By Angela Cook, MSW, LCSW
I’m the first one to admit that I love a good acronym and have even created several of my own. However, one acronym that gets thrown around way too much is the one that stands for Obsessive Compulsive Disorder (OCD). People who have it know all too well that it’s nothing to joke about. The symptoms not only torment them endlessly but also wreak havoc on their loved ones.
People get accused of “being OCD” if they are overly clean or excessively cautious when it comes to safety. But it’s not a personality description – OCD is a serious mental health issue. Does being clean or cautious necessarily make someone OCD? No. Plus, using the term in that way can minimize the intense inner turmoil that an individual with true OCD is experiencing. Without proper treatment, OCD can be debilitating and drastically decrease one’s ability to be happy. It’s important to shed some light on what OCD actually is, to help break down the stigma, so that sufferers will be more willing to reach out for the help they need and begin their journey to more peaceful times.
There are two parts of OCD that make up the diagnosis. The first part is obsessions that manifest as unwanted, intrusive thoughts or images that are often continuous and disturbing. The second is compulsions in the form of actions, thinking loops, or behaviors that are carried out over and over to bring relief from the distressing obsessions. Both parts are fueled by fear of something bad happening, such as getting sick or harming oneself or someone else.
OCD is a serious mental health condition that is neurologically based. According to Neuroscience News, researchers at the University of Michigan discovered that there are often misfires between the signal to stop a behavior and being able to actually stop. In other words, you want the bike to stop but nothing happens when pressing on the brakes. For diagnosis, a minimum of one hour per day is spent engaging in obsessive thoughts and compulsive actions in an attempt to bring relief. According to the National Institute of Mental Health (NIMH), OCD affects one in 40 adults and one in 100 children in the United States. The average age of onset is 19, though a third of the people who have it first experienced symptoms in childhood.
HOW CAN YOU TELL THE DIFFERENCE?
One of the main differences between people who are extremely particular about where they want to place their belongings or how clean they are and people with diagnosable OCD can be explained this way: Someone with OCD will spend an excessive amount of time consumed in obsessive thoughts and compulsive behaviors that interfere with what they need to get done at work, home or school. A great deal of mental energy goes into the ‘what ifs’ and trying to gain control over the uncertainty of not knowing for sure if something is completely safe, sanitary or morally appropriate. Examples include: repeatedly checking to see if a person was hit while driving by turning around multiple times after going over a bump; or repeatedly obsessing over whether a door is locked, while worrying about the possible dangers if someone breaks in. When it’s OCD, a simple check of the lock is not enough… because what if it malfunctions?
4 COMMON TYPES OF OCD
Some people have significant difficulty parting with objects they no longer need or use. This becomes pathological when serious health hazards erupt due to being surrounded by trash, bugs, unsanitary conditions and fire hazards with the threat of eviction looming, due to not being able to throw things out or part with unwanted items. Questions and doubts arise: Will I need this item again someday? I can’t throw this out because it might be worth a lot of money. There’s constant fear revolving around the thought of not having something and worry that something bad could happen if it’s discarded.
Symptoms include: thinking harm will follow if you throw something out; constantly reviewing what you have; buying multiple items due to fear of not having what you need; and feeling fear that you might need something later.
This type of OCD revolves around the fear of something bad happening if not done properly. Individuals go to great lengths to make sure there are no safety hazards by repeatedly making sure everything is off, doors are locked, and all appliances are turned off, in order to avoid a major catastrophe. There’s constant fear that someone will break in or a fire will start unless they check over and over. Someone with this type of OCD can’t just drive home and check the door; they think about it all day and are able to do very little else.
Symptoms include: constant doubt about whether the door is locked or the iron is off, or repeatedly turning a light switch on and off to verify it still works.
ORDERING & SYMMETRY:
This type of OCD is fueled by the need to have control over every aspect of life in order to make it perfect. Compulsions consist of spending a great deal of time placing objects in a certain way in order to get that “just right” feeling. There’s also an incessant need to keep everything symmetrical and balanced visually, cognitively and/or physically. Oftentimes, the person recognizes that their thinking behind the need for order is illogical but still thinks, for example, that if everything isn’t perfect for the party, their friends will no longer hang out with them. Life is consumed with maintaining order and control by doing things like constantly moving papers and decorative items, or reorganizing drawers. An excessive amount of time is spent obsessing over every detail that creates barriers to time management and seeing the big picture. Compulsive behaviors interfere with spending time with loved ones, who often feel neglected.
Symptoms include: arranging items in a certain way over and over; constant anxiety about something bad happening if not in the right order; feeling that symmetrical body parts have to be used equally, such as when picking something up or stretching; and putting an inordinate amount of emphasis on visual symmetry, i.e., making sure that pictures being hung aren’t crooked.
Most people are familiar with this form of OCD, in which people are obsessed with decreasing their obsessive thoughts and images of being contaminated from germs, blood or toxic chemicals, while engaging in compulsive behaviors that help them or their belongings feel clean. The difference between someone who takes frequent showers and someone with contamination OCD is that a hot shower will help someone feel clean without the need to think about it again. But people with Contamination OCD will take a two-hour shower a couple times a day. There’s a preoccupation with the fear of getting themselves or a loved one sick from touching something that is suspected of being contaminated with blood, germs or hazardous chemicals.
Symptoms include: going to great lengths toward feeling safe by avoiding touching certain objects, or cleaning excessively to avoid feeling contaminated.
There are many more subtypes of OCD, which will be covered in future articles. Remember, it’s important to get treatment sooner rather than later, because if left untreated, OCD can be debilitating and impair one’s ability to function at home, work, school and/or in social settings. If you or a loved one is struggling with chronic and intrusive thoughts and engaging in distressing, ritualistic behaviors over and over, then start the process and reach out to a mental health practitioner for help today. A trained therapist whose area of focus is OCD can do an initial assessment and begin the process of helping you find peace within and overcome the obstacles that are holding you back.