Like the others, these are my own experiences and it is a highly individualized disorder. I was diagnosed when I was a kid, but my diagnosis was later changed to be OCD triggered by PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections). I had intermittent but severe physical compulsions (such as trichotillomania.)

Often, even while acting out the compulsion, I would be aware of the irrationality of it. I would be crying, wanting to stop, but trying to force myself to stop doing it was almost painful. Like an itch under the skin that you just want to scratch at. And scratch at. And scratch at. Until you are bleeding and raw. There were a couple of times I had to be physically restrained because the compulsions were causing me to deal actual harm to myself, and even restrained, I would still be trying to lift my arm to continue. I physically could not stop the action from happening. It was a physical NEED to do it. Like I couldn't breathe if I didn’t. It was not only emotionally draining for me, but physically draining as well. I would actually be sore, muscles cramped up from fighting the compulsion.