The ABCs of OCD

The ABC's of Obsessive compulsive disorder

These days, it’s common to hear Americans say “he is OCD.” We laugh and understand that the person is unrealistically particular or strict in his behavior. That’s funny and lighthearted, but the REAL meaning of OCD in a clinical sense is really NOT funny at all. Let’s make a distinction between the OCD people laugh about and the very real clinical condition of OCD.

What is OCD?

Obsessive-Compulsive Disorder (OCD) is characterized by intrusive thoughts that produce anxiety (obsessions), repetitive behaviors that are engaged in to reduce anxiety (compulsions), or a combination of both. While many are concerned about germs or leaving their stove on, people with OCD are unable to control their anxiety-producing thoughts and their need to engage in ritualized behaviors. As a result, OCD can have a tremendous negative impact on day-to-day functioning. These rituals can be illogical or strange, having little to do with the fear. For instance, a person may click his heels together 7 times to stop obsessing about how they swallowed their last meal; someone may have to click the light switch 8 times to believe that he is allowed to sleep; or the rituals can be completely logically connected such as continued hand washing because of the fear of having germs or being contaminated in some way.

OCD has often been referred to as the “disease of doubt” because its sufferers are not quite sure if they did the last ritual quite right or are unsure if they really completed it correctly! They may need to repeat it until it’s exactly correct. The routine can be exhausting – hours every day can be involved in a severe case of OCD.

How do people develop OCD?

There are several theories on the development of the disorder. The behavioral theory says that a person with OCD connects certain objects or situations with fear, and then uses avoidance toward the feared objects or situations or performs rituals that help reduce the fear. This pattern of fear and avoidance/ritual may begin when people are under periods of high emotional stress, such as the death of a loved one or a divorce.

The cognitive theory suggests that as long as people interpret intrusive thoughts as “catastrophic,” and as long as they continue to believe that such thinking holds truth, they will continue to be distressed and to practice avoidance and/or ritual behaviors. According to this theory, people who attach exaggerated danger to their thoughts do so because of false beliefs learned earlier in life.

The biological theory involves the regulation of brain chemistry. Research into the biological causes and effects of OCD has revealed a link between OCD and insufficient levels of the brain chemical serotonin. Serotonin is one of the brain’s chemical messengers that transmit signals between brain cells. Serotonin plays a role in the regulation of energy levels, mood, aggression, impulse control, sleep, and appetite. All of the medicines used to treat OCD raise the levels of serotonin available to transmit messages (1).

How common is OCD?

It is estimated that OCD affects approximately 1% of American adults. The average age of onset is 19 years old (2) which is the typical age of a college age freshmen.

What do these rituals look like?

Remember that you can have the obsessions ONLY and still be diagnosed with OCD (they cannot get obsessional thoughts to go away or move from one obsession to another). People who also have the “compulsions” do rituals to try to make the obsessions or anxiety calm down or go away. Frequent rituals are checking items over and over (the stove being left on or the locks on the windows/doors), washing hands/avoiding germs by extreme rituals, tapping and clicking objects, counting (the number of stairs, ceiling tiles, telephone poles, etc), or having to have all objects in a row, lined up evenly, or symmetrical.

What do you do if you think you (or a loved one) has OCD?

Well, first of all – don’t obsess about it! A mental health professional can diagnose the condition properly and knows how to treat the condition. OCD can be treated by counseling, medication or a combination of both. Family physicians and psychiatrists are more prone to use the biological model in treating OCD and prescribe medication.

Remember, it’s not the presence of a few obsessive thoughts or checking a couple of times that makes the diagnosis real, it’s the excessive degree of these things which interfere with one’s life that makes it a diagnosable condition. The next time you hear “he’s OCD”, ask a few more questions!

(1) Centre for Addiction and Mental Health – website 2012 – Toronto, CAN

(2) NIMH Website 2015 The National Institute of Mental Health (NIMH) is part of the National Institutes of Health (NIH), a component of the U.S. Department of Health and Human Services.

Call Perspectives of Troy Counseling Centers at (248) 244-8644 if you or someone you know could benefit from speaking with a caring, qualified therapist.

by Eric Nordquist, MA, LPC