“Stop being so OCD!”

“You are obsessed with your phone.”

“I am obsessed with him!”

“I am obsessed with that line of make-up!”

The term OCD is thrown around casually in our culture. It usually refers to liking something a lot or being very particular. This causal use of the term implies something fleeting that doesn’t interfere with your life. It is just an expression. But Obsessive-Compulsive Disorder (OCD) is not a casual thing. It involves obsessions that can be quite debilitating.

Imagine beginning your day, showering 3 times to make sure you got all the germs washed away. Then you feel compelled to cut your toast into 3 sections and butter each section 3 times. Then you have to take 3 sips of coffee. You check yourself in the mirror 3 times, and finally turn off the lights when you leave the house. But you have to go back and check 3 times to feel OK. If you don’t do all of these rituals, you feel incredibly anxious.

Are you exhausted just thinking about this? Imagine living this type of life day after day! Imagine how disruptive it would be to getting things done. And how frustrating it would be in terms of relationships.

Obsessive-compulsive disorder is a psychiatric condition characterized by uncontrolled obsessions and compulsions. Obsessions are intrusive, recurrent thoughts that cause a great deal of anxiety. The thoughts are hard to ignore, suppress or neutralize. They just come into your head. Telling them to go away doesn’t work.

One way to deal with obsessive thoughts is to perform a compulsion. A compulsion is an act or repetitive behavior performed in order to reduce the anxiety of the obsession. For example, someone who obsesses about germs feels compelled to wash her hands. The unreasonable thought (obsessive) of germs and contamination prompts the person to perform a repetitive behavior (compulsion) to relieve their anxiety.

Common symptoms of OCD include:

• being obsessed with contamination and then washing or performing a cleaning ritual
• having deviant or worrisome sexual thoughts and then avoiding sexual situations
• obsessing over committing the unpardonable sin or having a religious thought of being immoral or dammed, and then compulsively asking for forgiveness or repeatedly pray due to anxiety
• obsessing over being aggressive and compulsively monitor the news with worry that you have harmed someone
• pathological doubt that results in checking and rechecking
• superstitious obsessions that involve counting rituals
• obsessive thoughts about sameness and symmetry that result in ordering and arranging.

Etiology:

We do believe this disorder is heritable, meaning it runs in families and that there are brain functions involved. Also, learning in the brain through a process called classical conditioning is involved.

OCD usually begins in the teen or young adult years. A person can also have more than one obsessive-compulsive behaviors. The need to engage in this obsessive-compulsive behavior interfere with many aspects of living. For example, engaging in compulsions requires time and often makes a person late. Those who have this condition may feel embarrassed and ashamed because they know this is not normal.

Treatments:

The most effective treatments for OCD are Cognitive Behavior Therapy (CBT) and/or medications. The type of CBT that works best is something called exposure and response prevention (ERP). Basically, you expose the person to the obsessive thoughts that make them anxious and then prevent the compulsion from happening. Over time, the urge to do the ritual decreases. The anxiety alarm goes off in your thoughts, but you don’t do the ritual to keep yourself safe. Instead, you disrupt the pattern by not doing. To do this type of therapy, work with a therapist trained in this type of behavior therapy.

In terms of medications, certain SSRIs (selective serotonin reuptake inhibitors) are approved by the FDA and work well for some people. Check with your doctor as to which ones are approved. And then discuss the potential side effects. Taking medication always involves an assessment of risk and benefits.

Finally, learning to cope well with stress may make a difference. It certainly won’t make things worse. The more you can manage your anxiety, the better. Exercise and relaxation are good helps to manage anxiety. So make a few lifestyle changes to help the therapy process along as well.