Obsessive compulsive disorder (OCD) is an anxiety disorder that often manifests through repeated, compulsive behaviors. While many associate it with behaviors like compulsively washing hands or checking locks, the disorder can take many forms and is often destructive to the person who struggles with it.
People with obsessive compulsive disorder can have both obsessive thoughts and urges to engage in repetitive behaviors. These thoughts and actions are often out of control and a person is unable to stop it. Even if the thoughts or behaviors bring about stress or negative consequences, they may feel as if they have no control over it. Some of the thoughts and behaviors commonly observed in those with OCD include:
- Fear or anxiety about getting dirty and germs
- Constant worry about someone getting hurt
- Belief that numbers and/or colors are good or bad
- Constant self-awareness regarding involuntary bodily functions such as breathing and blinking
- Repeatedly washing hands several times in a row
- Having a specific order to complete tasks in or a certain number of times a task must be performed
- Constantly counting things such as the number of steps someone takes
- Organizing objects in a specific order with the same facing
- Anxiety about touching other people’s hands, doorknobs, or public restrooms
Types of OCD
Obsessive compulsive disorder can present itself in numerous ways. There is often an obsession that leads to the execution of a compulsion. The most common obsessions include:
- Checking: A checking compulsion can cause a person to repeatedly look for something. They may repeatedly check their locks, make sure appliances are off, or check for signs of damage, leaks, or fire. They may also have a compulsion to check on people. This may mean repeatedly reading communications, validating memories, or checking to make sure a person is not getting an illness.
- Contamination: The fear of becoming ill can cause a person to continuously wash themselves or objects. They believe that something is contaminated and will continuously clean it until they feel it is no longer needed. The feeling of contamination may cause a person to avoid public places, shower or wash their hands excessively, or overbrush their teeth.
- Rumination: A person may obsessively think about broad philosophical topics such as the creation of the universe or what happens after death. These thoughts can become overwhelming and never produce a satisfactory answer.
- Intrusive thoughts: In some cases, a person may have upsetting horrific thoughts that they do not want. This may include thoughts of violence, both physical and sexual, suicide, and obsession with superstitions. These thoughts are severely distressing and can create anxiety, but they are almost never acted upon.
- Orderliness and organization: A person may become obsessed with objects being lined up or organized by size, shape, or color. They may repeatedly adjust objects and try to line them up perfectly. Not organizing objects can cause significant discomfort.
Obsessions are usually followed with a compulsion. Not all rituals or repetitive behaviors are compulsions, but those performed out response to an obsession are. Some of the most common compulsions include:
- Washing and cleaning, including hand-washing
- Checking body parts to ensure nothing bad has happened
- Repeating routine activities such as checking the locks or rereading the same line of text over and over
- Mental compulsions such as repeatedly reviewing events in your head
- Constantly reorganizing, refacing, and realigning objects
Diagnosis and Treatment of OCD
A number of mental health disorders have similar symptoms to obsessive compulsive disorder. In order to diagnose OCD, the following should be observed:
- The presence of both obsessions and compulsions
- The obsessions and compulsions cause distress, are time-consuming, and significantly impair different aspects of their life
- The symptoms are not caused by use of substances such as drugs, alcohol, or other medications
- The symptoms are not attributed to another mental health disorder
Without treatment, OCD can turn into a chronic condition with periods of time in which the symptoms may lessen. Treatment varies and is largely dependent on the extent it affects a person’s day-to-day functioning. Treatment may include any combination of therapy and medications.
There are various forms of therapy that may be used to help change the way a person thinks, behaves, or feels about specific situations. In many cases, cognitive behavioral therapy (CBT) and exposure therapy are used in conjunction to help reset a person’s response to situations. Over time, the obsessions decrease which reduces the compulsions or rituals they usually trigger.
In some cases, medications may be used to help treat symptoms like anxiety that may be associated with OCD, but medications are rarely effective on their own. While they can provide temporary relief from some symptoms, the use of therapy often provides the most significant changes in a person’s experience. The use of these treatment options together can improve, and in some cases, cure OCD.
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