Country Singer Luke Combs Shares Battle With ‘Pure O’ OCD: ‘People Suffer in Silence’

The 35-year-old musician says he was diagnosed with purely obsessional OCD when he was 21.

Luke Combs performs onstage during the Bobby Bones & The Raging Idiots' Million Dollar Show for St. Jude at the Ryman Auditorium on Jan. 22, 2018, in Nashville, Tenn. Jason Kempin/Getty Images for St. Jude

Country star Luke Combs has detailed his battle with purely obsessional OCD, or pure O, an unofficial type of obsessive-compulsive disorder that manifests in mental rather than observable behaviors.

The “Beautiful Crazy” singer discussed his mental health struggles during an Aug. 18 episode of the “Armchair Expert” podcast, hosted by actor and comedian Dax Shepard.

“There’s no outward compulsions,” the musician said. “The behaviors are all mental—mental rituals.”

Combs, 35, said he was initially told he suffered from generalized anxiety disorder in high school.

However, at the age of 21—the same year he learned to play the guitar—he was diagnosed with pure O, also known as primarily obsessional OCD.

Healthline reports that pure O isn’t a recognized clinical term, nor is it described in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), a resource used by mental health clinicians to diagnose mental disorders.

The DSM-5-TR defines OCD as being characterized by the “presence of obsessions and/or compulsions.”

“Obsessions are recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted,” the text reads, “whereas compulsions are repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.”

Some of the repetitive, intrusive thoughts that people suffering from OCD may experience include mental images related to sex, the fear of acting on an impulse to harm oneself or others, and concerns with touching perceived contaminated surfaces, the International OCD Foundation reports.

Luke Combs performs on stage during CMA Fest in Nashville, Tenn., on June 8, 2023. Jason Kempin/Getty Images

“There [are] a lot of themes that are very recurrent for people who have this,” Combs said.

“Religion is one. It essentially preys on the antithesis of who you are at your core, but it focuses on questions that are unanswerable, which is like, ‘Do I really love God?’ ‘Do I really believe in God?’ And then you spend over 90 percent of your day thinking about that. And that could happen for months on end.”

The Grammy-nominated musician, who released his debut album, “This One’s for You,” in 2017, said the “big key” to easing the discomfort wrought by the repetitive thoughts is understanding that “you'll never have an answer to any of these questions.”

“Answering the question will never cure you,” he added.

Combs said he doesn’t shy away from speaking out about his condition because he’s found that it encourages others to do the same.

“People always reach out to me about it, because there [aren’t] a lot of people who’ve talked openly about that particular form, which a lot of people have,” he said.

“I would say 99.9 percent of people suffer in silence with this thing, because how do you tell your parents when you’re 12 years old what you’re worried about? ... People will think you’re insane.”