What Is OCD?
Obsessive-compulsive disorder, or OCD, is a type of mental illness and is not something someone can control. OCD can affect all aspects of someone’s daily life including work, school and relationships. People with OCD may have either obsessive thoughts and urges or compulsive, repetitive behaviors. It’s possible that someone with OCD can have both.
The reality of OCD certainly goes beyond the misconception that the disorder involves consistent hand washing or double-checking door locks. Obsessive-compulsive disorder can interfere with people’s lives and make it challenging to complete daily tasks.
Types of OCD
There are several types of OCD including:
- Contamination or mental contamination
- Symmetry and ordering
- Intrusive thoughts
Individuals with checking OCD may live with an exaggeratedly obsessive and intense fear of possible harm. People with this type of OCD experience the fear of something happening to them, their loved one or their belongings, so they may compulsively check for safety.
If someone experiences this type of OCD, they may imagine their house catching on fire. People with OCD may continually drive by their house to make sure that there isn’t a fire. These individuals may feel a disastrous event is going to occur, just because it crosses their mind.
A few items these individuals may spend hours checking include:
- Oven knobs and appliances
- Doors and windows of their house and vehicle
- Medical websites about illness or disease
- Calling or texting loved ones to make sure nothing bad has happened to them
- Wallet or purse
It is common to double check the locks or make sure the oven is off before leaving home. However, people who live with checking OCD may review these items multiple times, sometimes for hours.
Contamination or Mental Contamination
Contamination OCD involves the obsessive impulse to wash or clean something for the fear of causing death or illness from contamination. Someone may obsessively worry over something like uncooked food contaminating their kitchen countertop. This worry may result in them scrubbing the countertop for hours for the fear that they will not be able to clean up all of the contaminated areas. The thought of someone possibly getting sick due to the contamination may drive the person to over-clean.
The fears that are present during contamination OCD can result in someone avoiding or fearing public places including hospitals or doctor’s offices, restaurants, crowds and anywhere there could be chemicals.
To cope with these obsessive fears, someone who has contamination OCD might compulsively:
- Wash their hands excessively
- Throw items away
- Sanitize or clean objects
- Change clothes frequently
- Create “off-limits” clean areas
Symmetry and Ordering
Symmetry, or ordering-type OCD, is the uncontrollable desire to have things in place and organized at all times. If something is just a little off-centered, even the slightest amount, the individual may experience great discomfort and anxiety. Sometimes, people with symmetry OCD believe that any disorganization or imbalance may result in something terrible happening.
Symptoms of symmetry obsessive-compulsive disorder include:
- Making sure everything is always in its place
- Arranging canned food items and stacking them with the labels all facing forward
- Having a perfectly clean home, free of stains
- Making sure everything is in even numbers or actions are done evenly
People with symmetry OCD may spend so much time arranging or counting things that they are often late for work, school, appointments and other events.
Ruminations and Intrusive Thoughts
Obsessive-compulsive disorder is often revealed through someone’s actions. Conversely, someone can also suffer from OCD internally by experiencing intrusive thoughts. These thoughts are involuntarily the person may think something is wrong with them for having these types of thoughts. People with this type of OCD may even fear that they might act out these unwanted thoughts. This fear may result in avoidance of social activities.
Intrusive thoughts can be about anything, but they often involve the fear of harming a family member, another loved one or themselves. Intrusive thoughts commonly fall into one of these categories:
- Obsessively doubting and analyzing a relationship.
- Hyper-aware of breathing, blinking or swallowing saliva and fearing the inability of doing these actions.
- Fear of sexually harming someone or of having an inappropriate attraction.
- Believing bad thoughts may cause actual harm.
- Fear of compulsively harming a loved one, child, themselves or an innocent stranger.
Hoarding is a type of OCD that involves an attachment to items that are no longer useful but are kept to avoid the extreme discomfort of discarding something. Hoarders may keep objects in fear the object will cause someone harm once discarded or they may need it once it is gone. The emotional significance is usually attached to each item, making it a challenge for them to throw something away.
Symptoms of hoarding usually include:
- Inability to discard items no matter how old or useless they are
- Intense anxiety when thoughts of throwing items away
- Unable to choose which items to keep or discard
- Unable to decide where to put objects
- Feeling overwhelmed by possessions
The result can be shattering for the family of the individual as they may never invite anyone to their home out of embarrassment or because there is not enough space. With a lack of social contact, a hoarder may soon feel isolated and depressed in addition to dealing with OCD.
Symptoms of OCD
Many people with OCD are aware that their thoughts and actions don’t make complete sense. They do not necessarily enjoy checking the locks and stove every few minutes or straightening the pantry for hours. However, they cannot quit doing these things because it is out of their control.
Signs of OCD include obsessions and compulsions that can involve many different activities and thoughts, including:
- Fear of germs, dirt or filth
- Washing hands repeatedly
- Worries about self or other people getting hurt
- Doing tasks in a specific order every time or a certain number of times
- Needing items to be placed in a specific order
- Belief that certain numbers or colors are good or bad
- Constant awareness of blinking, breathing or other body sensations
- Unsupported suspicion that a partner is unfaithful
- Repetitive checking on a locked door, light switch and other objects
- Fear of touching doorknobs, using public toilets or shaking hands
Causes of OCD
Like most mental illnesses, there is no known cause but there are several supporting factors that have been shown to what may cause OCD. Obsessive-compulsive disorder is slightly more common in women than in men and symptoms become present when someone is in their teens or as a young adult. A stressful lifestyle can make symptoms worse.
An individual is more likely to get the disorder if they have a parent, sibling or other family members with OCD. The disorder has been proven to have a genetic link, though is not guaranteed to affect all family members. Having depression or anxiety bouts also shares a connection with OCD. Obsessive-compulsive disorder is also more prominent in individuals who have experienced trauma or have a history of physical or sexual abuse.
How Is OCD Diagnosed?
A physician may do a physical exam and bloodwork to make sure that a physical medical problem does not cause symptoms. The physician may ask the patient about their feelings, thoughts and habits. If the lab work from the physical exams come back normal, the next step should be a referral to a mental health professional.
The patient can receive a psychological evaluation and discuss thoughts, feelings, symptoms and behavior patterns. If thoughts and habits keep an individual from doing what they want or need to do for at least an hour a day, they may have OCD.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), states that a diagnosis of OCD should include the presence of obsessions or compulsions, or both, which are recurrent and persistent thoughts, urges or impulses that are intrusive and unwanted.
Who Is at Risk for OCD?
Though there is no actual cause associated with OCD, the more risk factors an individual has, the greater the likelihood of developing OCD. Some of these risk factors include:
- Presence of other neurologic conditions.
OCD tends to develop in late adolescence or early adulthood, the disorder rarely occurs in the elderly. If someone has OCD symptoms, they have a 25 percent chance of having a relative who also has it. OCD often occurs in people who have pre-existing anxiety disorders, depression, ADHD, substance abuse and certain personality disorders.
The DSM reports the typical yearly occurrence of OCD is 1.2 percent, with a similar occurrence internationally of around 1.8 percent.
OCD becomes problematic and impacts someone’s life during late adolescence for males and during the early twenties for females. A child as young as six-years-old can develop this disorder, and 25 percent of cases become present around age 14. Obsessive-compulsive disorder onset is not likely after age 35.
Research suggests that OCD is slightly more predominant in women than in men. This could be attributed to the belief that women typically find talking about feelings and emotions more comfortable than men. This may also be a barrier which prevents men seeking professional help for their problems, so it’s likely that men and women are affected equally.
If you are or a loved one is struggling with a substance use or co-occurring disorder like OCD, The Recovery Village can help. A team of professionals offers a number of treatment programs for substance use and co-occurring disorders. Call and speak with a representative to learn more about which program could work for you.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.