By Lynn Hagan, PsyD, CTRL, LCSW
Excessive worries that consume a person’s thinking and interfere with their everyday lives are called “obsessions.” They can include uninvited thoughts, urges, or images that appear in the mind over and over.
Often people with obsessions will try to reduce or suppress their obsessions by acting out certain rituals, or specific ways of doing things. For example, a person who is obsessed with dirty hands may believe if he washes his hands and get them clean, he will be able to stop thinking about having dirty hands. Often the obsessive thoughts don’t stop and sometimes these rituals may last for hours.
Another example of a common obsession is repeatedly checking to see if the stove is off. When people act on their obsessions, their rituals are called “compulsions.” Thoughts are obsessions and actions compulsions.
When obsessions and compulsions get out of control and begin to interfere with the person’s day-to-day functioning, it is called an Obsessive-Compulsive Disorder or OCD. People with OCD usually know that their obsessions are creations of their own minds, but are unable to control or ignore them. Likewise they often know that their compulsions are unwarranted, yet they are similarly unable to refrain from doing them.
Obsessive-Compulsive Disorder is an anxiety disorder that affects about one adult in 40 worldwide and affects men and women at an equal rate. OCD usually begins gradually and most individuals who suffer from the disorder will develop symptoms in adolescence or early adulthood.
Symptoms
The main symptoms of Obsessive-Compulsive Disorder are recurrent obsessions or compulsions that interfere with a person’s life. The symptoms:
- Take up more than one hour a day or
- Cause marked distress or significant impairment.
At some point, the person is likely to become aware that the obsessions and/or compulsions are excessive or unreasonable, and they may feel ashamed and try to hide them from others.
Common Obsessions:
- Fear of contamination (such as fear of dirt, germs, body fluids or diseases)
- Repeated doubting (such as whether the stove is turned off )
- Focus on exactness and order
- Preoccupation with religious images and thoughts or fear of having blasphemous thoughts
- Fear of harming oneself or others
- Fear of blurting out obscenities in public
- Forbidden or unwanted sexual thoughts, images, or urges.
Common Compulsions:
- Cleaning/washing (washing hands too often, cleaning household
items or other objects) - Checking (repeatedly checking something, i.e. paperwork, for mistakes)
- Ordering/arranging (repeatedly making sure objects are in a certain order)
- Hoarding (collecting seemingly useless items)
- Mental rituals, such as excessively counting or repeating words.
Causes
Obsessive-Compulsive Disorder appears to be caused by a combination of psychological, biological, and genetic factors.
Psychological Factors
- People may associate certain objects or situations with fear (thus the obsession) and either avoid the things they fear or perform rituals that help reduce the fears (the compulsion).
Biological Factors
- Research shows a link between OCD and insufficient levels of the brain chemical serotonin (a neurotransmitter that plays a role in regulation of mood, aggression, impulse control, sleep, appetite, body temperature and pain).
- Researchers have also found that people with OCD appear to have greater than usual activity in areas of the brain that may be involved in controlling feelings and actions.
Genetic Factors
- Appears to run in families
- Genes involved in regulating serotonin may be passed on through generations
Treatments
- Counseling (cognitive-behavioral therapy is the most common)
- Medication (usually antidepressant medication; sometimes anti-anxiety medication)
- Group therapy (with people who have similar concerns) can also help.
- Support Groups.
Recovery
While therapy and medications can help reduce the symptoms of Obsessive-Compulsive Disorder, the process of recovery, like the onset of the illness, is gradual and ongoing. Continuing with treatment, even when symptoms have improved, can help maintain health and prevent relapse.
The opinions expressed in this article are those of the writer, and do not necessarily reflect those of the National Association of Social Workers or its members.
