What is Obsessive-Compulsive Disorder (OCD)?
As mentioned above, OCD is characterized by a person experiencing a cycle of obsessions and compulsions that interfere with their ability to function. So, what exactly does that mean?
While we use the term ‘obsessions’ in casual language to mean that someone is preoccupied with an idea, an activity, or a person, in this context the word takes on a different meaning. With OCD, obsessions are intrusive, unwanted thoughts, impulses, or images that occur over and over again. Individuals with OCD typically find these thoughts disturbing, and they are often accompanied by uncomfortable feelings such as disgust, doubt or uncertainty, and fear. Obsessions get in the way of important life activities and a person’s values, and are significantly time consuming.
Obsessions are different for every individual and can change over time. They can also vary in clarity and vividness; a vague obsession might involve a general sense of tension or imbalance, while a more specific obsession could involve the thought of a close friend or family member dying. These are some of the most common types of obsessions that people with OCD experience:
- Contamination obsessions: Intense fear of coming into contact with contaminated things or substances, such as bodily fluids, germs, dirt, or household chemicals.
- Violent obsessions: Fears of impulsively harming oneself or others, or fear of violent or horrific images in one’s mind
- Perfectionism obsessions: Excessive concern about exactness or evenness, performing tasks perfectly, or a fear of making mistakes or forgetting/losing important information
- Responsibility obsessions: Fear of being responsible for a terrible incident (a car accident, fire, etc.)
- Sexual obsessions: Unwanted mental images or thoughts pertaining to sex
- Identity obsessions: Excessive concern with one’s gender identity or sexual orientation
- Religious or moral obsessions: Excessive concern with morality or damnation, blasphemy, or offending God
Obsessions and the intense emotions that come with them drive individuals to carry out compulsions. Compulsions are repetitive and specific thoughts or behaviors that are intended to counteract or neutralize obsessions. Some people perform compulsions because they feel inexplicably that they must do so, whereas others are trying to mitigate anxiety that comes with obsessive thoughts. People with OCD realize that compulsions are a temporary solution and often illogical, but they rely on compulsions as a coping mechanism for the anxiety and fear caused by obsessions. Compulsions are time consuming and interfere with daily life; they can also include avoiding situations that may trigger obsessions.
The nature of compulsions is usually related to the obsession it is meant to counteract. Common compulsions include:
- Cleaning and washing: Excessively washing hands, bathing, brushing teeth, cleaning household items, or avoiding contact with contaminants
- Checking: Repeatedly checking that one did not harm others or make a mistake, that nothing terrible happened, or the physical condition of one’s body
- Mental compulsions: Counting while performing a task, ‘cancelling’ bad thoughts with good thoughts, praying to prevent harm
- Repeating: Rewriting or rereading, repeating body movements or routine activities in multiples
The main symptoms of OCD are the presence of obsessions and compulsions, but individuals also deal with symptoms related to those. This often includes anxiety, insomnia, difficulty carrying out daily tasks or maintaining relationships, and avoiding events, activities, or situations that could trigger obsessions.