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Home / Diseases & Conditions / OCD

OCD

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by uncontrollable, unwanted thoughts and repetitive, ritualized behaviours one feels compelled to perform. The thoughts are intrusive in nature, unpleasant and distressing which causes uneasiness, apprehension, fear, or worry. The repetitive behaviours are aimed at reducing the associated anxiety.

Types

To understand OCD better, Obsessions and Compulsions have to be understood clearly –

Obsessions are involuntary, seemingly uncontrollable thoughts, images, or impulses that occur over and over again in your mind. You feel you don’t have the choice to control your thoughts and ideas. Unfortunately, these obsessive thoughts are often disturbing and distracting.

Compulsions are behaviour or rituals that you feel driven to act out again and again. Usually, compulsions are performed in an attempt to make obsessions go away. For example, if you’re afraid of contamination, you might develop elaborate cleaning rituals. However, the relief never lasts. In fact, the obsessive thoughts usually come back stronger. And the compulsive behaviours often end up causing anxiety themselves as they become more demanding and time-consuming.

The categories under which most people suffering from OCD fall under are as follows:

  • Checkers repeatedly check things (oven turned off, door locked, etc.) that they associate with harm or danger.
  • Counters and arrangers are obsessed with order and symmetry. They may have superstitions about certain numbers, colours, or arrangements.
  • Doubters and sinners are afraid that if everything isn’t perfect or done just right something terrible will happen or they will be punished.
  • Hoarders fear that something bad will happen if they throw anything away. They compulsively hoard things that they don’t need or use.
  • Washers are afraid of contamination. They usually have cleaning or hand-washing compulsions.


Causes

The biological framework pinpoints the focus on a circuit in the brain which regulates primitive aspects of our behaviour such as aggression, sexuality, and bodily excretions. This can be one of the causes of OCD. When the brain has difficulty turning off or ignoring impulses from this circuit, it can lead to OCD.

Cognitive-behavioural theories attribute the reason as if you are vulnerable to OCD you are unable to ignore bizarre thoughts. The need to control these thoughts becomes important to you, leading to compulsive behaviour.

Psychodynamic theories suggest that obsessions and compulsions are signs of unconscious conflict that you might be trying to suppress, resolve or cope with.


Symptoms

Most people with obsessive-compulsive disorder (OCD) have both obsessions and compulsions, but some people experience just one or the other.

OCD signs and symptoms: Obsessive thoughts

Common obsessive thoughts in obsessive-compulsive disorder (OCD) include:

  • Fear of being contaminated by germs or dirt or contaminating others.
  • Fear of causing harm to yourself or others.
  • Intrusive sexually explicit or violent thoughts and images.
  • Excessive focus on religious or moral ideas.
  • Fear of losing or not having things you might need.
  • Order and symmetry: the idea that everything must line up “just right.”
  • Superstitions; excessive attention to something considered lucky or unlucky.

OCD signs and symptoms: Compulsive behaviours

Common compulsive behaviours in obsessive-compulsive disorder (OCD) include:

  • Excessive double-checking of things, such as locks, appliances, and switches.
  • Repeatedly checking in on loved ones to make sure they’re safe.
  • Counting, tapping, repeating certain words, or doing other senseless things to reduce anxiety.
  • Spending a lot of time washing or cleaning.
  • Ordering or arranging things “just so.”
  • Praying excessively or engaging in rituals triggered by religious fear.
  • Accumulating “junk” such as old newspapers or empty food containers.

Obsessive-compulsive disorder (OCD) symptoms in children

While the onset of obsessive-compulsive disorder usually occurs during adolescence or young adulthood, younger children sometimes have symptoms that look like OCD. However, the symptoms of other disorders, such as ADD, autism, and Tourette’s syndrome, can also look like obsessive-compulsive disorder, so a thorough medical and psychological exam is essential before any diagnosis is made. 


Treatment

Treatment options for obsessive compulsive disorder include Cognitive-behavioural therapy which focuses on two main approaches namely –

  • Exposure and response prevention or ERP
  • Cognitive therapy

Here is additional information on treatment for OCD.


Prognosis

There are four key steps for dealing with OCD. These include –

  • RELABEL
  • REATTRIBUTE
  • REFOCUS
  • REVALUE

Read in detail about various ways to deal with OCD.


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