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OCD

OCD is one of those terms that are always thrown around in popular culture, often massively incorrectly. This article will explain what OCD really is, and correct some common misconceptions the public has of it.

What is OCD?


OCD (Obsessive Compulsive Disorder) is a common, chronic and long-lasting disorder in which many and most people know of, but few know about. What comes to mind when someone brings up OCD? Do your thoughts subconsciously associate repeated washing of hands, or flicking of switches or even excessive cleanliness with OCD? However, obsessive compulsive disorder is far more complex than what seems to be common interpretations. OCD involves anxious thoughts or rituals one feels and can control; it’s a mental illness that causes repeated unwanted thoughts or sensations (obsessions) or the urge to do something over and over again (compulsions).

Note: Some people can have both obsessions and compulsions.

Obsessions


OCD obsessions are repeated and unwanted thoughts, urges or mental images that are intrusive and cause distress or anxiety; these persistent impulses repeatedly well up in the mind of a person with OCD.

These are thoughts and ideas that the sufferer cannot stop thinking about. These obsessions also typically intrude when you are trying to think or do other things. Some common ideas include persistent fears that harm may come to self or a loved one, an unreasonable concern with becoming contaminated or an excessive need to do things correctly or perfectly.


Examples of frequent themes regarding obsessions, include:

  • Fear of contamination or dirt

  • Doubting and having difficulty tolerating uncertainty

  • Needing things to be orderly and symmetrical

  • Aggressive or horrific thoughts about losing control and harming yourself or others

  • Unwanted, forbidden or taboo thoughts involving aggression/ harm or sexual or religious subjects

Which may lead to (examples of obsession signs + symptoms)

  • Fear of being contaminated by touching objects others have touched

  • Avoidance of situations that can trigger obsessions such as shaking hands

  • Doubts that you’ve locked the door or turned off the stove

  • Intense stress when objects aren’t orderly or facing a certain way

  • Images of driving your car into a crowd of people

  • Thoughts about shouting obscenities or acting inappropriately in public

  • Unpleasant sexual images


Obsessions are automatic, frequent, distressing and difficult to control or put an end to by themselves. With these recurring obsessions continuously being played in the sufferer’s mind, one may begin performing repetitive acts that reassure them that their hands aren’t dirty or the gas for the stove is turned off. This response to their obsession is called a compulsion.

Compulsions


OCD compulsions – the second part of the obsessive-compulsive disorder. They are repetitive behaviors that one may feel driven to perform. These constant behaviors, thoughts or mental acts are performed with the intentions of neutralizing, counteracting, or making their obsessions go away, so that one can reduce anxiety related to their obsessions or prevent something bad from happening. However, engaging in the compulsions brings absolutely no pleasure and may offer only a temporary relief from anxiety, therefore without a better solution to cope, people with OCD rely on compulsions as temporary escape. Examples of compulsions may include:

· hand washing until your skin becomes raw

· checking doors repeatedly to make sure they are locked

· checking the stove repeatedly to make sure it’s off

· counting in certain pattern

· silently repeating a prayer, word or phrase

· arranged your canned goods to face the same way

However, just like obsessions, not all repetitive behaviors or rituals are compulsions. In OCD, compulsive behaviors is done with the intention of trying to escape or reduce anxiety or the presence of obsessions; individuals with OCD feel driven to engage in compulsive behavior and would rather not have to do time consuming and torturous acts. So be mindful and aware of the context of the behavior. Hence, examples such as bedtime routines, religious practices or learning a new skill which involve a certain level and extent of repeating an activity over and over is not a display of compulsive behavior because these actions usually present a positive and functional part of daily life.

Causes and Risk Factors


Though causes of obsessive-compulsive disorder isn’t fully understood, main theories behind the origin of this include

1) Biology – OCD may be a result of changes in your body’s own natural chemistry or brain functions. According to many medical research and American Addiction Centers Resource, OCD is triggered by communication problems between the brain’s deeper structures and the front part of the brain. These parts of the brain primarily use serotonin (chemical messenger also known as neurotransmitter) to communicate. Therefore, increasing levels of serotonin in the brain can help to alleviate OCD symptoms.


2) Genetics and family history – One’s genes also seem to play a role in the development of OCD, however specific genes have yet to be identified. Research shows that OCD does run in families; some researchers found that OCD was much more likely to occur if a primary family member (parent, sibling, or offspring) had OCD. They were also more likely to have OCD if an immediate family member had a tic disorder, affective disorder, or anxiety disorder.


3) (Childhood) Stress and trauma – Risks for OCD increase if one has experienced traumatic or stressful events, their reaction may trigger intrusive thoughts, rituals and emotional distress- which are all characteristics of OCD.


4) Pregnancy – Due to the major changes of hormones in the body during pregnancy and in the time after giving birth, it is very much possible to trigger OCD because of the sudden increase in the levels of the hormone oxytocin.


5) Other mental disorders – OCD very rarely occurs alone, in fact 90% of OCD patients have another diagnosis, this means that it is related to many other conditions such as

  • Anxiety disorder

  • Phobias

  • Major depressive disorder

  • Substance abuse

  • ADD and tic disorders

Common Misconceptions


“We are all a little OCD.’”

This is not only very inaccurate but also extremely invalidating. OCD is not an adjective that can be used to describe someone who is “clean or a perfectionist”. In fact most individuals with OCD don’t even fit this stereotype; OCD is a chronic anxiety disorder that takes lives, one should not invalidate this mental health diagnosis by dismissing it as only “a very passionate love of organisation and cleaning”, this completely drowns out the severe torment that people live with OCD experience.


“They just need to chill/ be more relaxed.”

This is not possible, people with OCD find it extremely difficult to dismiss their anxiety and unpleasant thoughts. As mentioned before, OCD consists of repeated and unwanted thoughts or sensations, this means that these “obsessions” are not only persistent but intrusive, people with OCD have no control over their thoughts whatsoever, which also strongly urge them to complete certain actions in hopes that they go away. In fact, without treatment, the thoughts can become more distressing and take over someone’s life. This means that it could affect their relationship with others as well as their well-being and ability to function.


Sources


"What is OCD? - International OCD Foundation." https://iocdf.org/about-ocd/.


"7 Different Types of OCD & Intrusive ...." 6 Jul. 2021, https://www.treatmyocd.com/education/different-types-of-ocd.


"OCD: Myths vs Reality | Benenden Health." https://www.benenden.co.uk/be-healthy/mind/ocd-myths/.


"OCD: Types, Symptoms, Causes, Diagnosis ...." 7 Jul. 2017, https://www.webmd.com/mental-health/obsessive-compulsive-disorder.

Writer: Hayley Wan, Editor: Christiane Au, Thumbnail: Cassandra Lui, Text Transcription: Megan Kwok


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