Obsessive-compulsive behavior often leads to secondary avoidance behavior. For example, people who obsess about germs compulsively wash their hands, and may also compulsively avoid places and situations that cause their anxiety in the first place, like public restrooms, doorknobs, and handshaking. Avoidance-related anxiety prohibits some people from leaving the house. And compulsive washing can lead to dermatological problems.
The fact that compulsive behavior can consume most of a person's time makes OCD a particularly devastating disease, especially when behavior becomes daily routine. In fact, the time aspect is stipulated in the criterion for diagnosis. Ironically, behavior that is intended to suppress anxiety usually causes greater distress, prohibits concentration, and interferes with normal daily activities.
Adult OCD sufferers recognize the futility of their compulsive behavior, but they are powerless to change it and cannot provide reason for their compulsive behavior. Some people lack this insighta factor that is specified in the criteria for diagnosis.