What is OCD?
Obsessive-compulsive disorder (OCD) is a mental health disorder that affects people of all ages and walks of life and occurs when a person gets caught in a cycle of obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, images, or urges that trigger intensely distressing feelings. Compulsions are behaviors an individual engages in to attempt to get rid of obsessions and/or decrease his or her distress.
Most people have obsessive thoughts and/or compulsive behaviors at some point in their lives, but that does not mean that we all have “some OCD.” For a diagnosis of obsessive-compulsive disorder to be made, this cycle of obsessions and compulsions becomes so extreme that it consumes a lot of time and gets in the way of important activities that the person values.
Did you know there are 4 Different Types of OCD?
When we talk about OCD, we talk not only about the presence of obsessions, compulsions, or both, we also talk about the focus of those symptoms. Symptoms tend to fall into four general categories, called symptom dimensions that include both obsessions and compulsions.
These dimensions are akin to looking at the different sides of an OCD box. They are not mutually exclusive. You can have elements from one or more of the dimensions. Each blend of symptoms is unique.
TYPE 1: Contamination: Excessive Cleaning or Washing
Contamination OCD is what most people think of when they hear the phrase “OCD.” Driven by an underlying fear of contamination or germs, people will go to great lengths to avoid situations seen as “risky” for exposure to contaminants. Some of the more common protective rituals include:
• Disinfecting and sterilizing, excessive cleaning
• Excessive hand washing
• Throwing away objects believed to be contaminated or sources of contamination
• Frequent clothing changes
• Creating “safe” or “clean” zones
These rituals provide temporary relief from the perceived risk of exposure to contaminants and germs.
TYPE 2: Perfection: Symmetry, Ordering, Exactness
People whose symptoms fall in this dimension have an overwhelming preoccupation with order and getting something “just right.”
They will spend inordinate amounts of time moving, counting, and arranging things to alleviate or prevent distress. They may also have specific superstitions about numbers, patterns, and symmetry.
These rituals are sometimes attached to magical thinking (i.e., the belief that something bad will happen if something is not “just right.”)
Some of the commonly seen behaviors include:
• A need for items to be arranged in a specific way
• An extreme need for symmetry or organization
• A need for symmetry in actions (if you touch your right elbow, you must also touch your left elbow)
• Arranging items until they feel “just right”
• Counting rituals
• Magical thinking, or believing something bad will happen if things are not “just right”
• Organization rituals or superstitions about the arrangement of objects
• Excessive attachment to and hoarding of certain items
The endless quest for perfection can be physically and mentally exhausting. The person may avoid social contact at home to prevent the symmetry and order being disrupted. This can have devastating effects on relationships.
TYPE 3: Doubt and Harm: Checking and Rechecking
This is the dimension of checking and re-checking. People with obsessions in this dimension tend to experience intrusive thoughts, images or urges related to the fear of unintentionally harming themselves or someone else due to carelessness or negligence.
A common example is that of leaving the gas stove on before leaving home possibly causing a house fire. Along with their fear of accidental harm is also often an overwhelming feeling of self-doubt or dread and being responsible for what may happen.
Some of the common behaviors you might see are:
• Checking and rechecking things like door locks, stoves, windows, light switches, etc.
• Checking may include a symmetrical component of checking a specific number of times.
• Checking may include an asymmetrical component of checking a specific number of times to make sure no one was harmed.
TYPE 4: Forbidden Thoughts:
Sometimes referred to as taboo thinking. This symptom dimension is characterized by unwanted, intrusive thoughts. These thoughts are often of a violent, religious, or sexual nature that significantly violates the person’s morals or values.
This dimension is particularly difficult to recognize and was once considered purely obsessional (thought-based). In fact, people with this type of OCD do engage in behavioral rituals to manage these unwanted thoughts.
These rituals tend to be covert and consist of mental compulsions and seeking reassurance. Some of the common themes and rituals associated with this dimension include:
• Persistent intrusive thoughts that are often sexual, religious, or violent in nature
• Persistent worry about acting on intrusive thoughts or that having them makes one a bad person
• Obsessions about religious ideas that feel blasphemous or wrong
• Engaging in mental rituals to dispel or cancel out the bothersome thoughts.
Some of these rituals might include:
• Neutralizing thoughts through mentally canceling out negative thoughts with positive ones or excessive praying.
• Excessive reviewing behavior or the seeking of reassurance.
• Avoidance of situations perceived as thought triggers
It should be noted that, despite the nature of their thoughts, people with this type of OCD usually have no history of violence, nor do they act on their thoughts or urges.
They do, however, often believe their thoughts are dangerous and will devote enormous time and mental effort to suppress them.
Obsessions are intrusive, repetitive thoughts, urges, or mental images or impulses that create anxiety and distress. This occurs repeatedly outside of the person’s control. Individuals with OCD do not want to have these thoughts and find them disturbing. In most cases, people with OCD realize that these thoughts do not make any sense.
Obsessions are typically accompanied by intense and uncomfortable feelings such as fear, disgust, doubt, or a feeling that things must be done in a way that is “just right.” In the context of OCD, obsessions are time-consuming and get in the way of important activities the person values. This last part is extremely important to keep in mind as it, in part, determines whether someone has OCD — a psychological disorder — rather than an obsessive personality trait.
What exactly are obsessions?
Obsessions are intrusive, repetitive thoughts, urges, or mental images or impulses that create anxiety and distress. This occurs repeatedly outside of the person’s control. Individuals with OCD do not want to have these thoughts and find them disturbing. In most cases, people with OCD realize that these thoughts do not make any sense.
Obsessions are typically accompanied by intense and uncomfortable feelings such as fear, disgust, doubt, or a feeling that things must be done in a way that is “just right.” In the context of OCD, obsessions are time-consuming and get in the way of important activities the person values. This last part is extremely important to keep in mind as it, in part, determines whether someone has OCD — a psychological disorder — rather than an obsessive personality trait.
Unfortunately, “obsessing” or “being obsessed” are commonly used terms in everyday language. These more casual uses of the word mean that someone is preoccupied with a topic or an idea or even a person.
“Obsessed” in this everyday sense does not involve problems in day-to-day living and even has a pleasurable component to it. You can be “obsessed” with a new song you hear on the radio, but you can still meet your friend for dinner, get ready for bed in a timely way, get to work on time in the morning, etc., despite this obsession. In fact, individuals with OCD have a tough time hearing this usage of “obsession” as it feels as though it diminishes their struggle with OCD symptoms.
Even if the content of the “obsession” is more serious, for example, everyone might have had a thought from time to time about getting sick, or worrying about a loved one’s safety, or wondering if a mistake they made might be catastrophic in some way, that does not mean these obsessions are necessarily symptoms of OCD. While these thoughts look the same as what you would see in OCD, someone without OCD may have these thoughts, be momentarily concerned, and then move on. In fact, research has shown that most people have unwanted “intrusive thoughts” from time to time, but in the context of OCD, these intrusive thoughts come frequently and trigger extreme anxiety that gets in the way of day-to-day functioning.
Similar to obsessions, not all repetitive behaviors or “rituals” are compulsions. You must look at the function and the behavior’s context. For example, bedtime routines, religious practices, and learning a new skill all involve repeating an activity but are usually a positive and functional part of daily life.
People with OCD realize this is only a temporary solution but without a better way to cope they rely on the compulsion as a temporary escape. Compulsions can also include avoiding situations that trigger obsessions. Compulsions are time consuming and get in the way of important activities the person values.
Compulsions are the second part of obsessive-compulsive disorder. These are repetitive behaviors or thoughts that a person uses with the intention of neutralizing, counteracting, or making their obsessions go away. People with OCD realize this is only a temporary solution but without a better way to cope they rely on the compulsion as a temporary escape. Compulsions can also include avoiding situations that trigger obsessions. Compulsions are time-consuming and get in the way of important activities the person values.
Behaviors depend on the context. Arranging and ordering books for eight hours a day is not a compulsion if the person works in a library. Similarly, you may have “compulsive” behaviors that would not fall under OCD, if you are just a stickler for details or like to have things neatly arranged. In this case, “compulsive” refers to a personality trait or something about yourself that you prefer or like.
In most cases, individuals with OCD feel driven to engage in compulsive behavior and would rather not have to do these time-consuming and often torturous acts. In OCD, compulsive behavior is done to try to escape or reduce anxiety or obsessions.
What are compulsions?
Compulsions are the second part of obsessive-compulsive disorder. These are repetitive behaviors or thoughts that a person uses with the intention of neutralizing, counteracting, or making their obsessions go away. People with OCD realize this is only a temporary solution but without a better way to cope they rely on the compulsion as a temporary escape. Compulsions can also include avoiding situations that trigger obsessions. Compulsions are time consuming and get in the way of important activities the person values.
When is it OCD?
People who have disorders like OCD experience a significant set of distressing consequences of their symptoms. To be given a diagnosis of OCD, a person must meet a specific set of criteria as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM 5).
Some of the hallmark signs of something more than just quirky behavior include:
• Avoiding situations that might trigger your obsessions
• Attempts to control or neutralize distressing thoughts, urges or behaviors are not successful
• Excessive time is spent engaging in obsessive and compulsive behaviors
• There is no pleasure from time spent in these activities but there is brief relief from the anxiety they cause
• The obsessions and compulsions cause significant impairment in social, occupational, or interpersonal functioning
What is more, it is common to see people with OCD struggle with other issues such as depression or substance abuse to cope. As you can see, true OCD is complicated and has a lot of pieces. Simply calling it OCD does not tell the whole story.
Research suggests that OCD involves problems in communication between the front part of the brain and deeper structures of the brain. These brain structures use a neurotransmitter (a chemical messenger) called serotonin. Pictures of the brain at work also show that, in some people, the brain circuits involved in OCD become more normal with either medication that affects serotonin levels (serotonin reuptake inhibitors, or SRIs) or cognitive behavior therapy (CBT).
Research shows that OCD runs in families and genes play a role in the disorder’s development. Genes are only partly responsible for causing the disorder, though. No one really knows what other factors might be involved, perhaps an illness or even ordinary life stresses that may induce the activity of genes associated with the symptoms of OCD.
Welcome back, folks! So today we are discussing health disorders that affect people of all ages and walks of life and occur when a person gets caught in a cycle of obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, images, or urges that trigger intensely distressing feelings. Compulsions are behaviors an individual engages in to attempt to get rid of obsessions and/or decrease his or her distress.
Research suggests that OCD involves problems in communication between the front part of the brain and deeper structures of the brain. These brain structures use a neurotransmitter (a chemical messenger) called serotonin. Pictures of the brain at work also show that, in some people, the brain circuits involved in OCD become more normal with either medication that affects serotonin levels (serotonin reuptake inhibitors, or SRIs) or cognitive behavior therapy (CBT).
Is OCD a Brain Disorder?
Research suggests that OCD involves problems in communication between the front part of the brain and deeper structures of the brain. These brain structures use a neurotransmitter (a chemical messenger) called serotonin. Pictures of the brain at work also show that, in some people, the brain circuits involved in OCD become more normal with either medication that affects serotonin levels (serotonin reuptake inhibitors, or SRIs) or cognitive behavior therapy (CBT).
Is OCD inherited?
Research shows that OCD runs in families and that genes play a role in the disorder’s development. Genes appear to be only partly responsible for causing the disorder, though. No one really knows what other factors might be involved, perhaps an illness or even ordinary life stresses that may induce the activity of genes associated with the symptoms of OCD.
Some experts think that OCD that begins in childhood may be different from OCD that begins in adults. For example, a recent review of twin studies has shown that genes play a larger role when OCD starts in childhood (45-65%) compared to when it starts in adulthood (27-47%).
In closing: There are several types of OCD disorders, and many people suffer so severely from these disorders that they feel they cannot leave home, they are confined to being home in their comfort zone. OCD is real, it is entrapment to many, and many are unable to cope with these conditions on their own, although many will never seek help.
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