There are many times when being organized, responsible, neat and tidy can help someone to live better. On the other hand, when these types of behaviors and following of rules take over then OCD can become a large problem. OCD is a common, chronic disorder that is made of two parts – obsessions and compulsions.
Obsessions
Obsessions are uncontrollable, recurring thoughts, impulses, or images that trigger intense anxiety. Here’s a list of some common examples of obsessions:
- That you might harm self or others
- Dirt, germs, or bodily secretions
- Contaminants (asbestos, radiation, toxic waste)
- Getting ill from possible contaminants
- Fear of blurting out obscenities or insults
- Being responsible for something terrible happening (a fire, burglary or hitting someone with your car)
- Sexual thoughts, images, or urges
- Sacrilege and blasphemy, right/wrong, or morality
- Someone will have an accident unless things are in the right place
- Saying certain things because they might come true
- Fear of losing things
- Fear of animals and insects
Compulsions
Compulsions are repetitive behaviors or rituals that a person with OCD feels the urge to do following having an obsessive thought, image or impulse in order to find a temporary relief or feeling of safety. Here are the common types:
Thinking & Counting Rituals
- repeating “good” thoughts to take care of “bad” thoughts
- counting objects like books, nails in the wall, your teeth, floor tiles etc.
Checking & Repeating Rituals
- Checking locks, stoves, windows
- Checking that you did not/will not harm others or yourself
- Needing to repeat routine activities (up/down from chair, re-reading, re-writing)
- Needing to touch, tap, or rub in the “right” way
Ordering & Cleaning Rituals
- Ordering and arranging things in a specific, particular way
- There is lots of pressure to clean & the amount of time spent cleaning seems unreasonable compared to others
- Following a set order during grooming & starting over if order is interrupted
- Taking very long showers or baths to decontaminate
Contamination & Danger Rituals
- Excessive/ritualized cleaning (hand washing, bathing, toothbrushing, grooming)
- Avoid shaking hands, public restrooms, doorknobs, raw meat, cleaners, dirt, sticky substances etc
Hoarding Rituals
- Saving old newspaper, notes, cans, paper towels, napkins, wrappers, or other items
- Difficulty throwing things away for fear that I may need them in the future
- Worry excessively about saving money or food even though I don’t need to
Health & Illness Rituals
- Repeatedly taking pulse, temperature, checking for injuries
- Compulsive hair pulling (top of head, eyelashes, eyebrows)
Not all rituals or habits are compulsions. Everyone can find themselves double checks things sometimes. The difference between healthy levels of anxiety and OCD is the person with OCD:
- Feels like there isn’t an ability to control their thoughts or behaviors, even when those thoughts or behaviors are recognized as excessive
- They spend at least 1 hour per day on these thoughts or behaviors
- There isn’t any pleasure from doing the compulsions, but there can be a sense of relief from the stress of the obsessional thoughts
- Have some significant problems in their daily life due to the severity of this anxiety
Though people with OCD typically understand their obsessional thoughts images and impulses to be excessive and unreasonable it does not help to make them stop or to be less stressful. In fact, the obsessions usually are reported as being quite intrusive (happening despite trying to not think of them). The stress can become so intense that some people get worked up into a panic attack from them.
Likewise, their rituals are typically understood to be excessive and unreasonable. Yet they continue to do them, chasing a sense of relief that comes about by struggling to neutralise unwanted thoughts and associated anxiety. Unfortunately the relief is only short lived and the anxiety returns quickly. Even worse, research indicates that these attempts to suppress anxiety tends to heighten the anxiety over time and increasing the frequency and intensity. The vicious cycle of OCD is fed by the very thing that they feel like they must do. For some people with severe OCD hospitalization is needed to break the cycle, but for most others medications and therapy can be effective.
OCD affects approximately 1% of the U.S. population and is equally common among men and women. The average age of onset is 19, with 25 percent of cases occurring by age 14.