Category: OCD

This article explains the symptoms of Obsessive-Compulsive Disorder (OCD), the types and how they impact daily life.

You will learn to identify early signs, understand the OCD cycle, and explore treatment options.

What is OCD?

Obsessive-Compulsive Disorder (OCD) is a mental health condition characterised by recurring, intrusive thoughts (obsessions) and repetitive behaviours (compulsions).

It affects people of all ages and backgrounds, often causing significant distress and impacting daily life.

OCD is not simply about being “neat” or “perfectionistic”; it is a complex disorder requiring understanding and support.

Key Symptoms of OCD

Obsessions

Obsessions are intrusive and unwanted thoughts, images, or urges that cause significant anxiety or discomfort.

Common obsessions include:

• Fear of contamination or germs.
• Concerns about harming oneself or others.
• Doubts about completing tasks (e.g., locking doors).
• Intrusive, taboo thoughts involving religion, violence, or sexuality.

Example: “What if I left the stove on and my house burns down?”

These thoughts are persistent and challenging to ignore, even though the person recognises them as irrational.

Compulsions

Compulsions are repetitive behaviours or mental acts performed to reduce the anxiety caused by obsessions.

Examples of compulsions include:

• Washing hands excessively to avoid germs.
• Checking locks or appliances repeatedly.
• Arranging objects to feel “just right.”
• Mentally counting or praying to neutralise distressing thoughts.

Early Signs of OCD

Identifying OCD early can lead to better outcomes through timely intervention.

Signs to watch for include:

• Spending excessive time on daily tasks.
• Avoidance of situations that trigger obsessions (e.g., public spaces for contamination fears).
• Difficulty focusing due to intrusive thoughts.
• Unexplained rituals or behaviours that disrupt normal routines.

Children with OCD may show repetitive questioning or seek constant reassurance from parents.

The OCD Cycle

OCD follows a predictable cycle:

1. Trigger: An event or thought sparks anxiety (e.g., touching a doorknob).
2. Obsession: Intense distress due to intrusive thoughts (e.g., fear of contamination).
3. Compulsion: A repetitive act to relieve anxiety (e.g., excessive handwashing).
4. Temporary Relief: The behaviour momentarily reduces distress but reinforces the cycle.

Breaking this cycle is a key goal of OCD treatment.

Types of OCD

While OCD symptoms vary widely, they often fall into distinct categories:

Contamination OCD

Obsessions focus on germs, illness, or dirt.

Compulsions often include excessive cleaning or avoiding perceived sources of contamination.

Symmetry and Order OCD

This involves a preoccupation with symmetry or things feeling “just right.”

Compulsions include rearranging objects or performing tasks until they meet rigid standards.

Harm OCD

This subtype involves fears of harming oneself or others.

People may avoid sharp objects or seek reassurance to neutralise these fears.

Pure OCD (Purely Obsessional)

Unlike other forms, Pure OCD primarily involves mental compulsions, such as rumination or mental checking, without visible rituals.

What causes OCD?

It’s not known exactly what causes OCD symptoms, but it’s likely a combination of genetic and environmental factors.

In other words: it runs in the family and it’s likely brought on by stress.

Misdiagnosing OCD

OCD symptoms can overlap with other conditions, leading to misdiagnosis.

It is often confused with:

• Generalised Anxiety Disorder (GAD).
• Attention Deficit Hyperactivity Disorder (ADHD).
• Autism Spectrum Disorder (ASD).

Proper diagnosis requires thorough clinical evaluation, including the use of DSM-5 criteria.

Treatment Options for OCD

OCD is treatable, though recovery may take time and effort.

Cognitive Behavioural Therapy (CBT)

CBT, particularly Exposure and Response Prevention (ERP), is highly effective for OCD.

It involves gradual exposure to triggers while preventing compulsive responses.

Medications

Selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant, are commonly prescribed for OCD.

These can help regulate intrusive thoughts and reduce compulsions.

Lifestyle Changes

• Regular exercise to reduce overall anxiety.
• Mindfulness practices to manage intrusive thoughts.
• Support groups for shared experiences and coping strategies.

Living with OCD

OCD often impacts relationships, work, and daily activities.

However, many people learn to manage symptoms effectively with treatment and support.

Coping Strategies

• Break tasks into smaller steps to reduce their overwhelming nature.
• Educate family and friends about OCD to build understanding.
• Celebrate small victories, even if progress feels slow.

Quote: “Recovery is not linear, but every step forward is meaningful.”

Future Directions in OCD Treatment

Research is exploring new therapies, such as deep brain stimulation (DBS) and virtual reality exposure therapy.

These innovations hold promise for individuals with severe or treatment-resistant OCD.

The reason the world is more uncertain and surprising to people with OCD.

Distrusting your own experience is a sign of having obsessive-compulsive disorder or OCD, research finds.

People with higher OCD symptoms tend not to believe their own memories or automatic predictions about the future.

This helps to explain the checking behaviour that people with OCD experience.

It also leads to people with OCD feeling the world is more unpredictable than for others without the condition.

For example, someone with OCD can easily become distrustful of whether they have turned off the light.

This leads them to keep returning to the light switch to check.

The conclusions come from a study involving 58 people who were given a computer-based learning task.

The results showed that people with higher OCD symptoms were more distrustful of what they had learned.

People with higher OCD symptoms were also more surprised by events that most people would consider predictable.

As a result, they found the world more uncertain and surprising.

The researchers developed a computational model that accurately reflected how people with OCD make decisions.

Dr Isaac Fradkin, the study’s first author, said:

“Our findings highlight a novel framework for understanding the cognitive and computational process that gives rise to obsessive compulsive symptoms.

The results also stand in stark contrast with the common preconception of OCD as being characterized by inflexible behavior, distinguished by overreliance on past experience.”

OCD is normally thought to be caused by unreasonable fears (called obsessions) which people try to reduce by performing certain behaviours (called compulsions).

Conventionally, people with OCD are thought to be creatures of habit, with the habits protecting them from feeling bad.

Rather than obsessions being the root of the disorder, though, the current study is suggesting that it can be traced back to a problem in how people make predictions about present and future events.

As the study’s authors put it, people with OCD ‘doubt what they already know’.

OCD

OCD is thought to affect around 2.3% of people at some point in their lives.

Most people develop symptoms before they are twenty-years-old.

Perhaps the most familiar example is people repeatedly washing their hands (a compulsion) to avoid getting a disease (an obsession).

That said, though, some people are considered to have OCD despite ‘only’ having obsessions or ‘only’ having compulsions.

Around 70% have both obsessions and compulsions, 20% just obsessions and 10% compulsions alone.

The study was published in the journal PLOS Computational Biology (Fradkin et al., 2020).