Country music star Luke Combs talks about living with lesser-known form of OCD

American country music sensation Luke Combs got real about his struggle with obsessive-compulsive disorder and anxiety, as well as the challenges of being on the road, in a recent interview with 60 Minutes Australia.

"Mine is more of an obscure form of OCD," the 35-year-old singer said, describing the disorder sometimes referred to as "purely obsessional" or "pure O." However, there is some scientific disagreement over the use of the term and subtype, with some calling it slang.

Combs described the condition as "particularly wicked because there is no outward manifestation of it." He said he can experience everything from intrusively violent thoughts to thoughts about religion, and focus on questions that don't have an answer.

"It's really questions about who you are as a person that you really can't ever get an answer to ... and that's what fuels the anxiety," he said.

Pure O is one of those subtypes of OCD in which people experience disturbing, unwanted thoughts that will cause anxiety, said Sarah Innes, a psychotherapist at the Canadian online therapy practice Shift Collab.

"But instead of performing those obvious physical rituals that we see with other subtypes, such as checking or symmetry, they'll be engaging in mental rituals — so over-analyzing their thoughts, seeking reassurance or avoiding mental triggers," she said.

Innes said the pure O form of OCD is not uncommon and isn't less severe than other types, but it is harder to diagnose as the symptoms are more internal and the compulsions may not be as obvious.

Combs described the debilitating way the disorder functions, explaining that a really bad flare-up could have him fixating on thoughts for 45 seconds of every minute for weeks.

"It's thoughts that you essentially don't want to have that you're having, and then they cause you stress," he said, explaining the vicious cycle. "And then you're stressed up and the stress causes you to have more thoughts. You don't understand why you're having them and you're trying to get rid of them, but trying to get rid of them makes you have more of them.

"It's very tedious to pull yourself out of it.... I'm lucky to be an expert in how to get out of it now, but I feel for people that struggle with this."

The eight-time Grammy nominee — who shot to fame in 2017 with his debut single Hurricane, which sold 10,000 copies in just the first week — described his sprint to the top of country music as "a crazy 10 years."

His viral cover of the 1988 Tracy Chapman song Fast Car topped charts in 2023, and he went on to perform the song with Chapman during the 2024 Grammys. Among his several wins are nine Country Music Association awards and three Academy of Country Music awards.

Combs, a native of North Carolina, said his light-bulb moment came the summer after he turned 21, when he moved on from being in the choir to picking up his guitar and singing.

A flare-up could hit while on stage, and "when it hits, it can be all consuming," said Combs, who is currently on tour.