OCD: It’s about more than just cleaning

Trivializing obsessive-compulsive disorder (OCD) is common. There is a common misconception in popular media that having OCD means a need to clean obsessively or having everything ordered just so. 

The reality is that obsessive-compulsive disorder (OCD) is a crippling condition that can ruin your quality of life. Many suffer undiagnosed, feeling like they cannot find help, and thus reach breaking point

What is OCD?

Obsessive-compulsive disorder (OCD) is a mental health disorder affecting people of all ages and walks of life. A person with OCD stagnates in a cycle of compulsions and obsessions. 

Obsessions are intrusive images, urges, or thoughts that trigger intensely distressing feelings. Compulsions describe behaviors an individual engages in to rid themselves of the obsession to reduce their mental anguish.

Individuals who do not suffer from OCD will have upsetting thoughts or perform repetitive actions every day. What distinguishes these individuals from someone with OCD is that these thoughts do not disrupt their daily lives. 

A person with OCD experiencing upsetting thoughts and repetitive behaviors cannot function beyond their OCD symptoms and is inexplicably distressed if they cannot perform the ritual. It is the rituals that alleviate their stress. 

Most afflicted people are aware that their obsessions are unreasonable but cannot disengage themselves from the obsessive thoughts or cease the compulsive behaviors that follow. Others, having limited insight, believe their obsessions to be true.

To correctly diagnose an obsessive-compulsive disorder, there needs to be evidence that obsessions and compulsions exist, are disruptive, cause extreme anxiety, and prevent individuals from working productively or socially. 
In the US, 2-3% of the population suffers from OCD. More women are affected than men. Although OCD can begin in childhood, the average age symptoms appear approximately 19 years old. In most cases, OCD treatment is recommended.

Symptoms of OCD

Obsessions are disturbing impulses, thoughts, or images that intrude in a person’s consciousness or sub-consciousness. The thoughts are beyond their control. Generally, they do not want these thoughts and would prefer they were not there.

People with OCD symptoms generally recognize that the thoughts they are having do not make sense. Usually, accompanying obsessions are intense feelings of disgust, doubt, or fear. 

Obsessions are time-consuming and obstruct a person from ordinary activities. 

Obstructive thought occurring to this extent defines the gravity of the individual’s condition. Inability to carry out activities may indicate a psychological disorder as opposed to an obsessive personality trait. 

Common obsessions prevalent in OCD include:-

  • Contamination:
    • Dirt
    • Bodily fluids
    • Household chemicals
    • Germs or Disease
    • Environmental contaminants
  • A fear of:
    • Self-harm impulses
    • Impulses to harm others
    • Horrific or violent images
    • Shouting out obscenities or insults
    • Stealing things
  • Harm:
    • Responsibility for harming others, e.g., dropping something on the floor for someone to slip on
    • Responsibility for a disaster, e.g., a house fire, vehicle accident
  • Unwanted sexual thoughts:
    • Perverse thoughts or actions
    • Obsessive thoughts about young children
    • Sexual abuse or harm to another person
  • Religious obsessions:
    • Concern about offending God by actions or words
    • Worry about what is right and wrong 
  • Obsession with perfection:
    • The exactness or evenness, e.g., of a pattern
    • Hoarding to avoid loss of perceived important information
    • A need to know and remember information
    • Fear of losing something 

Compulsions follow on from obsessive behavior in a person with OCD. They are often used to cope with the stress of obsessions. The compulsions will present as repetitive actions or thoughts carried out to try to eradicate the obsessions. 

A person with compulsive OCD symptoms knows these actions offer reprieve but act nonetheless. Compulsions can also become time-consuming as the person avoids a situation that may trigger obsessions. 

Not all repetitive behaviors are compulsions. One needs to look at the context. A neat person who routinely makes their bed, folds their clothes, wipes the kitchen counters, and sweeps the patio regularly cannot be diagnosed as OCD by these actions. 

Generally, a person with OCD feels driven to carry out tasks and, if questioned, would prefer not to carry out these time-consuming rituals. The intention of performing these sometimes torturous acts is to escape the anxiety presented by the obsession.

Common compulsions may include:-

  • Washing and cleaning:
    • Washing hands repeatedly or in a specific manner
    • Washing household items excessively
    • Bathing, showering or brushing teeth excessively
    • Other excessive actions to prevent contamination
  • Checking constantly that they did not:
    • Harm others
    • Harm themselves
    • Make an error
  • Repeating:
    • Rewriting or rereading a piece
    • Routine actions, e.g., closing doors, checking locks, taps, switches
    • Repeating steps in specific multiples  
    • Body movements repeated exactly multiple times, e.g., blinking or tapping
  • Mental compulsions:
    • Counting while executing a task to end on a number they consider safe.
    • Repeating a rhyme, praying, or chanting while doing something
    • Canceling good or bad words out 
  • Other compulsions:
    • Reorganizing objects in order repeatedly until they are happy
    • Constantly seeking reassurance by repeated asking, telling, confessing to get reassurance
    • Avoidance of situations that may trigger obsessions.

What causes OCD?

Although no cure exists yet, OCD treatment is similar to other mental health disorder treatments. Through therapy, doctors can manage medication, or a combination of both, symptoms affecting a person’s day-to-day life.

OCD Treatment

An individual may self-prescribe CBT; alternatively, they might have a doctor’s referral to a psychotherapist for mental health treatment. Either way, preparation for CBT may look like the following:

Psychotherapy

Cognitive-behavioral therapy (CBT) is an effective mental illness treatment. CBT exposes a person to conditions that trigger them in a controlled situation. The goal is to desensitize the person, thereby reducing their need to use their habitual thoughts or behaviors to cope.

Meditation, yoga, and massage

Relaxation through meditation, yoga, and massage can relieve stress and reduce OCD symptoms

Medication

Treatment aims to control and reduce OCD symptoms. There are medications that a doctor can prescribe to help. They are selective serotonin reuptake inhibitors (SSRIs) that take a few weeks to start working and reduce the obsessions and compulsions combined with CBT or meditation.

Common drugs used in OCD treatment are:

  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac)
  • Sertraline (Zoloft)

Neuromodulation

Rarely, CBT and medication do not work. In such cases, a doctor may prescribe electrical stimulation to specific regions of the brain. Transcranial magnetic stimulation is FDA approved for OCD treatment. that stimulates nerve cells using magnetic fields.

Transcranial magnetic stimulation (TMS)

TMS is a non-invasive OCD treatment that targets specific brain areas through a device held above the individual’s head. It aims to regulate OCD symptoms.

OCD is a mental illness

To conclude and answer the question, what is OCD, a person with OCD may typically have been living with (and hiding) their illness for years. It takes a brave person with a solid support network to seek medical help from their doctor or mental health facility. 

Trivialization or misunderstandings by people around them about their experiences will make their symptoms worse. As the friend of someone who has OCD, make their lives easier by educating others about their condition. 

Approach an OCD sufferer as you would any other person suffering from a mental health problem. This way, their support network will become a part of the solution and not the problem.

If you suspect that you may have OCD, then getting help from a professional mental health facility is the best way to live a fulfilling, normal life. Get in touch with Psyclarity Health, a registered mental health center, to get diagnosed and the right treatment plan for managing your condition. 

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