Compulsive and Anxiety-Fueled Disorder (OCAD): Signs and Beyond
OCD, or obsessive-compulsive disorder, is a mental health issue characterized by unwanted, distressing thoughts and the urge to carry out specific actions to alleviate the anxiety associated with these thoughts. These obsessions and compulsions can significantly impact a person's daily life and quality of living.
The global population has a certain percentage of individuals suffering from OCD, with the condition commonly manifesting between the ages of 18 and 29.
An individual with OCD might:
- grapple with intrusive, unwanted thoughts, images, or urges
- experience significant discomfort, potentially involving fear, disgust, doubt, or a conviction that things must be done in a certain way
- spend a substantial amount of time focusing on these obsessions and engaging in compulsions, which can hamper personal, social, and professional activities
The fourth edition of the Diagnostic and Statistical Manual (DSM-IV) classified OCD as an anxiety disorder. However, the fifth edition (DSM-5) reclassified it under the new category of "obsessive-compulsive and related disorders," along with conditions such as hoarding and body dysmorphia.
There are various types of OCD, each affecting individuals differently. According to the charity OCD-UK, these include:
Concern with checking
A person with OCD might feel the urge to repeatedly check for issues, such as:
- inspecting taps, alarms, door locks, house lights, and appliances to prevent leaks, damage, or fire
- scrutinizing their body for signs of illness
- verifying the authenticity of memories
- reviewing communication, such as e-mails, excessively for fear of errors or offense
These checks can consume a lot of time and negatively impact a person’s daily life, routines, and relationships.
Fears of contamination
Some individuals with OCD have a persistent, overwhelming need to clean. They might be worried about contamination from objects they touch, leading to:
- excessive toothbrushing or handwashing
- repeated cleaning of the home
- avoiding crowds due to the fear of contracting germs
Some may also feel contaminated if they feel someone mistreats or criticizes them. They may attempt to remove this feeling by washing.
Read about OCD and cleaning.
Hoarding
This involves a person struggling to discard used or unimportant items.
Intrusive thoughts
This includes feeling unable to suppress repetitious, unwanted thoughts, which may involve violence, including self-harm or harming others.
The thoughts can cause intense distress, but the person is unlikely to act in a manner reflecting this violence.
Learn about OCD intrusive thoughts.
Symmetry and orderliness
A person with this type of OCD might feel the need to arrange objects in a particular order to avoid discomfort or harm. For example, they may repeatedly rearrange books on a shelf.
Suicide prevention
If somebody is at immediate risk of self-harm, suicide, or hurting others:
- Ask the difficult question: "Are you considering suicide?"
- Listen without judgment.
- Contact 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Safely remove any potential harmful objects if possible.
If you or someone you know is having thoughts of suicide, a prevention hotline can provide assistance. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, individuals who are hard of hearing can use their preferred relay service or dial 711 then 988.
Find more links and local resources.
Signs and symptoms of OCD
OCD can manifest as obsessions, compulsions, or both, causing distress and interfering with a person’s ability to carry out routine activities.
Obsessions
While everyone experiences worry, in individuals with OCD, anxiety can take over, making it challenging to perform simple tasks.
Common sources of anxiety include:
- contamination by bodily fluids, germs, dirt, and other substances
- violence, such as the fear of acting on an urge to self-harm or hurt others
- perfectionism, which may involve fear of losing items or an intense concentration on exactness or remembering things
- responsibility, including a fear of being responsible for a catastrophic event
- unwanted sexual thoughts, including thoughts about inappropriate activities
- religious or superstitious beliefs, such as concern about offending a deity or stepping on cracks in the sidewalk
- identity, which might involve sexual orientation or gender identity
OCD in Kids
OCD symptoms can appear during childhood or adolescence.
Issues that might arise with young people and kids with OCD include:
- Low self-confidence
- Interrupted daily routines
- Struggles with school and academic work
- Physical health issues due to stress
- Difficulty building and maintaining friendships and relationships
- Other mental health problems
Predictors of OCD
A mix of genetic, neurological, behavioral, cognitive, and environmental factors might contribute to OCD.
Genetic factors
OCD seems to have a genetic link, as it often runs in families. Researchers are exploring this possibility.
Neuroimaging studies suggest that people with OCD have brains that work differently.
Autoimmune-linked causes
Sometimes, OCD symptoms appear in children after an infection, such as:
- Group A streptococcal infections (like strep throat)
- Lyme disease
- The H1N1 flu virus
Doctors may refer to this occurrence of OCD symptoms in children as pediatric acute-onset neuropsychiatric syndrome (PANS).
Behavioral causes
The theory is that people with OCD learn to avoid fear associated with certain situations or objects by performing rituals to reduce perceived risk.
Initial fear may stem from a period of high stress, such as a traumatic event or significant loss.
Once a person associates an object or situation with this feeling of fear, they start avoiding it, which can become a characteristic of OCD.
Cognitive causes
Another theory is that OCD starts when people misinterpret their own thoughts.
Most people have unwelcome or intrusive thoughts at times, but for people with OCD, the importance of these thoughts becomes more intense or extreme.
Environmental causes
It's still unclear whether stressful life events and trauma can independently cause OCD or are triggers for people with a predisposition to the condition.
Environmental events that might contribute to OCD include:
- Complications during pregnancy or delivery
- Age-related reproductive changes
- Socioeconomic problems
- Traumatic injuries
- A serious illness
OCD might also occur alongside post-traumatic stress disorder (PTSD).
How doctors diagnose OCD
Doctors look for specific criteria when diagnosing OCD:
- Presence of obsessions, compulsions, or both
- Obsessions and compulsions take up time or cause significant distress or impairment in social, occupational, or other important settings
- OCD symptoms are not caused by substance use or medication
- OCD symptoms are not due to another health issue
OCD treatment options
The best treatment approach may depend on a person's symptoms and severity. Doctors may recommend psychotherapy, medication, or both.
Cognitive behavioral therapy (CBT)
CBT is a type of psychotherapy that's effective for OCD. It can help a person change their thoughts, feelings, and behaviors.
CBT might involve exposure and response prevention (ERP). ERP exposes the person to situations and objects that trigger fear and anxiety.
Over time, through a process called habituation, repeated exposure can lead to a decrease or elimination of anxiety. This teaches the person to resist performing compulsive behaviors.
Individual and group CBT can be effective at treating OCD.
Medications
Selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant, are often used for OCD. Examples of SSRIs include:
- Escitalopram (Lexapro)
- Citalopram (Celexa)
- Fluvoxamine (Luvox)
- Paroxetine (Paxil)
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
Doctors might also prescribe other medications, such as antipsychotics, alongside SSRIs.
Additional treatments
Although CBT and SSRIs are popular options, doctors may also explore other possibilities, such as:
- Deep brain stimulation, which involves electrical stimulation of the brain
- Transcranial magnetic stimulation, a type of noninvasive brain stimulation
- Stereotactic ablation, a type of radiotherapy
Managing OCD
Maintaining a healthy lifestyle can help manage OCD for some people. This might involve:
- A balanced diet
- Regular exercise
- Adequate sleep
- Spending time with loved ones
- Relaxation techniques, such as:
- Yoga
- Meditation
- Massage
Discover more ideas for managing OCD.
Prognosis
Untreated mild OCD might improve over time, but moderate or severe OCD symptoms usually do not improve and may worsen.
Treatment can be effective, but it's an ongoing process. About half of people might still experience OCD symptoms after treatment with CBT and SSRIs.
Anyone dealing with OCD symptoms should consult a healthcare professional to discuss available treatment options.
A person struggling with bipolar disorder might experience intense mood swings, periods of mania and depression, and difficulty in maintaining daily activities due to their unstable mood. This mental health condition can be challenging to predict and manage.
In some cases, cancer patients undergoing chemotherapy or radiation may develop temporary OCD symptoms, such as an intense focus on cleanliness or the need to perform specific routines, as a side effect of their treatment. These symptoms often improve once the cancer treatment is over.
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