Obsessive Compulsive Disorder (OCD) - Obsessive-Compulsive Disorder (OCD) is a common, chronic, and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and/or behaviors (compulsions) that he or she feels the urge to repeat over and over. People with OCD may have symptoms of obsessions, compulsions, or both. These symptoms can interfere with all aspects of life, such as work, school, and personal relationships.
What are Obsessions?
Obsessions are thoughts, images or impulses that occur over and over again and are outside of the person’s control. Individuals with OCD do not want to have these thoughts and sometimes find them disturbing. In most cases, people with OCD realize that these thoughts don’t make any sense. Obsessions are typically accompanied by intense and uncomfortable feelings such as fear, disgust, doubt, or a feeling that things have to be done in a way that is “just right.”
Common Obsessions in OCD
Contamination:
- Body fluids (examples: urine, feces)
- Germs/disease (examples: herpes, HIV)
- Environmental contaminants (examples: asbestos, radiation)
- Household chemicals (examples: cleaners, solvents)
- Dirt
Losing Control:
- Fear of acting on an impulse to harm oneself
- Fear of acting on an impulse to harm others
- Fear of violent or horrific images in one's mind
- Fear of blurting out obscenities or insults
- Fear of stealing things
Harm:
- Fear of being responsible for something terrible happening (examples: fire, burglary)
- Fear of harming others because of not being careful enough (example: dropping something on the ground that might cause someone to slip and hurt him/herself)
Obsessions Related to Perfectionism:
- Concern about evenness or exactness
- Concern with a need to know or remember
- Fear of losing or forgetting important information when throwing something out
- Inability to decide whether to keep or to discard things
- Fear of losing things
Unwanted Sexual Thoughts:
- Forbidden or perverse sexual thoughts or images
- Forbidden or perverse sexual impulses about others
- Sexual obsessions that involve children or incest
- Obsessions about aggressive sexual behavior towards others
Religious Obsessions (Scrupulosity):
- Concern with offending God, or concern about blasphemy
- Excessive concern with right/wrong or morality
Other Obsessions:
- Obsessions about one's sexual orientation
- Concern with getting a physical illness or disease (not by contamination, e.g. cancer)
- Superstitious ideas about lucky/unlucky numbers certain colors
What are Compulsions?:
Compulsions are repetitive behaviors or mental acts that a person feels driven to perform in response to an obsession. The behaviors typically prevent or reduce a person's distress related to an obsession. Compulsions may be excessive responses that are directly related to an obsession (such as excessive hand washing due to the fear of contamination) or actions that are completely unrelated to the obsession. In the most severe cases, a constant repetition of rituals may fill the day, making a normal routine impossible. (https://psychiatry.org/patients-families/obsessive-compulsive-disorder/what-is-obsessive-compulsive-disorder
Washing and Cleaning:
- Washing hands excessively or in a certain way
- Excessive showering, bathing, tooth-brushing, grooming ,or toilet routines
- Cleaning household items or other objects excessively
- Doing other things to prevent or remove contact with contaminants
Checking:
- Checking that you did not/will not harm others
- Checking that you did not/will not harm yourself
- Checking that nothing terrible happened
- Checking that you did not make a mistake
- Checking some parts of your physical condition or body
Repeating:
- Rereading or rewriting
- Repeating routine activities (examples: going in or out doors, getting up or down from chairs)
- Repeating body movements (example: tapping, touching, blinking)
- Repeating activities in "multiples" (examples: doing a task three times because three is a "good," "right," "safe" number)
Mental Compulsions:
- Mental review of events to prevent harm (to oneself others, to prevent terrible consequences)
- Praying to prevent harm (to oneself others, to prevent terrible consequences)
- Counting while performing a task to end on a "good," "right," or "safe" number
- "Canceling" or "Undoing" (example: replacing a "bad" word with a "good" word to cancel it out)
Other Compulsions:
- Putting things in order or arranging things until it "feels right"
- Telling asking or confessing to get reassurance
- Avoiding situations that might trigger your obsessions
Risk Factors for OCD (https://www.healthline.com/health/ocd/social-signs#diagnosis)
If you’re genetically more likely to develop OCD, other factors can also increase your chances of developing the condition.
These include:
- Stress or trauma
- Significant stress at home, school, work, or in personal relationships can raise your chances of developing OCD or worsen existing symptoms
- Personality. Certain personality traits, including difficulty handling uncertainty, heightened feelings of responsibility, or perfectionism, may factor into OCD. However, there’s some debate over whether these are actually fixed traits or more flexible learned responses that can change
- Abuse in childhood. Children who experience abuse or other traumatic childhood experiences, like bullying or severe neglect, have a higher chance of developing the condition
- Childhood acute neuropsychiatric symptoms (CANS). For some children, OCD begins suddenly after an infection. After a streptococcal infection, this syndrome is known as PANDAS, which stands for pediatric autoimmune neuropsychiatric disorders associated with streptococcus. But other infections or diseases can also cause symptoms
- Traumatic brain injury. According to a 2021 study, symptoms of OCD may appear for the first time following a head injury
Keep in mind, that it is possible to have a family history of OCD, along with other risk factors, and still never develop the condition yourself. What’s more, people without any known risk factors can still have OCD.
