What Is Obsessive-Compulsive Disorder?
Obsessive-compulsive disorder (OCD) features a pattern of unreasonable thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). These obsessions and compulsions interfere with daily activities and cause significant distress.
You may try to ignore or stop your obsessions, but that only increases your distress and anxiety. Ultimately, you feel driven to perform compulsive acts to try to ease your stress. Despite efforts to ignore or get rid of bothersome thoughts or urges, they keep coming back. This leads to more ritualistic behavior — the vicious cycle of OCD.
OCD often centers around certain themes — for example, a fear of getting contaminated by germs. To ease your contamination fears, you may compulsively wash your hands until they’re sore and chapped.
If you have OCD, you may be ashamed and embarrassed about the condition, but treatment can be effective.
What Causes Obsessive-Compulsive Disorder?
Scientists still don’t know the exact causes of OCD.
- Genetics appear to play a role, as OCD sometimes runs in families. You have a higher risk of developing OCD if you have a parent, sibling, or child with the disorder.
- Differences in brain structure may also contribute to OCD.
- Scientists have discovered that OCD symptoms appear to be connected to abnormalities in certain parts of the brain, but this connection isn’t yet fully understood.
- In addition, environmental factors may sometimes contribute to OCD development.
- Early childhood trauma — such as physical or sexual abuse — increases your risk of developing OCD or another anxiety disorder.
Additionally, a childhood streptococcal infection can sometimes cause OCD symptoms (known as pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, or PANDAS).
People with Obsessive-Compulsive Disorder (OCD) Symptoms
Just because you have obsessive thoughts or perform compulsive behaviors does NOT mean that you have obsessive-compulsive disorder. With OCD, these thoughts and behaviors cause tremendous distress, take up a lot of time, and interfere with your daily life and relationships.
Most people with obsessive-compulsive disorder have both obsessions and compulsions, but some people experience just one or the other.
Common obsessive thoughts in OCD include:
- Fear of being contaminated by germs or dirt or contaminating others
- Fear of losing control and harming 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
Common compulsive behaviors in 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 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 ADHD, 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.
People with Obsessive thoughts
Almost everyone has unpleasant or unwanted thoughts at some point, such as thinking they may have forgotten to lock the door of the house, or even sudden unwelcome violent or offensive mental images.
But if you have a persistent, unpleasant thought that dominates your thinking to the extent it interrupts other thoughts, you may have an obsession.
Some common obsessions that affect people with OCD include:
- fear of deliberately harming yourself or others – for example, fear you may attack someone else, such as your children
- fear of harming yourself or others by mistake – for example, fear you may set the house on fire by leaving the cooker on
- fear of contamination by disease, infection or an unpleasant substance
- a need for symmetry or orderliness – for example, you may feel the need to ensure all the labels on the tins in your cupboard face the same way
You may have obsessive thoughts of a violent or sexual nature that you find repulsive or frightening. But they’re just thoughts and having them doesn’t mean you’ll act on them.
People with Compulsive behavior
Compulsions arise as a way of trying to reduce or prevent anxiety caused by the obsessive thought, although in reality this behavior is either excessive or not realistically connected.
For example, a person who fears contamination with germs may wash their hands repeatedly, or someone with a fear of harming their family may have the urge to repeat an action multiple times to “neutralize” the thought.
Most people with OCD realize that such compulsive behavior is irrational and makes no logical sense, but they can’t stop acting on it and feel they need to do it “just in case”.
Common types of compulsive behavior in people with OCD include:
- cleaning and hand washing
- checking – such as checking doors are locked or that the gas is off
- ordering and arranging
- asking for reassurance
- repeating words in their head
- thinking “neutralizing” thoughts to counter the obsessive thoughts
- avoiding places and situations that could trigger obsessive thoughts
Obsessive-Compulsive Disorder OCD Treatment
Taking care of yourself every day is important in dealing with obsessive-compulsive disorder (OCD). This includes taking your medicines as directed every day and doing the homework your therapist gives you to do at home, such as self-directed exposure and response prevention exercises. With exposure and response prevention therapy, you repeatedly expose yourself to an obsession, such as something you fear is contaminated, and deny yourself the ritual compulsive act, which in this case would be washing your hands.
It’s also important to involve family members and loved ones in your treatment, especially if your doctor suggested that you participate in therapy together. Keeping lines of communication open may help you deal with relationships that have become strained during your illness.
Reducing overall stress in your life, although not proven treatment for OCD symptoms, may help you cope. Tips to relieve stress and anxiety include:
- Taking slow, deep breaths.
- Soaking in a warm bath.
- Listening to soothing music.
- Taking a walk or doing some other exercise.
- Taking a yoga class.
- Having a massage or back rub.
- Drinking a warm, nonalcoholic, non-caffeinated beverage.
Eating a healthy, balanced diet and avoiding certain foods or drinks may also help you reduce stress.
- Avoid or limit caffeine. Coffee, tea, some soda pop, and chocolate contain caffeine. Caffeine can make stressful situations seem more intense. If you drink a lot of caffeine, reduce the amount gradually. Stopping use of caffeine suddenly can cause headaches and make it hard to concentrate.
- If you drink alcohol, do so in moderation. If you are feeling very stressed, you might be turning to alcohol for relief more often than you realize. If you drink, limit yourself to 2 drinks a day for men and 1 drink a day for women.
- Make mealtimes calm and relaxed. Try not to skip meals or eat on the run. Skipping meals can cause your blood sugar to drop, which will make other stress-related symptoms worse, such as headaches or stomach tension. Eating on the run can cause indigestion. Use mealtime to relax, enjoy the flavor of your meal, and reflect on your day.
- Avoid eating to relieve stress. Some people turn to food to comfort themselves when they are under stress. This can lead to overeating and guilt. If this is a problem for you, try to replace eating with other actions that relieve stress, like taking a walk, playing with a pet, or taking a bath