How does it usually manifest?
The individual may have obsessions pertaining to the fear of getting dirty, contaminated or infected by persons or things in the environment. In such cases they generally express concern over bodily secretions and disgust over waste or sticky substance. These obsessions are usually associated with cleaning compulsions. They are likely to indulge in repeated hand-washing and may consume many hours of the day cleaning their hands, they may take unusually long time to bathe or for cleaning items in the house. All these compulsions might follow some stringent rituals.
Pathological doubts can often present as doubts regarding door locks or gas knobs and are usually associated with checking compulsions which are usually performed to avoid a feared catastrophe. Their need to check repeatedly is driven by the possibility that something terrible will happen even though they recognize that the possibility is an extremely remote one. For instance, the compulsion of checking the gas multiple times before leaving the kitchen might arise out of the thoughts that in case the individual does not act responsibly a fire might break and the whole house will burn. The thought itself is so anxiety provoking for the individual that even though they spend substantial time in checking they are rarely satisfied.
Then the need for symmetry and exactness is often manifested as concern about things not being properly aligned, symmetrical or perfect. There is a constant preoccupation to have objects arranged in a certain order or position. They are constantly disturbed and discontented until they put things in perfect order. The associated compulsions include continually ordering and arranging things. They may spend hours arranging their work table before the actually sit down to work and till they are satisfied that everything is in the right place.
Presence of forbidden thoughts like blasphemous thinking, recurring sexual thoughts or images, fear of blurting out obscenities can be associated with outward compulsions like washing hands or even mental compulsions like praying, replacing bad thought with good thought because most often the obsessions make the patient feel immensely guilty.
Sometimes compulsions can also be in the form of repeating or counting. Such individuals might spend a lot of time repeating a certain task several time. Similarly, some would count the number of tiles on the floor as they enter a room.
How long do I have to continue the treatment?
The definite time required to treat OCD is not clear and often case and symptom dependent however the treatment does continue for 1-2 years and the clinician observes if the symptoms reappear. OCD is a chronic condition but it is treatable and adequate improvement in the condition is possible if the person takes guidance from a treating clinician and demonstrates compliance for treatment.