Obsessive compulsive disorder, commonly referred to as ‘OCD’, refers to repetitive, intrusive and unwanted fears and thoughts (obsessions), as well as repetitive mental or physical actions and routines (compulsions) in an attempt to relieve the relevant thoughts and anxiety.
When suffering from OCD, the need to repeat certain actions over and over (in order to relieve intrusive thoughts and associated anxiety) can largely disrupt a person’s quality of life. Obsessive compulsive disorder can significantly affect a number of elements of an individual’s day-to-day life, such as meeting family and household responsibilities, their relationships with others, as well as their ability to study and/or work effectively.
A large number of people who struggle with obsessive compulsive disorder understand their intrusive and unwanted thoughts are irrational and as a result, feel embarrassed by their situation. Where this is the case, a sufferer may work to conceal their rituals (compulsions) from people around them, such as family, friends and colleagues.
What are Obsessions?
Obsessions are specific and repetitive, negative and fearful thoughts that cause a person distress. These thoughts can be especially challenging for a person with obsessive compulsive disorder to stop, despite trying to do so. Relief from these persistent and unwanted thoughts is sought by executing certain actions and/or routines. If these actions and routines are not completed in a certain way, the obsessive thoughts persist and the cycle continues to repeat itself.
Examples of Obsessions
A number of key examples exist when it comes to obsessions experienced by people suffering from obsessive compulsive disorder. Common obsessions include the following:
- Fear of contamination: i.e. contact with substances such as chemicals (e.g. those used for cleaning), dirt, and/or germs (such as when preparing a meal or shaking hands with someone who is ill)
- Fear of harm: to oneself or others due to carelessness (such as accidents, illness or death)
- The requirement for order, symmetry and exactness: for example, with regards to arranging certain items such as books, shoes or certain areas such as a coffee or bedside table.
- The requirement for perfection: is identified in a number of children and teens who are suffering from obsessive compulsive disorder. For example, a child or teen with OCD may feel unable to attend school if their uniform is not ironed to perfection, or submit a school project until feeling completely sure it is perfect. Some children struggling with OCD may fret over the smallest of mistakes and feel a need for complete perfection in all activities they undertake.
- Specific types of intrusive thoughts/images: regarding morality, religion, sexual behaviour, violence and/or other issues. Some people suffering from obsessive compulsive disorder are overcome by the need to know and remember all details regarding all activities they undertake in their day-to-day life.
What are Compulsions?
Compulsions specifically refer to the behaviours (actions and routines) that are performed with the intent to relieve an individual from the anxiety associated with their unwanted, repetitive and intrusive thoughts. In many instances, compulsions must be performed in a specific manner, and like obsessive thoughts, despite trying, a person suffering from obsessive compulsive disorder often significantly struggles not to carry out the relevant actions and routines.
Compulsive behaviours in many cases become precise, ordered and largely time-consuming rituals, as a person turns to these behaviours to relieve their feelings of anxiety. Short term relief from their fear and repetitive thoughts may occur, until the need to repeat the process strikes all over again. Depending on the nature of a person’s obsessions and relevant compulsions, OCD can affect a person when they are at home, in the company of loved ones, at their workplace and/or in public.
Examples of Compulsions
A number of key examples exist regarding compulsions, as experienced by people suffering from obsessive compulsive disorder. Common compulsive behaviours include:
- Arranging and ordering: Items (such as books or shoes) must be placed in a certain fashion, with regards to factors such as size, direction, spacing and/or colour.
- Checking: certain things repeatedly, such as appliances, switches, locks, bags or family members, to feel sure that the individual affected by OCD themselves, their loved ones and their belongings are safe.
- Cleaning: rituals or excessive cleaning associated with kitchen/food preparation, household items, bathrooms, doing the laundry, or car, for example.
- Counting, moving, tapping, touching etc.: in a certain way and/or a specific number of times (such as the requirement to tap a door handle three times before entering a room).
- Mental rituals: such as mental repetition of certain words, phrases or numbers, or the need to visualise certain images in the mind.
- Washing (personal hygiene): rituals (such as washing in a certain order and/or a specific number of times) and/or excessive washing with regards to hand washing, showering, the toilet, brushing your teeth or personal grooming.
Signs and Symptoms of Obsessive Compulsive Disorder
There are a number of signs and symptoms that may be evident where a person is suffering from obsessive compulsive disorder, and these symptoms may be physical, mental, emotional and/or behavioural in nature.
An individual with OCD may be troubled by repetitive fears and thoughts about problems that others may not be able to identify. In order to relieve these troubling thoughts and associated anxiety, a person struggling with obsessive compulsive disorder may repeat certain actions and routines, in a specific and orderly way, over and over again. For example, a fear of germs or contamination may lead to a constant requirement to wash your hands, or a fear of harm may lead to repeatedly checking that the doors and windows around the home are locked. Despite feeling some short-term relief, a person suffering from OCD will soon feel they must repeat their compulsive actions/routine. Where the compulsive actions or routine are not carried out in response to the obsessive thoughts, intense anxiety results.
Obsessive compulsive disorder can significantly affect a sufferer’s ability to go about their day as normal, and their troubling thoughts (obsessions) combined with compulsive behaviour may constitute an hour or more of their time on a daily basis. A sufferer may or may not recognise that these thoughts and fears are irrational and find themselves unable to control their repetitive thoughts and behaviours. In some cases, they may be embarrassed by their fearful thoughts and corresponding behaviour.
Loved ones may be able to recognise behavioural signs and symptoms of obsessive compulsive disorder in a person suffering from this anxiety disorder, such as the need to wash their hands on an excessively regular basis, the requirement to repeatedly check doors and windows are locked or avoidance of particular places or situations (e.g. using public transport). OCD may cause a sufferer to feel doubtful that certain activities have been completed correctly (e.g. the washing of another’s hands before preparing a meal).
An individual struggling with OCD may feel the need to adhere to a strict daily routine and may become angry and/or upset if plans change. They may also constantly seek reassurance from their loved ones and struggle to maintain interpersonal relationships with other people, where their obsessive compulsive disorder interferes with social situations. Social withdrawal may occur.
Physical signs and symptoms of obsessive compulsive disorder include an increased heart rate, shortness of breath, tightness in the chest, muscle tension, excessive perspiration and trembling or shaking. Dizziness may be apparent and a person may experience derealisation, or detachment from their surroundings. Headaches or stomach discomfort may also be apparent.
Emotionally, a person suffering from obsessive compulsive disorder may be overcome by extreme fear, concern and anxiety. They may also feel guilty about their situation, and at times may experience sadness and/or anger.
Risk Factors for the Development of Obsessive Compulsive Disorder
What exactly causes a person to develop obsessive compulsive disorder is not yet understood. However, there are thought to be a wide number of risk factors which may increase the likelihood of a person developing obsessive compulsive disorder, including the following:
- Genetics and Learned Behaviour: A large proportion of a person’s overall risk for the development of obsessive compulsive disorder comes from their genetic makeup. Where family members have experienced OCD, a person’s personal risk is increased. Learned behaviour from family members may also increase the likelihood of developing OCD (such as learning poor strategies from your parents for dealing with stressful situations when they arise).
- Mental Illness: Suffering from a mental health illness, such as anxiety or depression, can increase a person’s risk of developing obsessive compulsive disorder. Similarly, experiencing OCD may increase a person’s risk of developing another mental health illness (such as depression, where a person with OCD is socially withdrawn).
- Gender: Gender and its impact on a person’s risk for developing OCD depends on a person’s age group. In childhood, boys are more likely than girls to suffer from obsessive compulsive disorder. Although, once puberty hits, young adults, both male and female, share a similar risk with regards to the development of OCD.
- Age: People aged between 18 years and 21 years (i.e. late adolescence) appear to be at the most significant risk of developing obsessive compulsive disorder. The risk of developing OCD tends to drop away following this age group.
- Personality: People who display particular personality characteristics, such as perfectionism seen in Type A personalities, may be more likely to develop OCD compared to other people.
- Life Events: Exposure to intense stress and/or trauma (as is often the case regarding serious accidents and/or illness, for example) can increase a person’s likelihood of developing obsessive compulsive disorder. This may especially be the case where the event occurred in childhood.
Things You Can Implement to Help You Manage Obsessive Compulsive Disorder
There are a number of activities you can consider implementing to help you manage the symptoms associated with obsessive compulsive disorder, such as writing down your thoughts and learning/practising relaxation techniques:
- Jotting down on paper or in a journal the intrusive and worrying thoughts you are experiencing (obsessions) and when they occur, can help you to uncover patterns in your thinking and can assist you to anticipate when you might be overcome with the urge to undertake rituals to relieve your anxiety (compulsive behaviours), and instead understand that the thoughts are obsessive only, and irrational and unreasonable.
- Learning and practicing relaxation techniques such as deep breathing and/or mindfulness meditation can help you to manage physical, emotional and behavioural symptoms of your anxiety (for more information, see our article ‘Beginners Guide to Mindfulness Meditation for Depression and Anxiety’ by clicking here). Mastering the skill of mindfulness meditation may also assist you to more clearly identify and separate yourself from negative and intrusive thoughts.
How to Support Someone Suffering from Obsessive Compulsive Disorder
Obsessive compulsive disorder has the potential to not only drastically affect the life of the individual who is suffering from this mental health illness, but also their loved ones. Coping with a loved one who is struggling with OCD can be confusing, frustrating, exhausting, stressful and overwhelming.
Thankfully, there are a number of things you can do to support your loved one in managing and recovering from obsessive compulsive disorder. Encouraging someone you care about suffering from OCD to seek professional help for their condition is a great starting point. Researching and learning all you can about OCD can also be very beneficial, in order for you to best understand what your loved one is going through.
It can be helpful for you and your loved one to attend any appointments together. Finally, gentle and effective encouragement of your loved one to face situations that may induce their anxiety may be helpful (preferably under the guidance of a professional trained in treating people suffering from OCD).
Obsessive compulsive disorder can leave a person feeling physically, mentally and emotionally exhausted, thanks to their mind being constantly overcome with negative and intrusive thoughts and the need to carry out precise actions or rituals in an attempt to relieve their anxiety. When left untreated, OCD can drastically affect a person’s day-to-day life, as well as the lives of those around them.
If you or someone you know are struggling with anxiety, feel free to get in touch with our friendly team at Blissiree Pty Ltd, for professional assistance with recovery from this common mental health illness.