Some people experience strong urges and repeated thoughts that push them to do certain behaviors again and again, even when those behaviors harm their daily life. These behaviors are not done for pleasure. Instead, they are done to reduce anxiety, discomfort, or tension. Examples include repeatedly checking things, saving unnecessary items, pulling out hair, picking skin, or constantly worrying about appearance.

In the past, mental health professionals described these problems using different labels, such as habit disorders, impulse-control disorders, or behavioral addictions. However, research has shown that many of these behaviors are closely related to obsessive-compulsive disorder (OCD). Like OCD, they involve unwanted thoughts, strong urges, and repetitive actions that are difficult to control. Because of these similarities, the DSM-5 now groups several of these conditions under Obsessive-Compulsive–Related Disorders.

The main disorders in this category are Hoarding Disorder, Trichotillomania (Hair-Pulling Disorder), Excoriation (Skin-Picking) Disorder, and Body Dysmorphic Disorder. Together, these disorders affect a significant number of people and can seriously disturb emotional well-being, relationships, work, and everyday functioning.

Hoarding Disorder

Hoarding Disorder is a condition in which a person feels a strong need to keep possessions and experiences intense distress when asked to throw things away. The items saved are often not useful or valuable, such as old newspapers, empty containers, broken objects, or junk mail. The problem is not laziness; rather, the person believes the items may be needed later or feels emotionally attached to them.

Over time, the accumulation of objects fills living spaces, making it hard to walk through rooms, sleep on beds, or use kitchens and bathrooms properly. Homes may become unsafe due to fire risks, falling hazards, or poor hygiene. Hoarding often causes serious problems in family relationships and may lead to social isolation. Many people with hoarding disorder feel ashamed or embarrassed and avoid letting others into their homes. Although they may recognize the problem, letting go of possessions feels extremely painful and anxiety-provoking.

Trichotillomania (Hair-Pulling Disorder)

Trichotillomania is a disorder in which a person repeatedly pulls out their own hair. Hair may be pulled from the scalp, eyebrows, eyelashes, beard, or other parts of the body. Most people pull one hair at a time, and the behavior may happen consciously or almost automatically.

This hair-pulling is often triggered by stress, anxiety, boredom, or strong emotions. Some individuals feel a sense of tension before pulling and brief relief afterward. Others follow specific rituals, such as searching for a hair that feels “just right” before pulling it out. Over time, this behavior can lead to noticeable hair loss, bald patches, skin damage, and infections.

People with trichotillomania usually feel ashamed or guilty about their behavior and try many times to stop, but find it very difficult. The disorder can lower self-esteem and interfere with social life, especially when hair loss becomes visible.

Excoriation (Skin-Picking) Disorder

Excoriation Disorder involves repeated picking, scratching, or squeezing of the skin, which results in sores, wounds, or scars. People most commonly pick at the face, but other areas such as the arms, legs, lips, scalp, or back may also be affected. Skin-picking is often done with fingers, but some people use tools like tweezers or pins.

This behavior is commonly triggered by stress, anxiety, or feelings of tension. Similar to hair-pulling, individuals may feel temporary relief after picking, followed by regret or shame. Many people spend a long time in front of mirrors examining their skin and picking at small imperfections.

Despite repeated efforts to stop, the behavior continues and can cause pain, infections, scarring, and serious emotional distress. The disorder often affects social confidence, as individuals may avoid social situations to hide their skin.

Body Dysmorphic Disorder (BDD)

Body Dysmorphic Disorder is a condition in which a person becomes excessively preoccupied with a perceived flaw in their physical appearance. The flaw is usually very minor or not noticeable to others, but the person experiences it as severe and upsetting. Common areas of concern include the skin, nose, hair, facial features, body shape, or body odor.

People with BDD often engage in repetitive behaviors such as frequently checking mirrors, avoiding mirrors, excessive grooming, comparing themselves with others, seeking reassurance, or picking at the “defect.” These behaviors are attempts to reduce anxiety, but they usually make the distress worse over time.

BDD can cause severe emotional suffering and greatly interfere with daily life. Individuals may avoid social interactions, miss school or work, and experience depression or anxiety. In some cases, people seek repeated cosmetic procedures, but these rarely relieve their distress because the core problem is psychological, not physical.