It’s normal, on occasion, to go back and double-check that the iron is unplugged or your car is locked. But in obsessive-compulsive disorder (OCD), obsessive thoughts and compulsive behaviors become so excessive that they interfere with daily life. And no matter what you do, you can’t seem to shake them.
If you or someone you love has obsessive-compulsive disorder, you may feel isolated and helpless, but there is help available. Many treatments and self-help strategies can reduce the symptoms of 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.
Understanding obsessions and compulsions
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.
Just because you have obsessive thoughts or perform compulsive behaviors does NOT mean that you have obsessive-compulsive disorder. Many people have mild obsessions or compulsions that are strange or irrational, but they’re still able to lead their lives without much disruption. But with obsessive-compulsive disorder, these thoughts and behaviors cause tremendous distress, take up a lot of time, and interfere with your daily routine, job, or relationships.
Signs and symptoms of obsessive-compulsive disorder (OCD)
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:
- 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
Common compulsive behaviors in OCD include:
- 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.
Obsessive-compulsive disorder (OCD) symptoms in children
While the onset of obsessive-compulsive disorder usually occurs during adolescence or young adulthood, younger children sometimes have symptoms that look like OCD. However, the symptoms of other disorders, such as ADD, autism, and Tourette’s syndrome can also look like obsessive-compulsive disorder, so a thorough medical and psychological exam is essential before any diagnosis is made. It’s also important to note that OCD is an anxiety disorder, and in children, the symptoms of anxiety usually change over time. So a child with OCD symptoms will not necessarily have OCD as an adult. What’s most important is to make environmental and behavioral changes to reduce your child’s anxiety.
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