OCD Article List

List of "What we need to know about OCD" 

Original Article by Lisa Firestone. Edited by Jack Lawrence. 

Around 1 in 40 people in the US are affected by obsessive-compulsive disorder. 

OCD is the fourth-most-common mental health disorder, occurring in people of all ages, but most commonly showing up in individuals at a young age. People can experience OCD symptoms to varying degrees of severity, but the World Health Organization ranks it as one of the 10 most handicapping conditions in terms of lost income and decreased quality of life. Unfortunately, many people experiencing symptoms are not even aware that OCD exists or that treatment is available. The shame they feel about their symptoms can inhibit them from exposing what’s going on and seeking the help they need. This is why it is so crucial that we get the word out about OCD.

    

What is OCD? 

The International OCD Foundation describes OCD as an anxiety disorder in which people become stuck in a cycle of obsessions (“unwanted, intrusive thoughts, images or urges that trigger intensely distressing feelings”) and compulsions (“behaviors an individual engages in to attempt to get rid of the obsessions and/or decrease his or her distress”). 

• When a person has OCD, it’s as if the alarm system in their brain is faulty, seeing danger where there may be none, trapping them in a hyper-aroused state. 
• They may experience irrational or disturbing thoughts and engage in compulsive actions to relieve their anxiety and uncertainty or feeling that things are just not “right. This is because a part of the brain that is designed to protect them by warning them of danger is being triggered. This part of the brain is an ancient protection system evolutionarily developed to keep you safe, but in the case of OCD, it gets stuck.

What does OCD look like?

• Unwanted thoughts can come in the form of extreme worry about contamination (e.g., “Germs from that doorknob could spread to the kitchen. 
•  These thoughts can be experienced as doubt (“Did I leave the house unlocked? Could I have just run over something on the road?”). 
• They may come in the form of disturbing images, sometimes violent or sexual, or fears that you may hurt someone or yourself (“What if you picked up that knife and cut someone?”). 
• They may hone in on health (“That twitch on your arm is probably cancer”). 
• They may drive you toward perfectionism (“Keep every item straight on your desk. Don’t leave a crinkle in the sheets.”)
• People with OCD often have a heightened fear of guilt and a sense of obligation. They feel like they must worry about and do certain things to protect others and themselves.
•  In a recent study from the University of Waterloo, researcher Brenda Chiang concluded that “people with OCD have generally been shown in research to have this inflated feeling of responsibility... 
• They often feel that they are going to be responsible for something bad that will happen or that if they fail to do something, they will be responsible for that harm too. 

How do people get stuck in the OCD cycle? 

• The “stuckness” and suffering one often feels when they have OCD is further exacerbated by their compulsions. These can be mental or physical and may include behaviors like chronically cleaning, checking, or repeating. 

•  A person may be caught in a cycle of scrubbing the same item or washing their hands until they crack. 
• They may drive home several times to make sure the door is locked, the lights are off, etc. 
• They may engage in counting, tapping, or repeating specific actions a certain number of times. 
• They may also act on mental compulsions, reviewing the same information over and over to make sure something is okay or safe, mentally checking for danger. 
• They may attempt to control their thoughts, trying to replace a bad image with a good image or counting to a certain number. 

• People may recognize their own thoughts and behaviors as irrational, but they are stuck in a cycle from which they feel they can’t escape. 
• They may try to hide their obsessions and compulsions, which makes it even harder for them to get the help they need. 
• Or they may seek endless reassurance for their worries, which actually further exacerbates their OCD. 

• When someone pays attention and responds to these false alarms, they teach their brain that these signals matter. 
• When they ignore their OCD and stand up to it, the anxiety may temporarily heighten, but the alarms stop going off as much. 
• Their brain no longer thinks these warnings and signals are important, so it sends out less of them. In effect, the person has the power to change their brain.

OCD Therapy and Treatment 

• There are effective, very specific treatments for OCD that differ from traditional talk therapy and can be life-changing for people affected by this disorder.
• Exposure Response Prevention Therapy (ERP) is a type of Cognitive Behavioral Therapy that involves patients repeatedly exposing themselves to or “testing out” their fears. 
• For example, a patient afraid of contamination who worries about household dirt may touch his bathroom floor without washing his hands.
•  A person who chronically checks for the stove to be off may have to leave the house without checking any appliances. 
• As they perform an exposure, the person learns to tolerate the anxiety that arises, while refusing to engage in any compulsive behaviors to relieve the discomfort. 
• Exposures are often ranked from least to most frightening for the person and are usually done gradually as the person builds up resilience.