Obsessive-Compulsive Disorder

What is obsessive-compulsive disorder (OCD)?

According to various data, obsessive-compulsive disorder (OCD) affects 2–4% of the world’s population. [1]

What are the main symptoms of OCD?

Obsessive (intrusive) thoughts/images

A battle within the mind

Obsessions appear as intrusive words, thoughts, ideas, or vivid mental images. The person experiences them as inappropriate, absurd, and meaningless thoughts. They force their way into consciousness repeatedly and persistently, causing anxiety, tension, and discomfort. The individual tries to resist them internally, but is unable to do so,

They are unable to control how long the thought lasts or to stop this thought.

A sense of losing control over one’s thoughts emerges. The content of the obsessive thoughts and images triggers feelings of fear, anxiety, shame, and guilt.

Depending on the content, intensity, or duration of the obsession, its negative impact on the person, as well as the level of anxiety it causes, can vary.

Compulsion

Behavioral rituals that control you

A compulsion is a repetitive physical or mental behavior, carried out in a specific sequence and number of times.

to reduce obsessions and the anxiety and discomfort they cause. The person is aware that the ritual is irrational, however

Performing the ritual feels like an absolute necessity, driven by a sense of compulsion. When the person tries to resist, they experience a feeling of losing control, intense anxiety, and panic.

Spending a large part of the day on obsessions and compulsions

Lowered mood

Anxiety and its physical manifestations

Sleep disturbance

Social isolation

Reduced ability to work

What types of compulsions are most commonly seen in obsessive-compulsive disorder?

Frequent washing or cleaning of the hands or body

For example, because of a fear of contamination, washing the hands for hours with a specific amount of soap after touching any surface, shaking hands, or traveling on public transport.

Cleaning

For example, a person may find it very hard to feel sure that things are clean or that a task has been properly completed, and may wash and boil the dishes over and over again.

Checking

For example, repeatedly turning back to lock the front door, checking it several times, and having difficulty feeling sure it has been done. The compulsion can be so strong that, even in the presence of photographic proof, the person still feels an overwhelming urge to check again.

Counting, symmetry

For example, counting objects, actions, steps, stairs, objects of the same color… maintaining a certain symmetry when arranging things, when taking steps, or in other situations, in order to have the feeling that “everything is just right.”

Strict adherence to a specific sequence

For example, they may feel compelled to perform every action in an exact, meticulous sequence when getting themselves ready or leaving the house.

Silently repeating a prayer, phrase, number, or word in your mind

People do not perform compulsions in order to feel pleasure. A compulsion is a mechanism for trying to manage anxiety and gain control over one’s emotional state. Often, carrying out a compulsive ritual can take hours, because the exact sequence is disrupted or the person feels that they have not done it well enough and therefore starts the ritual over from the beginning.

Common themes of obsessive thoughts:

An obsession can have any content, but there are certain themes that occur more frequently.

Contamination and cleanliness

For example: thoughts that by touching objects, other people, or animals, or by breathing shared air… one will become contaminated or fall ill

Doubt and uncertainty in everyday routine activities

For example: wondering whether you locked the door, or whether you turned off the gas stove...

Thoughts or mental images of harming others or oneself, which feel completely immoral and unacceptable to the person.

Thoughts about behaving inappropriately or unacceptably in social situations, or losing control

For example, they might say or do something inappropriate or embarrassing.

Sexual and religious thoughts that feel shameful and inappropriate to the individual

Thoughts about becoming seriously ill, hypochondriacal obsessive thoughts

Negative anticipatory thoughts that something bad will happen

For example, it may relate to their own health or the health of their loved ones.

For example, the person cannot get rid of the thought that something bad might happen to their loved one.

Excessive superstitions

For example, they may believe that stepping on a specific spot will harm their family.

Obsessive doubt: out of fear of breaking laws or violating a moral code, the individual is preoccupied with doubts about their own actions and spoken words, for example, constantly wondering whether they said something wrong or behaved inappropriately...

Intrusive images or urges toward antisocial behavior that the person experiences as obscene, shameful, or frightening

Images and mental pictures of you causing physical or other types of harm to people

Intrusive sexual images

Associated symptoms:

Obsessions and/or compulsions

Spending a large part of the day on obsessions and compulsions

Reduced social skills and work capacity

Anxiety

Sleep disturbance

Low mood

Irritability

Genetic and social factors in OCD

Although

Genetics

It plays an important role in the development of OCD, and it is important to note that

Social and environmental factors

They also influence the onset and severity of the disorder.

The age at which obsessions and compulsions emerge, as well as their proportion, content, and frequency, depends on individual factors.

When should we see a doctor?

This mental health condition is often interpreted by society as simply perfectionism or an excessive need for cleanliness and order; however, obsessive-compulsive disorder is a far more complex and challenging condition.

Obsessive thoughts are not simply excessive worry about real issues in your life. If your obsessions and compulsions are affecting the quality of your everyday life, please consult a doctor.

Treatment

The manifestations of obsessive-compulsive disorder are diverse. It affects multiple domains, influencing emotional stability and overall quality of life.

It is recommended that, based on an individual assessment by a physician, a treatment plan be developed that includes both psychotherapeutic and pharmacological therapy.

Leading psychotherapeutic method

Cognitive-behavioral therapy (CBT)

It focuses on identifying and correcting negative patterns of thoughts and behaviors. Its goal is to develop healthy and adaptive (flexible, well-adjusted) ways of thinking and behaving.

Medication treatment

Treatment is primarily carried out with an antidepressant, and the need for medications from other groups, as well as the duration of the treatment course, is determined individually.

Day Clinic

Comprehensive treatment approach

See also

→ OCD treatment with CBT

→ Medication treatment for OCD

Related topics: Anxiety disorder · Depression · Psychiatrist consultation

Source: NIMH — Obsessive-Compulsive Disorder.

Sources

1. Ruscio AM, Stein DJ, Chiu WT, Kessler RC. The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry. 2010;15(1):53–63. doi:10.1038/mp.2008.94