Obsessive thoughts, paralyzing fears, strange rituals - to a certain extent, many of us are prone to all that. But how can we know if this is beyond the scope of healthy behavior and if it is time to seek help from a mental health professional? Living with obsessive-compulsive disorder (OCD) is not easy. A person suffering from this condition has to deal with intrusive thoughts that cause this individual severe anxiety. To get rid of this distress, an OCD person constantly feels like they have to perform specific rituals, otherwise referred to as compulsions.
OCD is classified as an anxiety disorder, and, as we mentioned above, anxiety is familiar to almost everyone. But it’s not like any healthy individual understands what an OCD person has to experience. For instance, headaches are familiar to everyone, but this does not mean that we all know how migraine sufferers feel exactly.
Symptoms of OCD can interfere with a person's ability to work, live, and build healthy relationships with other people. “Human brain is designed to always warn us of the dangers that threaten our survival. But in OCD patients, this brain system does not work properly. As a result, they are often overwhelmed by a real “tsunami” of unpleasant experiences, and they are not able to focus on anything else”, explains psychologist Stephen Philipson, clinical director of the Center for Cognitive Behavioral Therapy in New York.
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There are different rituals performed by individuals suffering from OCD. Most of them fall under one of the following four categories:
1. Repeating actions: constant hand washing, too frequent clothes changing;
2. Decontamination rituals: repeated thorough cleaning, sanitizing, disinfecting;
3. Ordering and arranging actions: proofreading letters or texts over and over again until they look perfect or meticulously lining up all the clothes in the closet so that they are arranged according to color;
4. Reassurance-seeking and checking rituals: constant checking in with a loved one over and over again to ensure everything is OK or monitoring one’s blood pressure, heart rate, or temperature.
Many people suffering from OCD find alcohol and/or drugs to be a “remedy” for their anxiety. Alcohol and other substances dull the mind, making it easier for an individual to ignore those insatiable compulsions they experience when sober. However, some report even worse feelings when they begin to sober up. And here is where it becomes dangerous because it can cause a person to use alcohol or drugs again and again to avoid these anxious thoughts. Continued substance use may eventually become a dependency; this can develop even quicker when the person uses alcohol or drugs as “self-medication” for OCD. Trying to escape this disorder can cause a more severe spiral into alcoholism. That is why as soon as someone finds out they have OCD, it is crucial to address the issue.
As happens with any other mental condition, only a qualified mental health professional can make a diagnosis. But there are a few symptoms that, with a high degree of accuracy, indicate the presence of OCD in a person:
OCD people often believe that if they check the stove once again or search the Internet for symptoms of the illness they claim to be suffering from, they will finally be able to calm down. But OCD is often deceptive. “Biochemical associations with the object of fear arise in the brain. And the repetition of obsessive rituals further convinces the brain of an OCD person that the danger is indeed real, and thus a vicious circle is completed”, explains Stephen Philipson.
Would you agree to stop performing the usual rituals (for example, not checking 20 times a day if the front door is locked) if you were paid ten thousand dollars or another amount that is significant enough for you? If it is so easy to “bribe” your anxiety, then very likely you are just more afraid of robbers than most people, but you do not have OCD. For a person suffering from this disorder, the performance of rituals seems to be a matter of life and death, and money can hardly buy survival.
OCD sufferers use the expression “Yes, but...” very often (for example, “Yes, the last three tests showed that I do not have this or that disease, but how do I know that the samples were not mixed up in the laboratory?”). Because it is rarely possible to be 100% sure of something, no beliefs help patients overcome these thoughts, and they continue to be tormented by their anxiety.
“Not everyone with OCD can tell exactly when their disorder first appeared, but most do remember it”, Philipson says. At first, there is just unreasonable anxiety in a person, which then shapes into a more specific fear - for instance, that they, while preparing dinner, will suddenly stab someone with a knife. For most people, these experiences pass without consequences. But OCD people seem to be falling into an abyss of their fears again and again. “At such moments, panic “allies” with a certain idea. And it’s not easy to end it, like any unhappy marriage”, Philipson says.
Almost all the phobias that torment OCD sufferers have some basis. These fears are not absolutely irrational - fires do happen, and hands are really full of bacteria. Obsessive-compulsive disorder is all about the intensity of those fears. If you realize that no one can ever be completely sure of anything and still live a normal life despite the constant uncertainty associated with these risk factors, you most likely do not have this disorder. Or maybe you do, but it is a very mild OCD case. Problems start when anxiety completely consumes an individual, not letting them live their life normally.
There is no cure for obsessive-compulsive disorder. However, fortunately, patients with this condition can manage how their symptoms affect their lives. Medications, including some types of antidepressants, play an important role in OCD therapy.
Psychotherapy, especially cognitive behavioral therapy (CBT),is also a very helpful and effective tool to help a person manage their OCD. Another powerful therapy for the treatment obsessive-compulsive disorder is exposure and response prevention therapy (ERP). In the course of treatment, the patient, under the supervision of a therapist, is purposedly placed in situations that cause fear while they must try and resist the urge to perform their usual ritual. For example, if someone has a contamination OCD subtype, is afraid of dirt and constantly washes their hands, the first exercise for them will be to touch a doorknob and not wash their hands after that. During the following exercises, the apparent danger is amplified - for example, an OCD person will have to touch a handrail on a bus, then the faucet in a public toilet, and so on. As a result, fear gradually begins to subside.
Practicing relaxation techniques and refocusing attention on other tasks is crucial too. It takes effort and time, but any OCD patient will eventually realize that their distress will pass, and so will their urge to perform their compulsive rituals.