Understanding Obsessive-Compulsive Disorder

Many of us have likely heard things like, “You’re so OCD” or “My OCD can’t handle it” in reference to traits like cleanliness and organization. Even Khloe Kardashian has famously referred to her meticulous organization as KhloCD. But what is OCD, really? It’s a little more complicated than what we may get brushed off as tidiness. 

The National Institute of Mental Health defines Obsessive-Compulsive disorder (OCD) as, “a long-lasting disorder in which a person experiences uncontrollable and recurring thoughts (obsessions), engages in repetitive behaviors (compulsions), or both.”

Obsessions:

The DSM defines obsessions with 2 criteria: 

“Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress.”

“The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion).”

Examples of obsessions: 

Fear of something (ex. Germs, losing control, death, contamination, losing/forgetting something)

Unwanted thoughts (ex. Taboo or forbidden thoughts involving sex or religion, thoughts of harm towards self or others) 

Wanting to have things in perfect order or symmetry

Obsessions vs GAD: 

You may be thinking, “What’s the difference between obsessions and anxiety symptoms?” The DSM categorizes generalized anxiety disorder and OCD completely separately, but I like to think of them as close cousins. Anxiety is “apprehensive expectation,” meaning an individual is worried about something that might happen due to experience (or lack of), and the cause of the worry will change as events change around them. Obsessions are almost always the same regardless of what is going on in one’s personal life, but they can develop and increase over time. An increase in obsessions usually leads to an increase in compulsions. 

Compulsions:

The DSM defines these as: 

“Repetitive behaviors or mental acts that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.”

“ The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive.”

Examples of Compulsions:

Often, a person with OCD will describe their compulsions of “having to get it just right.”

Hand washing

Ordering or rearranging in specific ways

Checking 

Praying

Counting 

Silently repeating words to oneself

What causes OCD? 

There is currently no exact known cause for OCD, but research has found that the following categories can contribute to OCD symptoms.

Genetics: It is not uncommon for individuals with OCD to pass down symptoms to their children. It is currently unknown what genes cause this in individuals. It is also not unlikely that a child witnessing a parent or guardian exhibiting symptoms would pick them up as well.

Biology: individuals with OCD have been found to have differences in the frontal cortex and subcortical structures in the brain. These areas impact the ability to control behavior and emotional responses. 

Temperament: children who are more reserved, experience negative emotions, anxiety, and/or depression are more likely to develop OCD

Childhood trauma: There is often an association between trauma and symptoms. Developing OCD can be a way of “feeling more in control,” with situations. 

What should I do if I think I may have OCD?

First, know that you are not alone! The International OCD Foundation estimates that 1 in 100 people suffer from OCD symptoms

There is treatment available and it is effective! Cognitive behavioral therapy (CBT) and exposure and response prevention therapy (ERP) are shown to be most effective in treating OCD and can be used in conjunction with SSRI medications. 

Exploration Counseling is here to help. Our team uses various evidence-based therapy modalities like CBT and ACT (Acceptance and Commitment Therapy) to treat OCD. You can contact our office with any questions, and to set up an appointment with one of our team members.