What is OCD?
Obsessive - Compulsive Disorder (OCD) is a mental health condition with traits of unwanted, intrusive thoughts (obsessions) and repetitive behaviors, mental acts, or rituals (compulsions) that a person feels driven to perform in response to those thoughts. These obsessions and compulsions can interfere with daily life, causing distress, anxiety, and a sense of being out of control.
Let’s look a little bit closer at obsessions. These are repetitive, intrusive thoughts, images, or urges that cause significant anxiety or distress. These are different from typical worries as they often seem senseless, illogical, or excessive. However, for someone with OCD, they feel very real and compelling. Obsessions are different from worries, generalized anxieties, or phobias. General worries or anxieties may be in the realm of feeling nervous about passing a big test or nervous about having to have difficult conversations. Obsessions may include things like doubting that you have done something correctly, fearful that you may have hurt someone, fear that you might say or do something embarrassing, fear that you might contaminate someone or fear that someone might contaminate you. The obsessive thoughts will most often feel like they do not fit your personality.
Compulsions are defined as the actions or mental rituals you feel compelled to perform in response to the obsessive thoughts or according to rules. Compulsions can include physical ats such as checking, cleaning, counting, or repeating actions over and over. They can also include mental rituals such as neutralizing thoughts, needing to tell or confess, or re-reading something. While compulsions may provide a brief relief from obsessive thoughts, they are typically not pleasurable to perform. Compulsions in this context are different from behaviors that may feel compulsive such as gambling or substance use.
Common Obsessions and Compulsions
There are several categories that obsessions or compulsion may fall in. Let’s look at a few:
Obsessions:
Aggressive
Contamination
Sexual
Hoarding or saving
Religious
Symmetry or exactness
And others
Compulsions:
Somatic
Cleaning or washing
Checking
Repeating rituals
Counting
Ordering or arranging
Hoarding or collecting
And others
The Impact of OCD on Daily Life
OCD behaviors will typically start out small and seem harmless. However, they have a snowball like quality - where the more you let them interfere the bigger they become. While OCD will look different and affect people in different ways - the cycle stays the same. A triggering event or intrusive thought occurs, anxiety builds, the compulsions are performed, there is temporary relief, and then it all starts again. OCD feeds on reassurance and it can’t get enough of it! Over time, these rituals can consume a person’s life, making it difficult to maintain relationships, perform well at work or school, or even complete everyday tasks.
For many, OCD leads to avoidance, distress, or perfectionism. You may start to avoid people, places, activities, or situations that you used to enjoy out of fear that it may trigger an obsession. The growing and seemingly endless cycle of OCD can cause emotional exhaustion, guilt or shame, frustration, and isolation. The fear of making mistakes, being judged, or missing something can lead to a sense of needing to be and do things perfectly. Many people go years before they receive an accurate diagnosis, and it can leave you feeling completely out of control or hopeless.
The good news is that OCD is treatable. With the right approach, you can learn to manage your symptoms and regain control over your life.
How Is OCD Treated?
OCD treatment can help you manage symptoms and live a fulfilling life. The two most effective forms of treatment are Cognitive Behavioral Therapy (CBT), specifically Exposure and Response Prevention (ERP), Acceptance and Commitment Therapy (ACT), and some medications may be helpful.
Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP)
CBT is one of the most effective treatments for OCD, particularly when combined with ERP. ERP is a daughter of CBT that focuses on gradually exposing you to the things that trigger your obsessions, while preventing the compulsive behavior that follows in a systematic and controlled way.
In ERP, the therapist works with you to:
Identify triggers: Together, you'll figure out what situations, thoughts, or objects trigger your obsessive thoughts and the level of distress that they cause.
Gradual exposure: You will determine a comfortably challenging place to start where you’ll be exposed to these triggers in a controlled way, starting with less anxiety-provoking situations and gradually moving toward more difficult ones.
Response prevention: As you're exposed to these triggers, you'll work on resisting the urge to perform the compulsions. Over time, this reduces the anxiety associated with the obsessions, allowing you to feel more in control.
ERP can be challenging at first, but research has shown it to be highly effective in reducing OCD symptoms and helping people regain their sense of normalcy.
Acceptance and Commitment Therapy (ACT)
Acceptance and Commitment Therapy (ACT) can help individuals by teaching skills to accept their thoughts and feelings without trying to suppress or control them. For individuals with OCD, this may look like learning to build tolerance to the distress that their thoughts or compulsions cause, while still enjoying things that they do. The idea is to build cognitive flexibility that allows them to take their thoughts exactly as they are - thoughts.
Cognitive Defusion: This is a technique commonly used in ACT treatment that allows the individual to separate the meaning being assigned to their thoughts to be able to see their thoughts as words or events in their mind vs. commands and facts.
Committed Action: this ACT intervention is a skills that encourages the individual to make choices and take action on the things that are in line with their values even when faced with distress and discomfort.
Mindfulness: Mindfulness is a technique adopted by many therapies that encourages a person to stay in the present moment and to acknowledge thought and feelings as they arise and pass without judgement. This can decrease the level of discomfort of intrusive thoughts and urges.
Medication
For some people, medication can also be an important part of treatment. Medication is often used in combination with therapy to provide the most effective treatment. For some, medications help reduce the intensity of their symptoms, making it easier to engage in therapies mentioned above. You should talk with a medication provider about what may be the best option for you.
Why Understanding OCD is Important
“Oh they are just a little OCD” - has been such a common saying, and it is important to understand what OCD really is, because this statement is just not accurate. OCD is a real medical diagnosis that causes a great deal of distress in the lives of many people. OCD is not just about being clean or organized, and it is certainly not something someone can just start doing. This condition causes a lot of shame and loneliness for the people affected by it.
We should be downplaying the severity just to describe a neat and organized person. If you think you might have OCD or have already been diagnosed - the first step is to reach out to a mental health professional who specializes in OCD treatment. Together, you can explore your symptoms, discuss treatment options, and take the first step to reduce the hold OCD has on your life.
You deserve to live without the constant weight of compulsions and obsessive thoughts. Reach out today to get started!