What is Obsessive Compulsive Disorder (OCD)?
Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by uncontrollable, unwanted thoughts and repetitive, ritualized behaviors you feel compelled to perform. If you have OCD, you probably recognize that your obsessive thoughts and compulsive behaviors are irrational – but even so, you feel unable to resist them and break free.
Like a needle getting stuck on an old record, obsessive-compulsive disorder (OCD) causes the brain to get stuck on a particular thought or urge. For example, you may check the stove twenty times to make sure it’s really turned off, you’re your hands until they’re scrubbed raw, or drive around for hours to make sure that the bump you heard while driving wasn’t a person you ran over.
Obsessions are involuntary, seemingly uncontrollable thoughts, images, or impulses that occur over and over again in your mind. You don’t want to have these ideas – in fact, you know that they don’t make any sense. But you can’t stop them. Unfortunately, these obsessive thoughts are usually disturbing and distracting.
Compulsions are behaviors or rituals that you feel driven to act out again and again. Usually, compulsions are performed in an attempt to make obsessions go away. For example, if you’re afraid of contamination, you might develop elaborate cleaning rituals. However, the relief never lasts. In fact, the obsessive thoughts usually come back stronger. And the compulsive behaviors often end up causing anxiety themselves as they become more demanding and time-consuming.
Most people with obsessive-compulsive disorder fall into one of the following categories:
Like a needle getting stuck on an old record, obsessive-compulsive disorder (OCD) causes the brain to get stuck on a particular thought or urge. For example, you may check the stove twenty times to make sure it’s really turned off, you’re your hands until they’re scrubbed raw, or drive around for hours to make sure that the bump you heard while driving wasn’t a person you ran over.
Obsessions are involuntary, seemingly uncontrollable thoughts, images, or impulses that occur over and over again in your mind. You don’t want to have these ideas – in fact, you know that they don’t make any sense. But you can’t stop them. Unfortunately, these obsessive thoughts are usually disturbing and distracting.
Compulsions are behaviors or rituals that you feel driven to act out again and again. Usually, compulsions are performed in an attempt to make obsessions go away. For example, if you’re afraid of contamination, you might develop elaborate cleaning rituals. However, the relief never lasts. In fact, the obsessive thoughts usually come back stronger. And the compulsive behaviors often end up causing anxiety themselves as they become more demanding and time-consuming.
Most people with obsessive-compulsive disorder fall into one of the following categories:
- Washers are afraid of contamination. They usually have cleaning or hand-washing compulsions.
- Checkers repeatedly check things (oven turned off, door locked, etc.) that they associate with harm or danger.
- Doubters and sinners are afraid that if everything isn’t perfect or done just right something terrible will happen or they will be punished.
- Counters and arrangers are obsessed with order and symmetry. They may have superstitions about certain numbers, colors, or arrangements.
- Hoarders fear that something bad will happen if they throw anything away. They compulsively hoard things that they don’t need or use.
Signs & Symptoms
Most people with obsessive-compulsive disorder (OCD) have both obsessions and compulsions, but some people experience just one or the other. The symptoms of OCD may wax and wane over time. Often, the symptoms get worse in times of stress.
Common obsessive thoughts in OCD include:
Common obsessive thoughts in OCD include:
- Fear of being contaminated by germs or dirt or contaminating others
- Fear of causing harm to 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
- 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, evening out, or arranging things “just so.”
- Praying excessively or engaging in rituals triggered by religious fear.
- Accumulating “junk” such as old newspapers, magazines, and empty food containers, or other things you don’t have a use for.
Therapy for Obsessive Compulsive Disorder (OCD)
There are many effective treatments for obsessive-compulsive disorder (OCD), ranging from therapy to self-help and medication. However, the treatment for OCD with the most research supporting its effectiveness is cognitive-behavioral therapy.
Cognitive-behavioral therapy for obsessive-compulsive disorder involves two components:
For example, if you are a compulsive hand washer, you might be asked to touch the door handle in a public restroom and then be prevented from washing up. As you sit with the anxiety, the urge to wash your hands will gradually begin to go away on its own. In this way, you learn that you don’t need the ritual to get rid of your anxiety – that you have some control over your obsessive thoughts and compulsive behaviors.
Studies show that exposure and response prevention can actually “retrain” the brain, permanently reducing the occurrence of obsessive-compulsive disorder symptoms. This type of OCD therapy can even extinguish compulsive behaviors entirely.
Cognitive therapy for OCD The cognitive therapy componentfor obsessive-compulsive disorder (OCD) focuses on the catastrophic thoughts and exaggerated sense of responsibility you feel. A big part of cognitive therapy for OCD is teaching you healthy and effective ways of responding to obsessive thoughts, without resorting to compulsive behavior.
Cognitive-behavioral therapy for obsessive-compulsive disorder involves two components:
- Exposure and response prevention
- Cognitive therapy
For example, if you are a compulsive hand washer, you might be asked to touch the door handle in a public restroom and then be prevented from washing up. As you sit with the anxiety, the urge to wash your hands will gradually begin to go away on its own. In this way, you learn that you don’t need the ritual to get rid of your anxiety – that you have some control over your obsessive thoughts and compulsive behaviors.
Studies show that exposure and response prevention can actually “retrain” the brain, permanently reducing the occurrence of obsessive-compulsive disorder symptoms. This type of OCD therapy can even extinguish compulsive behaviors entirely.
Cognitive therapy for OCD The cognitive therapy componentfor obsessive-compulsive disorder (OCD) focuses on the catastrophic thoughts and exaggerated sense of responsibility you feel. A big part of cognitive therapy for OCD is teaching you healthy and effective ways of responding to obsessive thoughts, without resorting to compulsive behavior.
Treatments
In addition to cognitive-behavioral therapy, the following treatments are also used for obsessive-compulsive disorder (OCD):
Dealing with and obsessive thoughts and compulsive behaviors:
- Medication – Antidepressants are sometimes used in conjunction with therapy for the treatment of obsessive-compulsive disorder. However, medication alone is rarely effective in relieving the symptoms of OCD.
- Family Therapy – Because OCD often causes problems in family life and social adjustment, family therapy is often advised. Family therapy promotes understanding of the disorder and can help reduce family conflicts. It can also motivate family members and teach them how to help their loved one.
- Group Therapy – Group therapy is another helpful obsessive-compulsive disorder treatment. Through interaction with fellow OCD sufferers, group therapy provides support and encouragement and decreases feelings of isolation.
Dealing with and obsessive thoughts and compulsive behaviors:
- Educate yourself. Learn everything you can about OCD. Read books on the disorder and talk to your therapist and doctor. The more you know, the better able you will be to manage your symptoms. You can find many books about OCD at local or online bookstores.
- Practice the skills you’ve learned in therapy. Using the skills you’ve learned in therapy, actively work toward eliminating your obsessions and compulsive behaviors. This is a challenge that requires commitment and daily practice.
- Stay connected to family and friends. Obsessions and compulsions can consume your life to the point of social isolation. In turn, social isolation can aggravate your OCD. It’s important to have a network of family and friends you can turn to for help and support. Involving others in your treatment can help guard against setbacks and keep you motivated.
- Join an OCD support group. You’re not alone in your struggle with OCD, and participating in a support group is an effective reminder of that. In a support group, you can share your experience and learn from others who are going through the same thing you are.
- Practice relaxation techniques. Meditation, yoga, deep breathing, and other stress relief techniques may help reduce the symptoms of anxiety brought on by OCD. Mindfulness meditation may be particularly helpful to OCD sufferers.
