Obsessive-Compulsive Disorder (OCD) is a chronic, often severe psychological disorder in which people perform behaviors (compulsions) to prevent or relieve intense anxiety caused by intrusive, repetitive thoughts (obsessions). OCD is relatively common, affecting about 1.2% of the US adult population.
The signs of having OCD involve obsessive thoughts and compulsive behaviors to such a degree that one’s life is harmed. Obsessive thoughts involved in OCD are unwelcome and disturbing thoughts, urges, emotions or mental images that intrude into a person’s consciousness. Compulsions are uncontrollable behaviors a person performs to reduce extremely high – almost unbearable – levels of anxiety. Anxiety is the force driving OCD symptoms.
A few common obsessions include:
- Thoughts about harming others
- Thoughts about religion
- Sexual thoughts
- Profound need for order, symmetry, balance or regularity
- Fear of being contaminated or sickened
- An overwhelming need to count items
It’s crucial to understand that obsessions are unwanted, uncontrollable, distressing and recurrent. They are not part of a delusional system; that is, people understand that their thoughts may be unusual, but they are unable to stop these harmful thought processes or their accompanying behaviors on their own. Compulsions accompany obsessions. They are ritualistic, repetitive behaviors people suffering from OCD feel an irresistible urge to perform to relieve the anxiety accompanying obsessive thoughts.
Common compulsions include:
- Washing and cleaning. Washers are afraid of being contaminated. They perform excessive hand washing or excessive bathing.
- Arranging. Arranging and ordering items over and over until they meet a particular, overly rigid idea of symmetry or order.
- Checking. Repeatedly checking to see doors are locked, appliances are unplugged, windows locked.
- Compulsive counting. Counting objects or assigning special significance to certain numbers.
- Repeating. Performing the same action repeatedly (e.g., going in and out of the door repeatedly or repeating words out loud).
- Tapping/Touching. A person might tap objects a certain number of times or in a particular sequence
- Hoarding. Hoarders worry incessantly that something terrible will happen if they discard something, no matter how useless or trivial the item. They may also suffer from compulsive buying, PTSD or depression.
- Harm. People fear losing control and harming others or themselves. They may experience intrusive and unwanted violent or sexually explicit thoughts.
We all have routines and when those get upset, we may feel uncomfortable. That’s an important point: OCD compulsions are typically extreme versions of common behaviors. For example, we know that hand-washing is essential for good health, but most people can regulate how much they perform any task. A lack of an ability to regulate one’s behavior is a hallmark of OCD.
People with OCD:
- Cannot regulate their thoughts or behaviors. They understand their behaviors are irrational but have little to no control over them.
- Do not get any enjoyment or pleasure performing the rituals or behaviors.
- Spend hours every day or most days performing ritualistic behavior.
- Endure significant distress and disruptions to their lives because of their obsessive thinking and compulsive behaviors.
OCD follows a vicious cycle. In the first stage of the cycle, a person experiences intrusive obsessive thoughts. These thoughts cause an overwhelming surge in anxiety. The person then engages in behaviors that reduce anxiety to a tolerable level, which leads to temporary relief until the obsessive thoughts recur. The compulsive behaviors people perform are not necessarily logically connected to the kinds of thoughts they have.
How Do I Know If I Have OCD Symptoms?
People with obsessive-compulsive disorder find their disorder uncontrollable. It also causes significant problems in their lives. To reach the level of a diagnosable disorder, a person’s life must be severely harmed and affected by their compulsive behaviors. Having the urge to straighten a messy desk or check every lock in the house before going to bed would not meet the criteria for OCD disorder.
Can OCD Go Away?
OCD does not go away on its own. However, with treatment, it can be controlled. There are several exceptionally effective treatments for OCD, including medication, psychotherapy, and transcranial magnetic stimulation (TMS). For those seeking treatment that is pain and side-effect free, as well as covered by most insurance, TMS therapy is the best option.
This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer.
Commissioner, O. of the. (n.d.). FDA permits marketing of transcranial magnetic stimulation for treatment of obsessive compulsive disorder. Retrieved April 4, 2020, from https://www.fda.gov/news-events/press-announcements/fda-permits-marketing-transcranial-magnetic-stimulation-treatment-obsessive-compulsive-disorder
Obsessive-Compulsive Disorder (OCD). (n.d.). Retrieved from https://www.nimh.nih.gov/health/statistics/obsessive-compulsive-disorder-OCD.shtml
Obsessive-compulsive disorder (OCD). (2020, March 11). Retrieved April 4, 2020, from https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/symptoms-causes/syc-20354432