What is obsessive-compulsive disorder (OCD)?
Obsessive-compulsive disorder is a common psychological disorder where a person experiences unwanted and reoccurring thoughts or urges (obsessions). The thoughts or urges the individual experiences causes intense anxiety (including anxiety attacks) or psychological distress. To alleviate the psychological distress the individual will perform a task (compulsions). The compulsion, which can be a specific behavior, or a mental act, becomes a repetitive behavior that the individual constantly carries out. Compulsions take up a lot of time and can interfere with the individual’s daily life.
There are different intensities of OCD. Individuals who have been diagnosed with OCD may realize that the beliefs they are experiencing are not real. Others may not be sure and think there is a possibility they are real. Some individuals may think the beliefs are based in reality and if they do not carry out the compulsion, there will be a consequence.
Are there different types of OCD?
According to the DSM-5, there are 5 main themes of OCD that are most common, though obsessions are not limited to these groups.
Contamination
The fear of becoming “contaminated” leads the individual to fear becoming sick and spreading that sickness or uncleanliness. These individuals spend much of their time preoccupied with the fear of becoming contaminated and/or spreading it. To relieve this anxiety, they may wash their hands continuously, clean frequently, and avoid places they feel could contaminate them. In order to ease the psychological distress, individuals may consistently wash their hands, constantly clean themselves and around them, avoiding others in order to keep from getting sick.
Symmetry
Individuals who have symmetry or “just right” OCD are obsessed with ensuring that objects such as clothing are folded perfectly and evenly, they may rearrange objects, so they are evenly spaced, or rewrite notes until the words are symmetrical and even. [1] People who are diagnosed with this type of OCD experience a discomforting feeling for things if they are not “just right” or symmetrical. The discomforting feeling will lead the individual to have the urge or to carry out a ritual that will alleviate the discomfort. Symmetry compulsions may also include tapping or touching a specific object a specific number of times, walking with even pressure on both feet, taking a specific number of steps, having an even number of objects, or similar.
Forbidden/Taboo thoughts
Individuals who experience forbidden or taboo thoughts have intrusive thought that may be aggressive, sexual, or religious in nature. The thoughts will constantly intrude the individuals mind causing feelings of guilt, shame, anxiety, or similar negative feelings. Individuals with aggressive thoughts may fear they will become violent and hurt or kill others. Those who have religious obsessions may be discomforted by the thought of sinning, having a blasphemous thought, or fear they are being immoral. Individuals who experience taboo thoughts OCD may carry out mental compulsions to get rid of unwanted thoughts. For example, an individual may compulsively pray, compulsively rethink about events, or have a mental ritual they carry out. There may also be obvious compulsions, such as knocking on wood, or repeating words or numbers a specific amount of time. These rituals can be time consuming and usually interfere with an individual’s daily life.
Harm
Individuals who experience harm OCD will have constant thoughts and fears that they may hurt themselves or others. Some may fear that they will impulsively kill someone or themselves. These thoughts cause great anxiety to the individual, which can cause disruptions in their daily life. Individuals with harm OCD may compulsively check in with others and themselves to ensure they did not hurt anyone. They may also avoid objects or situations that may be a trigger for them.
Are there any treatments for OCD?
Exposure and Response Prevention (ERP)
ERP is a form of cognitive-behavioral therapy which helps individuals confront their fears and learn tools to resist carrying out compulsions. EPR can be used to help individuals who avoid situations, objects, or places that may be triggering.
Imaginal Exposure
Imaginal exposure therapy also has the individual confront their fears, but the scenario takes place in their mind. This therapy is mainly used for individuals who have an extremely hard time facing their triggers in real life or for individuals who have intrusive thoughts. The therapist will help the individual create a script or a scenario that will trigger their obsessive thoughts and teach them tools to cope with them in a healthy manner.
Habit Reversal Training
Habit reversal training helps an individual unlearn their unhealthy habits and relearn healthy coping skills. Coping skills include awareness training, which helps individuals learn to identify warning signs and take preventative measures; relaxation skills, including mindfulness, breathing and grounding skills; competing response training, which teaches a person how to replace unwanted behaviors or compulsions; and general psychoeducation.
Medication
Deep Brain Stimulation
Some individuals may be resistant to traditional interventions for OCD and a doctor may recommend trying deep brain stimulation. Deep brain stimulation is a neurosurgery where a hole is drilled into the skull and cauterizes the area of the brain responsible for OCD (the anterior cingulate cortex).
Transcranial Magnetic Stimulation (TMS)
TMS is a noninvasive procedure that is used for patients that do not respond to traditional treatments for OCD. The treatment uses strong magnets to create more activity in specific areas of the brain. The process is not painful and can be helpful in reducing symptoms associated with OCD.
Check out these organizations that are dedicating to helping those with OCD here. You can also read a personal story, "How I Overcame My OCD" here.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7115475/
