Today I’m going to be focusing on Obsessive-Compulsive Disorder (abbreviated OCD), another anxiety disorder. OCD affects 1-2% of the population. While this isn’t a high number, it’s not excluded from media portrayal, by any means (Monk, As Good As It Gets, etc.)
If you’ve never heard of OCD, here’s a brief rundown: Obsessive-Compulsive Disorder is made up of two distinct parts of the disorder: obsessions, and compulsions.
Obsessions are unwanted thoughts, urges, or impulses that cause you an excessive amount of anxiety. While there is no specific definition of what obsessive thoughts are, many people with OCD often report experiencing constant thoughts of harm to themselves or others from an outside force, or frightening images (death of a loved one, natural disasters, etc.). Finally, people with OCD believe their obsessions can be either reduced or eliminated by completing compulsions.
Compulsions are either repeated mental or physical behaviors. The compulsions serve solely to reduce or eliminate the obsessive thoughts. Compulsions can include, but are not limited to: counting, praying, repeating words/sayings, washing things, cleaning, organizing, checking items, and more.
To be diagnosed with Obsessive-Compulsive Disorder, you have to:
- Have obsessions:
- Have constant unwanted thoughts/urges/impulses that cause you a lot of anxiety
- Attempt to ignore or reduce by completing some sort of action (“compulsion”)
- Have compulsions:
- Complete repetitive physical or mental behaviors that you feel driven to complete because of your obsessive thought
- Complete the tasks to either reduce/eliminate anxiety from obsessions, or to prevent a horrible outcome
- Spend at least 1 hour a day focusing on obsessions or completing compulsions
- Struggle to complete other activities, like school or work
- your symptoms from another diagnosis or drugs
People with OCD might vary in their awareness of their obsessions and compulsions. You may meet someone who is oblivious to their actions and you may also encounter someone who is totally aware their thoughts and actions make no sense. Both of these people still experience the same symptoms and inability to control their actions.
If you think you might have OCD, consult a medical and/or psychiatric professional.
How OCD Works
OCD is a vicious cycle, however, can be simply described: OCD is the relentless fear that something bad will happen (obsession) UNLESS you do a specific activity (compulsion). So obsessions are the thoughts and compulsions are the actions. To reduce the anxiety from the thoughts, you have to complete the action.
OCD is not like Monk.
OCD is not being able to sleep at night because you’re up for 8 hours vacuuming your carpet until the lines are perfect. OCD is being chronically late to everything because if you aren’t an odd number car at a red light, you have to circle the block until you are. OCD is being so concerned with possible germs that you wash your hands until they bleed and not being able to stop.
While many people have some annoyance and anxiety about having things out of place or misaligned, not many people meet the criteria to be diagnosed with OCD. Often, people who experience OCD are not fond of people using the term incorrectly (“I’m so OCD about _____.”).
If you can still function on a daily basis with only minor inconveniences, you do not have OCD.
OCD, like most mental health disorders, has no specific cause. OCD has a higher genetic component than other mental health disorders. Individuals born to a parent with OCD are more likely to have OCD that people with non-OCD parents.
OCD is a combination of debilitating, anxious thoughts and some sort of behavior to try to reduce or eliminate the anxiety. People with OCD have varying degrees of awareness of their behaviors and symptoms. Some people acknowledge there is no logical reason for their behaviors yet cannot stop. Other people believe their compulsions prevent their obsessions (think “step on a crack, break your mother’s back”). And other people may not even be aware that their behavior is abnormal.
People who have OCD are likely to have a co-occurring disorder, such as an eating disorder, depression, bipolar disorder, or anxiety.
Triggers & Expression
Not everyone with OCD has the same trigger or obsession. There are innumerable obsessive thoughts that people experience, however, there are several trending themes: Checkers, Repeaters, Counters, Arrangers, Washers, Hoarders, and Moralists.
Checkers often struggle with fear of harm or danger and feel compelled to repeatedly check their homes, cars, or check on family members to ensure safety.
Repeaters have a fear of negative events occurring if a behavior is not repeated a certain number of times. While similar to counting, this is a separate category in that it is typically more specific to the action rather than the number.
Counters feel compelled to complete actions in sets of a specific number (sets of 4, 7, etc.). There is no predominant underlying theme with counting, aside from an arbitrary value assignment to the number (such as a lucky number).
Arrangers typically struggle with immense discomfort/anxiety in the lack of order or predictability.
Washers have a constant fear of illness or germs. Washers spend hours washing their hands, homes, bodies, clothing, or more on a daily basis.
Hoarders often struggle with an intense fear that a catastrophic issue will occur if they decide to dispose of something. Some hoarders have specific items they hoard, while others hoard everything.
Moralists struggle with a fear of being a “bad” person if they do not follow through with self-punishment following their intrusive thoughts.
These are just some common themes of OCD compulsions. There are many, many more: urges to tell/confess, excessive list-making, excessive reassurance seeking, self-harm, urges to touch/rub/tap, and more.
Often, people with OCD report developing symptoms in their childhood. Because of the complexity, and the sheer “crazy-making” experience of OCD, many people with OCD are skilled and hiding their obsessive thoughts and/or compulsions. People with OCD often feel guilt, shame, and embarrassment about their disorder, and even worse: feel isolated and alone.
Most people with OCD are not diagnosed until their adulthood, often leading to an increased risk of another co-occurring disorder.
Medication can be helpful with reducing the anxiety associated with obsessions. Because of the nature of these medications, it may take longer than other medications to take effect (10-12 weeks, as opposed to 3-4 weeks for other psychotropic medications).
As always, medication isn’t the only way to manage and treat OCD. Therapy can be helpful, as well as intensive inpatient and outpatient programs. Currently research shows that Cognitive-Behavioral Therapy (CBT) is a successful form of treatment for OCD. As always, having a good support system is helpful. At this time, it is not established that OCD can be driven into full remission, however many of the symptoms can be reduced to aid in everyday functioning.
- OCD affects ~2% of U.S. adults, and 2.3% of the world population.
- Over 50% of people who are diagnosed with OCD are classified as severe cases.
- The average age for a person to be diagnosed with OCD is 19.
- OCD affects men and women equally.
- OCD is more common in developed countries.
- Children can be diagnosed with OCD.
- 1/3 of OCD cases report their symptoms started in childhood.
- Children diagnosed with OCD are often unable to explain their behavior or reasoning, or even recognize it is unusual.
- OCD can be treated.
- There is no known cause for OCD.
- CBT is considered the most effective therapy for OCD.
- People with OCD often do not respond to traditional therapy approaches.
Where did you learn about OCD? How accurate was it?