An Introduction to OCD

Obsessive-compulsive disorder (OCD) is a psychological disorder involving a variety of unwanted thoughts or feelings, referred to as obsessions. These obsessions compel individuals to engage in some form of repetitive behavior, known as compulsions. People living with OCD experience these obsessions and compulsions at such a frequency and intensity that it impacts their daily lives.

A common example of OCD involves the repeated washing of one’s hands. For an individual living with this type of OCD, they become obsessed with the thought or feeling that their hands are unclean or are otherwise in need of thorough washing, even if they have been washed just moments before. The compulsion to continuously, rigorously wash their hands can result in individuals causing physical harm to themselves.

From a clinical point of view, an OCD diagnosis can only be rendered when obsessions and compulsions occupy at least one hour of an individual’s day. Time and energy spent on obsessions and compulsions must result in significant distress and should have a direct impact on a person’s professional or social life. From 2 to 3 percent of the American population lives with OCD, with female adults receiving diagnoses at a slightly higher rate than male adults. OCD typically begins some time between childhood and early adulthood, with symptoms manifesting at age 19 on average.

Psychological distress is the key element behind OCD. Many individuals have uncomfortable thoughts or engage in repetitive, perhaps superstitious behaviors. For individuals living with OCD, however, refraining from the rigid behaviors dictated by these thoughts typically yields significant mental anguish.

In addition to compulsive hand washing, a more generalized fear of being contaminated by the environment or other people is a common obsession. Individuals living with OCD may also deal with a fixation on symmetry and order, the fear of suddenly shouting obscenities or insults, and disturbing sexual thoughts. OCD can be more abstract in nature, such as intrusive sounds, words, and numbers occupying one’s thoughts.

Further examples of compulsive behavior, meanwhile, range from constantly cleaning a room or object to ensuring certain items are ordered and arranged in a very precise manner. Others may spend prolonged periods of time checking the same house locks or ensuring home appliances are functioning properly. Compulsive behavior may also take on a more emotional context, with individuals constantly seeking out approval and reassurance from others.

Awareness of OCD varies from one individual to the next. In other words, some people living with OCD understand that their obsessions are not rooted in reality, while others suffer from “limited insight.” In cases of limited insight, the individual believes their obsessions and compulsions are logical. It can be helpful for medical professionals to understand a specific patient’s level of insight into their disorder, but individuals fully aware of their OCD diagnosis still remain hard pressed to avoid the intrusive behavior.

OCD treatments often involve a form of cognitive behavioral therapy known as exposure and response prevention, along with medications known as serotonin reuptake inhibitors. One or a combination of these approaches benefit about 70 percent of those living with an OCD diagnosis.