Obsessive-compulsive disorder is a very broad disorder often affiliated with anxiety disorders, and an unfortunately common one. Roughly 1 in 40 adults struggle with a form of OCD. As devastating as OCD might be sometimes, it is a condition that many Americans live with daily through the support of their loved ones and professional help. The biggest challenge for a person facing issues with OCD is lack of knowledge and understanding from those around them as to what their disorder really entails.
While only a mental health professional can diagnose a mental illness, there are a few characteristics that can help people more readily identify what is and is not a case of OCD. OCD has often been referred to as a form of extreme tidiness, but there is much more behind it than just a case of germaphobia or a passion for order.
What Is OCD?
As the name implies, OCD is a disorder centered around active obsessions and compulsions. While we all have our obsessions and compulsions, these patterns in thoughts and behavior are often relatively normal and harmless. A person is only diagnosed with a case of OCD when their obsessive thoughts and compulsive behavior very clearly damage their relationships, and negatively affect their health and safety. Someone who makes a habit of being tidy, even with a tick or a personality quirk, is not mentally ill. But a person who cannot go a day without worrying obsessively about something to such an extreme that they find their own thoughts distressing and disturbing, may be struggling with a form of OCD.
Obsessions are typically very time-consuming and are accompanied by overwhelming feelings of fear. While research shows that intrusive thoughts – thoughts we consider alarming or disturbing – are a normal phenomenon in healthy people, someone with OCD will have consistently disturbing obsessions that haunt them on an almost daily basis. Obsessions can trigger extreme anxiety and distress. Someone with OCD cannot move on past their obsessions like other people do. Common obsessions include:
- Fears and obsessions regarding physical order
- Fear of throwing something out (hoarding)
- Fear of getting sick with a debilitating disease
- Fears related to superstitions
- Fear of harming others with clumsy behavior
- Fear of acting on violent impulses
- Fear of offending God/sinning
- Fear of certain household objects or chemicals
- Fear of coming into contact with fluids or objects
- Struggling with explicit imagery/unwanted sexual thoughts
- Obsessive and disturbing thoughts of violence towards others
- Impulsive violent sexual feelings
- And more.
Compulsions are usually related to a person’s obsessions and are extreme or unusual coping mechanisms meant to counter the obsession, or make it go away. Most people with OCD understand that compulsions are not truly an effective answer for their obsessions but rely on them as the only thing that ‘works’. Just like obsessions are incredibly obstructive, compulsions also take a large chunk of a person’s day, as they must be performed every time the obsession returns.
Compulsions are not strictly speaking routines or rituals. Just as how intrusive thoughts are common enough to be considered normal, many humans rely on rituals to cope with daily challenges. Bedtime routines, prayer rituals and most sports and hobbies require repetitive and complex routines to help a person sleep, find peace, or be better at a certain task. When pertaining specifically to cases of OCD, compulsions are repetitive behaviors created by OCD patients to counter obsessions. These are tasks that a person with OCD would rather not do – but they must, to reduce their anxiety. Common compulsions include:
- Excessive hand-washing/hygiene routines
- Ordering objects for hours
- Excessively cleaning something for fear of contaminants (to the point that it may be damaged)
- Excessively praying (after every ‘bad’ thought, dozens of times per day)
- Counting to soothe an obsession
- Repetitively checking your belongings to ensure they’re there
- Reading and writing something several times
- Repeating a routine activity at least once, or in specific multiples (going up and down the stairs, flipping switches, opening and closing a door)
- Tapping, blinking, or snapping fingers a specific number of times before any activity
While OCD refers to people with obsessive and compulsive issues, there are people diagnosed with OCD but only struggle with the obsessions, with no real reliable way of relieving the anxiety related to them. Some research suggests that there are also cases of OCD where the obsessions develop after the compulsions, in the sense that a person develops a habit out of some sense of general anxiety, and that said anxiety only crystalizes into a true obsession over time.
The research also indicates that the repetitive behavior reinforces the obsession, and that helping individuals avoid the repetitive behavior (compulsion) caused the obsession to cease as well. Treating OCD is all about identifying an individual’s unique obsessions, and compulsions, and working with them through various therapies to find the right way to address these challenges.
How OCD Affects Everyday Life
The characteristics of OCD require that a person experiences a set of symptoms powerful enough to significantly disrupt their day-to-day lives. However, past that criteria, the specifics of any one OCD diagnosis vary considerably from individual to individual.
Struggling with OCD takes a substantial amount of time and energy. Many individuals with OCD struggle to maintain certain forms of employment, and feel incredibly self-conscious about their obsessions and compulsions, to the point that making new friends and going on dates become daunting challenges. As a mental illness, OCD presents itself as an additional barrier to breach in the quest to get things done day after day.
Concentrating becomes difficult. Several different things become triggers – from social interaction, to certain sounds or images. Therapy and treatment help, but it still takes time for the thoughts to go into remission.
Treatment Is Crucial
OCD is treated through certain types of medication, therapies that specialize in OCD, and a few other modalities, including transcranial magnetic stimulation. Research seems to indicate that OCD can be traced back to a specific ‘error’ in neurobiology – a problem in the processing of certain thoughts and impulses. When treated correctly, a person can lead a normal life without the constant interference of distressing thoughts and images.
However, treatment must be seen as more than just a one-time course. OCD is seen as chronic, and may require a few permanent lifestyle changes and repeated visits to mental health professionals to completely ‘overcome’ the disorder, and more aptly, prevent it from flaring back up in times of stress.