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Obsessive compulsive disorder (OCD), is described well by its name; it’s an anxiety disorder where individuals experience different obsessions and compulsions. More specifically, OCD “is characterized by repetitive, unwanted, intrusive thoughts (obsessions) and irrational, excessive urges to do certain actions (compulsions)” [1]. This anxiety disorder is relatively common; “in the United States, OCD affects about 2.2 million adults. The International OCD Foundation estimates that about 1 in 100 adults in the US have OCD while 1 in 200 children and teens suffer from the disorder” [2]. Keep in mind, these numbers only reflect the amount of recorded individuals with OCD in the United States, so many more individuals around the world are also living with this anxiety disorder.
Obsessions and compulsions show up in different ways for different individuals. “Obsessions are usually exaggerated versions of concerns and worries that most people have at some time” [3]. So, if you read the following list of common obsessions and notice some similarities to your own thoughts, just remember that a lot of people experience these same thoughts at some time or another; if you are truly worried that these thoughts affect you more than they do others, ask your primary physician if they can help you schedule a medical exam to help you try to figure out what might be going on. So, here is the list of common obsessions associated with OCD [3]:
fear of contamination from germs, dirt, poisons, and other physical and environmental substances
fear of harm from illness, accidents or death that may occur to oneself or to others. This may include an excessive sense of responsibility for preventing this harm
intrusive thoughts and images about sex, violence, accidents and other issues
excessive concern with symmetry, exactness and orderliness
excessive concerns about illness, religious issues or morality
needing to know and remember things
As you may be able to imagine, obsessions run through one’s mind continuously. Obsessions can be triggered by different things, such as "physical objects, situations, smells or something heard on television, radio or in a conversation” [3]. Although obsessive fears can have these triggers, they “usually move beyond a specific trigger – for example, a bottle of coolant – to include anything that might look like it or have been near it, such as cars, car keys, a puddle on the road, supermarket shelves and petrol stations” [3]. So, even if an individual is aware of what might trigger their obsessions, it could be extremely hard to avoid it since so many things can remind them of that trigger. “Obsessions can change in nature and severity and do not respond to logic, [...] [and] obsessions can produce feelings ranging from annoyance and discomfort to acute distress, disgust and panic” [3]. So, with this information, it makes it easier to understand how hard it is for someone living with OCD to control these obsessive thoughts without any treatment.
Compulsions, although still just as disruptive of one’s day as obsessions, are a bit different. “Compulsions are repetitive actions that are often carried out in a special pattern or according to specific rules. Compulsions are usually performed to try and prevent an obsessive fear from happening, to reduce the anxiety the obsessive thought creates, or to make things feel ‘just right’” [3]. There are many compulsions that individuals with OCD can experience, and not all individuals will experience the same ones, but here is a list of common compulsions experienced with OCD [3]:
excessive hand washing, showering and tooth brushing
excessive cleaning and washing of house, household items, food, car and other areas
excessive checking of locks, electrical and gas appliances, and other things associated with safety
repeating routine activities and actions such as reading, writing, walking, picking up something or opening a door
applying rigid rules and patterns to the placement of objects, furniture, books, clothes and other items
touching, tapping or moving in a particular way or a certain number of times
needing to constantly ask questions or confess to seek reassurance
mentally repeating words or numbers a certain number of times, or concentrating on ‘good’ or ‘safe’ numbers
replacing a ‘bad thought’ with a ‘good thought’
Obsessions and compulsions similarly affect one’s daily routine. Individuals with OCD may try extremely hard to avoid obsessive thoughts and compulsive behaviors, but those fears still run through their minds, and then they feel forced to execute the compulsive behaviors because they believe it will help them avoid the fears being produced by their obsessive thoughts. These thoughts running through someone’s mind constantly can take away from so much of their day. The thoughts aren’t only distracting, but they’re also anxiety-inducing, and that can take someone’s focus away from anything else they might need to be focusing on, such as work or even something as simple as a conversation in a social setting. Compulsive behaviors can also take a lot away from one’s daily routine depending on severity.
With so many common compulsive behaviors being repetitive and excessive tasks, they may take up what feels like a big part of someone’s day. Not only that, but they may even cause someone to stop doing something they need or want to do because they feel forced to perform a compulsion to help put their thoughts at ease. Since many compulsions are repeated multiple times, one might not even be able to bring their focus back to what they might have been doing for a good amount of time. If you feel that you may be experiencing obsessive thoughts or compulsive behaviors, I would like to emphasize how important it is to tell your primary care physician, if possible. To be diagnosed with this disorder, an individual must experience: “obsessions, compulsions or both [...] [and] obsessions or compulsions that are upsetting and cause difficulty with work, relationships, other parts of life and typically last for at least an hour each day” [1].
Although OCD can have such a strong effect on one’s daily routine, there are some treatments that may help individuals living with this disorder. Before going over these treatments, it is important to remember that OCD is not a curable disorder, but treatments can help with symptoms. Treatments include: medication and psychotherapy. “Medication, especially a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI), is helpful for many people to reduce the obsessions and compulsions. Psychotherapy is also helpful in relieving obsessions and compulsions. In particular, cognitive behavior therapy (CBT) and exposure and response therapy (ERT) are effective for many people. Exposure response prevention therapy helps a person tolerate the anxiety associated with obsessive thoughts while not acting out a compulsion to reduce that anxiety. Over time, this leads to less anxiety and more self-mastery” [1]. Again OCD has no cure, but these treatments can definitely help individuals take more control of their symptoms rather than their symptoms taking control over them.
“If left untreated, OCD can be chronic and can interfere with a person’s normal routine, schoolwork, job, family, or social activities” [2]. If you or a loved one lives with this disorder, it’s extremely important to understand what it is and how you may be able to help yourself or a loved one regain control to experience a better quality of life. When in doubt, always try to ask your doctor any questions you have, because they will likely be able to guide you and help you get a diagnosis and treatment plan, or refer you to a specific medical professional who specializes in disorders like OCD.
References:
1. National Alliance on Mental Illness. Obsessive-compulsive Disorder. NAMI. https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Obsessive-compulsive-Disorder
2. Anxiety & Depression Association of America. Obsessive-compulsive Disorder (OCD). ADAA. https://adaa.org/understanding-anxiety/obsessive-compulsive-disorder-ocd#:~:text=Approximately%202%25%20of%20the%20general,teens%20suffer%20from%20the%20disorder
3. Department of Health & Human Services. (2000, July 25). Obsessive Compulsive Disorder. Better Health Channel. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/obsessive-compulsive-disorder
Contributors:
Author: Lauryn Agron
Editor: Kayjah Taylor
Health scientist: Naiya Upadhyay