What is OCD?

It’s common for someone to flippantly call a friend or family member “OCD” as a means of teasing them about keeping their house spotless or being a perfectionist. True OCD, which stands for obsessive-compulsive disorder, affects approximately 2 percent of the population and is far from a joking matter. OCD is a chronic disorder in which uncontrollable, repetitive thoughts and behaviors trap people into cycles that can be completely debilitating.

Obsessive-Compulsive Disorder

Obsessive-compulsive disorder consists of obsessions, which are patterns of thoughts and fears, usually unreasonable, that lead to compulsive and repetitive behaviors or rituals. The compulsive component of the disorder is an attempt to stop the obsessive thoughts, although any relief that might be provided is temporary, at best. Those struggling with OCD are often aware that their obsessions are unrealistic and their compulsions ineffective, but they are powerless to stop them. In fact, attempts to ignore or control obsessions will generally tend to increase the related anxiety.

Symptoms of Obsessive-Compulsive Disorder

While it is possible to have only obsession symptoms or only compulsion symptoms, they usually come together, and they are often theme-based. Common obsession themes include:

  • Preoccupation with germs and contamination
  • Needing things in a specific order or symmetrical
  • Aggressive thoughts or thoughts about harming self or others
  • Unwanted, forbidden or taboo thoughts about aggression, sex or religion

Some examples of how obsessions can manifest are:

  • Fear of touching objects that have been touched by others and may be contaminated with germs
  • Inability to believe that the door has been locked or the stove has been turned off, even having personally done it
  • Extreme stress when objects are not in a precise order or are facing the wrong way, even when there is no true justification for the order or direction
  • Unwanted and distressing images of inflicting pain on self or others
  • Thoughts about personally uncharacteristic behavior, such as shouting obscenities or acting inappropriately that are unwanted and uncomfortable
  • Going to great lengths to avoid obsession-triggering situations, like shaking hands or touching door handles
  • Shame and embarrassment resulting from unwanted sexual images repeating in the mind

Common Compulsions

Even though the repetitive behaviors may only provide a very short period of relief from anxiety, they are labeled compulsions because the individual has no control. Also tending to follow themes, compulsions often center around:

  • Cleanliness
  • Constant checking
  • Counting
  • Orderliness
  • Adhering to a strict routine
  • Seeking constant reassurances

Examples of compulsion symptoms include:

  • Hand-washing to the point of skin becoming raw
  • Checking repeatedly to make sure doors are locked
  • Checking repeatedly to make sure the stove is turned off
  • Counting in certain patterns
  • Mentally repeating a word or phrase
  • Arranging canned goods and other items to face the same way

What causes OCD is unknown and the symptoms may worsen or lessen over time. For some, there may be the added characteristic of a tic. Motor tics appear as repetitive movements, like an eye blinking or twitching, and vocal ticks can include throat-clearing, sniffing or other sounds. Treatment can often be successful and is typically a combination of medication and psychotherapy.