Introduction
“I am so OCD”, this phrase has been tossed around casually on social media, trivialising a very agonising and difficult mental health condition. Obsessive-Compulsive Disorder (OCD) is much more than a desire for cleanliness or organisation; it is a clinical disorder that may have a debilitating effect on a person's life.
Sentences like these can resonate with those going through similar struggles, but they also risk trivialising seeking mental health support. This raises an important question, is dark humour helping normalise discussions? Or is it perpetrating mental health stigma?
What is OCD?
According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition), OCD is a type of an anxiety disorder and is characterised by two core components:
- 1. Obsessions: Intrusive, unwanted thoughts, urges, or images that cause significant anxiety or distress.
- 2. Compulsions: Repetitive behaviours or mental acts performed in response to the obsessions to reduce distress or prevent a feared event, even if the behaviour isn’t logically connected to the concern.
These obsessions and compulsions can greatly disrupt a person's everyday life, causing anguish and worry. People with OCD may feel forced to undertake certain rituals or routines, such as hand-washing, counting, or checking, in order to relieve their obsessive thoughts. However, these behaviours only give short-term respite and can be time-consuming and disruptive to their everyday routines. OCD can also lead to substantial suffering and impairment in relationships, careers, and other aspects of life. It is a chronic ailment that, if not addressed, can have a major negative influence on a person's quality of life.
How does OCD work?
People with OCD frequently have intrusive, unwelcome thoughts that cause severe suffering. However, the problem is not the ideas themselves, but the brain's reaction to them. The anxiety-producing region of the brain, specifically the amygdala, perceives some ideas as threats to safety. This miswiring activates an alarm, eliciting a strong anxiety reaction.
When the brain detects danger, the person feels obliged to act. This anxiety drives them to:
- Determine the 'why' underlying the thoughts—hours spent ruminating on why the ideas are occurring.
- Perform rituals for relief. These behaviours might include constant checking, avoiding particular circumstances, or seeking reassurance from others.
While these actions may temporarily relieve anxiety, they eventually backfire. Why? Because each time someone reacts to these ideas as if they are hazardous, the brain learns that they are significant and inappropriate. This reinforces the amygdala's anxiety spikes, exacerbating the illness over time.
Types of OCD
OCD subtypes are not official diagnostic classifications, but rather patterns of symptoms that characterise how OCD affects people.
A person's OCD subtype shows what their mind is predisposed to focus on, as well as the intrusive thoughts or obsessions that ensue. Subtypes can remain relatively constant over time, although it is not unusual for new symptoms to appear or existing ones to fade.
Subtypes of OCD are not perfect because they are not backed by rigorous scientific research, making them less precise as diagnostic tools. While the symptoms of OCD might differ, they always come from the same underlying anxiety-driven processes. Focussing too much on subtypes can lead individuals to mistake them for unique conditions rather than variations of the same disorder.
For many people, finding a subtype that matches their experiences is a source of great comfort. After years of feeling alienated and "uniquely broken," individuals find validation in having their issues explained in a logical manner.
This acknowledgement can serve as a reassuring beginning point for therapy, allowing patients to recognise that they are not alone and that others have faced—and overcome—similar obstacles.
Despite their limitations, subtypes are still a popular approach to describe OCD in the global community. Below are some of the most prevalent OCD symptom clusters:
1. Contamination OCD
Contamination OCD, one of the most well-known kinds, is characterised by an excessive fear of germs, sickness, or contamination. Individuals with this subtype frequently have intrusive concerns about becoming unwell or transmitting sickness to others.
Obsessions-
- Fear of contacting surfaces in public settings.
- Anxiety about becoming sick via physical interaction with people.
- Excessive handwashing or sanitising that could cause skin irritation.
- Avoid areas like hospitals and public bathrooms.
- Cleaning things or spaces in a ritualistic manner.
2. Checking OCD
At the heart of Checking OCD is strong anxiety that ignoring specific obligations or disregarding details would result in devastating repercussions. These obsessions are persistent, intrusive, and frequently irrational. Common examples include:
Obsessions-
- Concerned that leaving the stove on may start a fire.
- Fearing that open doors may allow attackers to do damage.
- Anxiety over sending an email with a serious error or hazardous content.
- Repeatedly checking appliances like stoves, irons, or heaters to ensure they’re turned off.
- Inspecting locks and security systems, sometimes leaving and returning home multiple times to confirm doors or windows are secure.
- Reviewing communications, such as rereading emails or messages repeatedly before sending to avoid errors.
3. Harm OCD
Harm OCD is defined by the fear of inflicting damage to oneself or others, even if there is no genuine intention to do so. These intrusive thoughts are extremely bothersome and sometimes misinterpreted as signs of intent when they are not.
Obsessions-
- Thoughts of causing damage to loved ones are disturbing.
- Fear of losing control and following through on aggressive desires.
- Avoid using sharp instruments, such as knives or scissors.
- Checking often to verify that no harm has happened.
- Seeking constant reassurance from others.
4. Symmetry and Order OCD
Until everything is in perfect harmony, the world seems "off" to those with Symmetry and Order OCD.
Obsessions-
- A deep-seated need for things to be perfectly arranged, symmetrical, or in a specific order.
- Even minor imperfections like a crooked picture frame or an unaligned desk can trigger intense distress.
- Engaging in repetitive organizing and rearranging behaviours.
5. Religious OCD
Religious OCD, also known as scrupulosity, is characterised by a dread of transgressing moral, ethical, or religious principles. These people frequently hold themselves to unachievably high moral and purity standards.
Obsessions-
- Fear of breaking religious laws or upsetting a god.
- Worry about ideas that are viewed as immoral or heretical.
- Excessive self-purification procedures or prayer.
- Admitting perceived transgressions on a regular basis.
- Avoiding circumstances that might give rise to moral dilemmas.
6. Relationship OCD
Relationship OCD is characterised by persistent concerns and anxieties regarding one's love relationships. These doubts may be overpowering and disrupt even the strongest relationships.
Obsessions-
- Fear that one does not actually love their companion.
- Concerns about being in the "wrong" relationship.
- Seeking comfort from pals or internet tests.
- Overanalysing one's sentiments for a spouse.
- Comparing your existing connection to others.
7. Intrusive thoughts OCD
Existential OCD delves into profound philosophical issues, turning thoughts about life and reality into a cause of intense anxiety.
Obsessions-
- Persistent, often unresolvable, questions about existence, reality, and the meaning of life.
- Individuals might repeatedly wonder, “What if nothing is real?” or “What if life has no purpose?”
- Engage in excessive rumination, research, or debates.
8. Sexual Orientation OCD
Sexual orientation OCD is characterised by a focus on inconsistencies about one's sexual orientation, regardless of genuine inclinations. It's not about one's orientation per se, but rather the compulsive questioning of it.
Obsessions-
- Persistent questions regarding whether you are attracted to the same or opposite sex.
- Persistent reservations about previous experiences or attractions.
- Examining previous encounters or sentiments for hints.
- Using mental tasks to test attractiveness.
- Avoiding those who may cause these ideas.
9. Pedophilia OCD
This especially disturbing subtype is characterised by intrusive thoughts about improper sexual actions involving children. It is critical to understand that these ideas are completely undesirable and do not reflect the individual's aspirations or intentions.
Obsessions-
- Fear of endangering children.
- Intrusive pictures or ideas that make you feel ashamed and anxious.
- Avoid being around children.
- Excessive investigation or seeking confirmation to dispel these anxieties.
Treatment
What is the good news? OCD is treatable. The solution is to retrain the brain's dysfunctional anxiety response via specialised treatment. CBT (cognitive behavioural therapy), particularly Exposure and Response Prevention (ERP), is extremely successful in treating OCD. This is how it works-
Expose the brain to fearful thoughts: Rather than avoiding or repressing unwanted ideas, the individual is encouraged to confront them full-on. For example, someone who is terrified of germs may purposefully touch a surface that they consider to be "dirty."
Prevent compulsive responses: The individual is asked to avoid their usual anxiety-reduction behaviours, such as extensive handwashing or seeking reassurance.
Rewire the Amygdala: By not reacting to the ideas, the brain learns that these concerns are not dangerous. The amygdala eventually quits generating anxiety signals in reaction to them.
This procedure progressively alleviates the anguish produced by intrusive thoughts, allowing them to recede into the background.
Conclusion
Obsessive-Compulsive condition (OCD) is a heterogeneous condition, which means that it manifests differently in everyone. Some may struggle with intrusive thoughts, while others are motivated by obsessive habits. Despite this variation, the fundamental mechanisms remain constant, a never-ending loop of obsessions and compulsions that can have a substantial influence on one's quality of life.
If you or someone you love suffers from OCD, seeking treatment is the first step towards recovery. Infiheal provides an OCD test to help discover possible patterns of obsessive-compulsive behaviour. While not diagnostic, it does give insight into whether professional assistance may be beneficial.
For quick emotional help, the Healo chatbot provides a safe place to address concerns and devise coping solutions. Although it does not give diagnoses, it is a helpful beginning point for understanding your issues. Take the first step towards self-awareness and assistance now.
