Are you wondering if you have OCD? Perhaps you just have obsessive or intrusive thoughts that cause you distress. Maybe you are even wondering if you are going crazy. This is common with any type of anxiety disorder. First I’m going to define OCD diagnostically and then I’ll share some common forms that it might take.

Criteria for OCD from the DSM-5

Having obsessions, compulsions or both

Obsessions are undesirable or intrusive thoughts that are bothersome and cause distress. You try to ignore the thought or get rid of the obsession with another thought or some type of ritual.

Compulsions

These are in response to an obsession. They may involve a ritual such as hand washing, checking, praying, counting, putting things in order. You apply these rules in a strict manner. The purpose of these behaviors or mental acts is to neutralize the negative thought and reduce anxiety for having the thought.

A lot of time occurs with these obsessions and compulsions, taking up an hour or more in a day, they cause a lot of distress, or get in the way of social, occupational or other areas of functioning.

Types of OCD (OCD Workbook)

Checking

With this type of OCD the person has a compulsive need to be sure for example the door is locked. They may need to lock and unlock it several times, or be sure it is locked “just right”. It may be an alarm clock, stove, iron or any item. The fear is that harm will come to them, or something bad will happen, or they will be responsible for some traumatic event if they don’t check properly or a specific number of times.

Washing and cleaning

People who excessively wash and clean may do so to relieve a fear of some type of contamination or infection. The fear is if they don’t do it, they will be responsible for someone getting sick or hurt. Perhaps they spend hours in the shower. As this goes on, the need to wash even longer, or more perfectly can occur.

Ordering and repeating

These people may need to put things in perfect order, or get it “just right”. It can be anything that needs to be a certain way, in a certain place etc. The person can tell just by walking in the room if it is not in its right place. If things aren’t in the perfect order, it causes great distress. Putting the item in its proper place or order reduces the stress for a short time period.

Scrupulosity

This obsession involves religious, ethical or moral issues. They go above and beyond what the average person would prescribe to. They must behave in a perfect manner with their thoughts and actions. If not, there is a need to pray compulsively, or seek reassurance from others (typically some type of religious leader) that they are good, pure or moral. Their anxiety is reduced for a short time period until they up the moral code to a place that no one can achieve. Then the cycle of reassurance seeking repeats itself.

Hoarding

These people keep things that are of no importance or meaning. They may keep scraps of paper, pieces of mail or other items that most people consider junk. Fear of letting go of any of these items is what is behind the hoarding. The person justifies that they may need that item at some point in time, so they need to save it.

Obsessional

With this type of OCD, the person has terrible thoughts of harm coming to himself or herself or someone they love, or have disturbing sexual images or thoughts. There are no behavioral compulsions, but the compulsions are typically mental in nature such as counting, praying, or having thoughts to neutralize the disturbing thought. They tend to seek reassurance to reduce their anxiety, which doesn’t help in the long term.

It is also common to start with one form of OCD, or obsessive thought and then switch to another one. In addition, the compulsions only reduce anxiety for a short period of time, and then it comes back. The need is to go back and repeat the compulsion to further reduce anxiety, thus setting up a vicious cycle. So the thing that is actually meant to reduce the anxiety is the very thing that maintains it.

If you or someone you love struggles with OCD, please give me a call at 713-304-6554.

Take care,

Debbie