It is currently estimated that about 2.3 percent of the American adult population struggles with obsessive-compulsive disorder. However, despite that figure, many still seem to misunderstand what the disease entails, and how it develops. OCD is more than an obsession for neatness, or the cause for a very quirky personality.
Whereas a focus on neatness and symmetry is normal and natural, individuals with OCD struggle with compulsive behavior they cannot control on their own, triggered by irrational anxieties or obsessions that seemingly come out of nowhere. More than just being an inconvenience, OCD can be a debilitating illness. When severe enough, it is counted as a disability. However, there is no one set form of OCD – the disorder can manifest in many ways. Each complicate life in their own way.
In the simplest terms, a diagnosis of OCD implies that a person is suffering from a cyclic struggle against obsessions and compulsions. These feed each other in different ways, forming a complex relationship wherein a person experiences severe and intensely distressing anxieties, and can only soothe them through a very specific set of compulsive behavior.
While OCD is often referred to in popular fiction, it is not always portrayed accurately. An often-cited example is the misanthropic character of Melvin Udall in As Good As It Gets, played by Jack Nicholson; while the character’s compulsive rituals are faithful to our understanding of OCD, his perceived personality quirks and curmudgeon attitude are not related to the disorder. OCD does not make people grumpy – however, OCD can make life socially awkward, and while the compulsions caused by the disorder are uncontrollable, they are often perceived as strange or disturbing by others.
How OCD manifests depends mostly on what the fears and anxieties (obsessions) are. Common obsessions in many cases of OCD include:
- Fear of germs or transmittable diseases lurking everywhere.
- Fear of environmental contaminants, from radiation to chemical leaks or toxins.
Fear of tragic events or accidents every day.
- Fear of sudden embarrassment or appearing awkward.
- Powerful intrusive thoughts (such as fleeting thoughts of assault or murder)
- Powerful and sudden sexual thoughts
- Extreme religious thoughts/behavior/guilt (scrupulosity)
- Fear of asymmetry or not doing things perfectly/just right
- And more
While intrusive thoughts are common, and many people struggle with certain fears such as losing their loved ones, obsessions are different. These are overwhelming and irrational anxieties fueled not by any happenstance or emotional reaction, but sudden and severely discomforting thoughts and feelings. These thoughts cannot be controlled or stopped and are very difficult to soothe. Because these anxieties are the primary driving factor behind OCD-related behavior, OCD is considered an anxiety disorder, and can be seen as existing on a spectrum alongside other forms of complex anxiety disorders.
Because these thoughts are so discomforting, patients with obsessions develop coping mechanisms that they perceive as effective for soothing their anxieties. People with OCD intellectually understand that their obsessions are irrational, and that their compulsive behavior is not always strictly related to ‘fixing’ the thing they had an issue with. Common compulsions include:
- Double- and triple-checking everything, from locks to light switches, appliances, air-conditioning, and so on
- Repeatedly sending messages to loved ones or checking on them several times in a row
- Excessively washing or cleaning (to the point of damaging objects or causing blisters/pain)
- Hoarding inanimate objects
- Spending inordinate amounts of time arranging and rearranging objects
- Counting, fidgeting, repeating phrases/mantras, and engaging in ‘superstitious’ behavior
Obsessions feed compulsions. The obsessions cause feelings of extreme discomfort, to the point that a person cannot properly function. Then, they lead to compulsive behavior as the only feasible coping mechanism. This creates temporary relief, but the cycle always repeats itself.
OCD, Depression and Anxiety
OCD is not perfectionism or a form of anal retentiveness. OCD is a condition that essentially changes the way an individual begins to perceive the world around them. Anything can cause them to think back to their inner fears and be confronted with such severe discomfort and anxiety that they struggle to leave the house, let alone function normally in the outside world. Even at home, they may have a hard time feeling well within their own walls, confronted by intrusive thoughts of potential break-ins, pests, or germs.
Because OCD is often such a severe disorder, it is not always alone. Individuals with OCD are at a higher risk of developing major depressive disorder than the general population, and it is not uncommon for individuals to struggle with other forms of anxiety as well, from certain phobias (such as an intense fear of germs or public speaking) to social anxiety and generalized anxiety.
Outside of their obsessions and following compulsions, individuals with OCD may also struggle with feelings of guilt, worthlessness, feeling like a burden, suicidal ideation, and problems with concentration and sleep, leading to a series of other health potential health problems, both physical and mental.
How OCD is Treated
While not entirely understood, there is evidence to suggest that OCD has its origins in biochemical differences in the brain, specifically relating to certain pathways that, if targeted through the right medical technology, may be the key to relieving or reducing symptoms of OCD. These pathways, alongside certain neurochemicals such as serotonin, seem to link OCD with other mental illnesses such as depression.
Because of this link to serotonin, most cases of OCD are still treated with a combination of pharmacological help (antidepressant medication) and regular counseling or therapy sessions. However, an alternative for individuals struggling with treatment-resistant OCD may find relief through a non-invasive treatment involving the use of magnetic waves, applied to the brain through a special helmet device. This type of treatment, known as transcranial magnetic stimulation, has been proven effective and has been approved by the FDA to help individuals with OCD seek treatment for their condition by targeting a portion of the brain with magnetic waves, to incite a reaction in limbic system that helps reduce OCD symptoms.
Treatment for OCD takes time, and often must be recurring. Part of overcoming the disorder is learning to find ways to minimize its effects and control it with the help of professional medical attention, medication, and many different therapeutic options. Over time, a patient can learn to better manage their symptoms, and even live life at their fullest capacity despite their disorder.