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WHEN IT MIGHT BE OCD…

Recognizing Obsessive-Compulsive Disorder
and what you can do to reclaim control.

WHAT IS OBSESSIVE-COMPULSIVE DISORDER (OCD)?

Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by repetitive, intrusive thoughts that leave an individual caught in a cycle of obsessions and compulsive responses.

Obsessions are unwanted, intrusive thoughts, images, or urges that trigger intensely distressing feelings.

Compulsions are repetitive behaviors or “rituals” an individual employs to attempt to abolish intrusions, diminish distress, and/or mitigate the believed harm associated with the obsession. Rituals can be thought of as safety mechanisms. When someone feels scared or anxious, their rituals help alleviate fear and create a temporary sense of safety. Thus, it is not so easy for people who engage in rituals to “just stop!”

In media, OCD is often portrayed as a need for tidiness and order. Commonly depicted rituals include compulsive hand-washing and repeatedly opening and closing doors. Not all rituals, however, are observable. In fact, there are numerous mental rituals, such as checking, counting, and repetition, that can consume hours of someone’s day, yet remain hidden from the outside world.

INTRUSIVE THOUGHTS AND THE MEANING WE ASSIGN TO THEM

Have you ever been caught off-guard by an unusual, bizarre, or maybe even horrifying thought that seemingly popped up out of thin air? You know, the kind of uncomfortable thought (or image) you try to erase from your mind before it has a chance to settle in?

We all have these intrusive thoughts from time to time. In fact, we quite frequently
have thoughts we’d consider strange if we stopped to analyze and attribute meaning to each one. Luckily, for most of us, these thoughts are usually fleeting — they pop into our heads and exit just as quickly, allowing us to get on with our day.

With OCD, it’s just not that simple. Though many people with OCD recognize that their obsessions and compulsions are not rational, when intrusive thoughts become repetitive, they can instill a great deal of distress. A person with OCD believes their thoughts could be true and have harmful, real world consequences if they are not addressed, so preventing the perceived harm becomes priority number #1. Because the thoughts are repetitive, the urge to fight them off (by engaging in a ritual) becomes unending. Now that this thought-and-response cycle has been established, it can be very challenging for a person with OCD to carry out routine tasks.

A SHADOW OF A DOUBT

OCD is often referred to as “the doubting disease.” A primary feature of many forms of OCD is the anxiety evoked by the fact that nothing in life is 100% certain. Nothing can be assured beyond a shadow of a doubt. And so, in any given situation, there will always be a chance to ask, “What if…?”

For those of us without OCD, there is no significant anxiety accompanied with the
thought, “What if I lose control of my body and punch someone?” We feel secure
enough in the event’s unlikeliness that we do not become concerned. “Unlikely,”
however, does not mean “impossible,” and that room for doubt, as small as it may be, provides fuel that feeds the OCD cycle.

COMMON OCD OBSESSIONS

  • Fear of contamination (body fluids, germs/contracting diseases, dirt, toxins)
  • Fear of getting sick (not by contamination)
  • Fear of acting on an unwanted impulse to harm yourself
  • Fear of acting on an impulse to harm others
  • Fear of being responsible for something terrible happening
  • Fear of blurting out obscenities or insults
  • Concern about symmetry, evenness or exactness
  • Inability to decide whether to keep or to discard things

OCD OBSESSIONS YOU DIDN’T KNOW ARE COMMON

  • Unwanted violent, graphic, and/or horrific thoughts or images
  • Unwanted “perverse, taboo, or violent” sexual thoughts or images
  • Unwanted “perverse, taboo, or violent” sexual impulses about others
  • Obsessions regarding sexual orientation
  • Distressing sexual thoughts that involve children or incest
  • Superstitious ideas about lucky/unlucky numbers, words, or colors
  • Concern with offending God, or concern about blasphemy
  • Excessive concern with right/wrong or morality

GETTING TREATMENT FOR YOUR OCD

While OCD does not have a “cure,” its distress-inducing symptoms can be successfully treated by a specialized form of therapy called Cognitive Behavioral Therapy (CBT). CBT involves the use of two evidence-based techniques: Cognitive Therapy and Exposure and Response Prevention Therapy (ERP). CBT, sometimes in combination with medication, is the most effective approach to reducing the frequency and severity of OCD flare-ups. 

Cognitive therapy can help individuals with OCD learn to recognize and modify patterns of thought that underlie and perpetuate obsessions and compulsions. Once a person is able to recognize when their cognitions are a symptom of OCD, they can learn to respond to them in new ways. 

The second component of OCD treatment, ERP, involves gradual exposure to situations that trigger the person’s obsessions and compulsions. Over time, the person learns to respond differently to these triggers, leading to a decrease in the frequency of compulsions and the intensity of obsessions.

Most mental health professionals are not trained in ERP therapy, so it is important to find a cognitive-behavioral therapist who has special training in treating OCD.

FAQ: HOW CAN I TELL IF I HAVE ANXIETY OR IF IT’S OCD?

Great question! Anxiety usually relates to the real-life concerns (work, school,
family, relationships, finances, etc.) that most people worry about to some degree.
While people with OCD suffer a great deal of anxiety, they tend to obsess about less common, often unrealistic issues and may feel the need to perform a specific act in response to these anxious thoughts. 

OCD can only be properly diagnosed by a mental health professional.