WHAT?

WHAT?

WHat?

WHAT IS OCD?

Obsessive compulsive disorder (OCD) is a mental health disorder that affects people of all ages and walks of life, and occurs when a person gets caught in a cycle of obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, images, or urges that trigger intensely distressing feelings. Compulsions are behaviors an individual engages in to attempt to get rid of the obsessions and/or decrease his or her distress.

Obsessive-Compulsive Disorder (OCD) is a common, chronic, and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and/or behaviors (compulsions) that he or she feels the urge to repeat over and over.

Diagnostic & Statistical Manual of Mental Disorders, fifth edition (DSM-5):

The characteristic symptoms of OCD are the presence of obsessions and compulsions. Obsessions are repetitive and persistent thoughts, images, or urges. Importantly, obsessions are not pleasurable or experienced as voluntary: they are intrusive and unwanted and cause marked distress or anxiety in most individuals. The individual attempts to ignore or suppress these obsessions, or to neu­tralize them with another thought or action (e.g., performing a compulsion). Compulsions (or rituals) are repetitive behaviors or mental acts that the individual feels driven to perform in response to an obsession... The aim is to reduce the distress triggered by obsessions or to prevent a feared event … obsessions and compulsions must be time-consuming (e.g., > 1 hour per day) or cause clinically significant distress or impairment to warrant a diagnosis of OCD. 

Obsessions

Obsessions are thoughts, images or impulses that occur over and over again and feel outside of the person’s control. Individuals with OCD do not want to have these thoughts and find them disturbing. In most cases, people with OCD realize that these thoughts don’t make any sense.  Obsessions are typically accompanied by intense and uncomfortable feelings such as fear, disgust, doubt, or a feeling that things have to be done in a way that is “just right.”

Compulsions

Compulsions are the second part of obsessive compulsive disorder. These are repetitive behaviors or thoughts that a person uses with the intention of neutralizing, counteracting, or making their obsessions go away. People with OCD realize this is only a temporary solution but without a better way to cope they rely on the compulsion as a temporary escape. Compulsions can also include avoiding situations that trigger obsessions. Compulsions are time consuming and get in the way of important activities the person values.

Common Symptom presentations / Dimensions

  • Concern about evenness or exactness

  • Concern with a need to know or remember

  • Fear of losing or forgetting important information when throwing something out

  • Inability to decide whether to keep or to discard things

  • Fear of losing things

Perfectionism & Not-Just-Right Feelings

Physical:

  • Body fluids

  • Germs/disease

  • Environmental contaminants

  • Household chemicals 

  • Dirt

Emotional:

  • fears that contact with a person or place will somehow contaminate and endanger him.

  • it can be a “type” of person who represents a disability that one fears contracting, such as a blind person or a person with deformed limbs. 

CONTAMINATION:

Physical & emotional

  • Concern with offending God, or concern about blasphemy

  • Excessive concern with right/wrong or morality

Scrupulosity:

Religious & moral obsessions

  • Fear of being responsible for something terrible happening (examples: fire, burglary)

  • Fear of harming others because of not being careful enough (example: dropping something on the ground that might cause someone to slip and hurt him/herself)

Harm Obsessions:

by intent or neglect

  • Forbidden or perverse sexual thoughts or images

  • Forbidden or perverse sexual impulses about others

  • Obsessions about homosexuality

  • Sexual obsessions that involve children or incest

  • Obsessions about aggressive sexual behavior towards others

Sexual Obsessions

Sexual Obsessions

  • Concern with getting a physical illness or disease (not by contamination, e.g. cancer)

Health Anxiety

Superstitious ideas about lucky/unlucky numbers, certain colors

Magical Thinking

  • Agoraphobia

  • Obsessing about speech patterns

  • Over-concern with being perceived inappropriately

  • Fear of harming people by saying the wrong thing

Social Anxiety

  • Comparing your relationships/friendships to other people's

  • Researching/checking if you're really "in love" or attracted to a significant other (reading about it, checking arousal, etc.)

  • Distress about thoughts critiquing one's significant other/friend

Relationship OCD

  • Obsessions regarding unanswerable questions of an existential or philosophical nature

  • Intrusive and repetitive questions regarding:

    • the meaning of life

    • one's purpose in life

    • one's own existence

    • the existence of the universe

    • if one is actually real

Existential/ Philosophical OCD

Related Obsessive-Compulsive Spectrum Disorders

  • Includes skin-picking (dermotillomania/excoriation disorder) & hair-pulling (trichotillomania)

  • Repeat body-focused picking and pulling behaviors in response to discomfort

    • Unlike OCD rituals, these behaviors elicit a positive feeling

  • May result in hair loss/bald spots or significant skin wounds

Body-focused Repetitive Behaviors

  • Preoccupation with an imagined or slight defect in one’s appearance. 

  • Causes clinically significant distress or impairment

  • Common concerns: asymmetry; blemishes; size; shape; complexion/color

  • BDD rituals may include:

    • excessive mirror-checking or avoidance of mirrors

    • comparing

    • camouflaging/covering up

    • excessive grooming

    • reassurance-seeking

    • seeking plastic surgery or other unnecessary medical care (e.g. from dermatologists)

Body Dysmorphic Disorder (BDD)

  • Preoccupation with collecting and saving items, including items that appear to be of little or no value to others

  • Experience significant difficulty getting rid of possessions that are no longer of use

  • Excessive collecting results in cluttered living spaces

  • Items cause significant distress or issues in daily functioning

Hoarding Disorder