting, reviewing, praying or silently neutralising a thought produce no observable behaviour at all. A person can appear completely unaffected while running a loop continuously.
The content is also often the opposite of what people expect. Intrusive thoughts about harm, violence, blasphemy or sexuality are common in OCD, and they are distressing precisely because they are repugnant to the person having them. Having the thought is not evidence of wanting it. This is one of the most important things a family can understand.
How it is treated
The evidence-based psychological treatment is a specific form of cognitive behavioural therapy involving graded exposure with prevention of the compulsion. This is a structured protocol, not general talking therapy, and it matters that the clinician is trained in it. Medication is also used, often at higher doses and over longer periods than in depression.
Getting assessed
The usual route applies: a GP or polyclinic for a referral into subsidised specialist care, or a private psychologist or psychiatrist for speed at full cost. When you call, ask specifically whether the clinician treats OCD with exposure and response prevention.
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