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Obsessive-compulsive disorder (OCD)


“I know it’s crazy but I could no sooner stop than fly to the moon and to me it makes perfect sense”

What is OCD?

Obsessive-compulsive disorder (OCD) has two main parts: obsessions and compulsions.


  • Obsessions are unwelcome thoughts, images, urges, worries or doubts that repeatedly appear in your mind. They can make you feel very anxious (although some people describe it as 'mental discomfort' rather than anxiety).
  • Compulsions are repetitive activities that you do to reduce the anxiety caused by the obsession. It could be something like repeatedly checking a door is locked, repeating a specific phrase in your head or checking how your body feels.

You might find that sometimes your obsessions and compulsions are manageable, and at other times they may make your day-to-day life really difficult. They may be more severe when you are stressed about other things, like life changes, health, money, work or relationships.


What are the symptoms?


Signs of OCD


Obsessions


Contamination obsessions


  • Excessive fear or disgust, and preoccupation with avoiding;
  • Bodily waste or secretions – urine, faeces, saliva, blood
  • Dirt or germs
  • Sticky substances or residues
  • Household cleaning agents or chemicals
  • Environmental contaminants – radon, asbestos, radiation, toxic waste
  • Touching animals
  • Insects
  • Becoming ill from contamination
  • Making others ill by contaminating them
  • Diseases – AIDS, hepatitis, sexually transmitted diseases


Hoarding, saving and collecting obsessions


  • Worry about throwing things away, even seemingly useless items
  • Urge to collect useless things
  • Urge to pick up items from the ground
  • Uncomfortable with empty space – need to fill it


Ordering Obsessions


  • Preoccupation with symmetry, exactness or order
  • Excessive concern that hand written be perfect or just so
  • Concern with aligning papers, books and other items a certain perfect way


Religious, Obsession/Scrupulosity


Excessive fear, worry and preoccupation with;


  • Having blasphemous thoughts or saying bad things
  • Being punished for blasphemous thoughts
  • Concern with religious beliefs
  • Issues of right and wrong, morality
  • Dwelling on religious images or thoughts


Somatic Obsessions


Excessive fear, worry and preoccupation with;


  • Having an illness or negative reactions of others to one’s appearance


Aggressive obsessions


Preoccupation and excessive, illogical fear of;


  • Harming yourself
  • Harming others
  • Acting on unwanted impulses – e.g. run someone over, stab someone
  • Harming others through your own carelessness
  • Responsibility for some terrible accident – or fire, burglary – especially if resulting from personal carelessness
  • Blurting out insults or obscenities
  • Doing something embarrassing or looking foolish
  • Violent or horrific images in your mind causing you to do harm to others


Sexual obsessions


Unwanted, worrisome and intrusive;


  • Sexual thoughts, images or impulses
  • Thoughts about molesting your own or other children
  • Thoughts about becoming an homosexual
  • Thoughts or images of violent sexual behaviour toward others


Miscellaneous obsessions


  • Urge to know or remember certain things – slogans, license plate numbers, names, words, events of the past
  • Fear of saying something wrong, not saying something just right, or leaving out details
  • Worry about losing things
  • Worry about making mistakes
  • Easily bothered by certain sounds and noises – clocks ticking, loud noises, buzzing
  • Easily bothered by the feel of clothing, textures on the skin
  • Intrusive nonsense sounds, music, words
  • Fear of saying certain words because of superstitious beliefs about particular words
  • Fear of using certain colours for superstitious reasons
  • Excessive concern with lucky or unlucky numbers with rigid adherence to them


Compulsions


Cleaning and washing compulsions


Excessive, illogical and uncontrollable;


  • Handwashing, often performed in an ritualistic way
  • Showering or bathing, often performed in a ritualistic way
  • Ritualistic tooth brushing, grooming, shaving
  • Cleaning of the house, certain rooms, garden, car
  • Cleaning of objects, household items
  • Use of special cleansers or cleaning techniques
  • Avoidance of objects considered contaminated
  • Avoidance of specific places- cities, towns, buildings – considered contaminated
  • Concern with wearing gloves or other protection to avoid contamination


Checking compulsions


Checking over and over (despite repeated confirmations)


  • That you did not harm others without knowing it
  • That you did not harm yourself
  • That others did not harm you
  • That you did not make a mistake
  • That nothing terrible happened
  • That you did not do something that could cause future harm
  • Some aspect of physical condition health – pulse, blood pressure, appearance
  • Physical surroundings, locks, windows, appliances, stoves
  • That jars are closed by excessive tightening
  • That doors are closed by excessive, repeated shutting, closing


Hoarding, saving and collecting compulsions


  • Saving, collecting seemingly useless items
  • Picking up useless items from the ground
  • Difficulty throwing seemingly useless items away – “maybe one day I may make use of this”


Repeating Countering, Ordering


  • Reading and rereading things, sometimes for hours
  • Excessive worrying that you didn’t understand something you read
  • Excessive writing and rewriting things
  • Repeating routine activities – going in and out of doorways, repeated crossing of thresholds, getting up and down from a chair, combing hair, tying shoes, dressing and undressing over and over
  • Doing certain activities a particular number of times
  • Counting items – books on a shelf, ceiling tiles, cars going by
  • Counting during compulsive activities such as checking and washing
  • Arranging items in a certain order – books, pencils, cupboards


Miscellaneous Compulsions


  • Mental rituals – prayers, repeating good thoughts to counteract bad thoughts
  • Reassuring self-talk or mantras stated over and over
  • The above are all performed with the intention of reducing anxiety
  • Excessive need to repetitively ask others for reassurance when ample reassurance is evident to others, and has already been provided by those around you
  • Need to confess wrong behaviour, even the slightest insignificant infractions of behaviour towards others
  • Superstitious behaviour that takes excessive amounts of time
  • Need to touch, tap, or rub certain items or people
  • Measures, other than checking, to prevent harm to self or others – for example, avoidance of certain objects or extreme precautions to prevent highly unlikely harm or danger
  • Eating ritualistically, according to specific rules – arranging food or utensils, eating at certain times, eating food in a particular order


Related symptoms


  • Pulling own hair from scalp, eyebrows, eyelashes, pubic area
  • Acts of self-damage or self-mutilation – picking skin
  • Compulsive shopping


Help should be sought when your compulsive behaviour severely affects your day to day life, when it has a big impact on your relationships and your ability to function and is causing anxiety or depression.