OCD Definition and What I Should Know About It
Christian Counselor Seattle
In this article, I’ll be sharing an OCD definition as well as some information you should know about this condition.
OCD Definition
OCD stands for Obsessive Compulsive Disorder. In order to be diagnosed with this, a person needs to have obsessions and compulsions. Obsessions are thoughts, urges or images that happen often and are hard to get out of your mind. They are unwanted and cause anxiety and distress.
The person that has these thoughts, urges, or images tries to ignore, suppress, or neutralize them in some other thought or action. An example of this would be, a constant, worry that they are going to hit someone with their car or an intense fear that something terrible will happen to a loved one.A compulsion is an action or behavior that a person is trying to neutralize their obsession with. This can be a repetitive behavior or a mental act. These behaviors can look like washing hands repetitively, straightening up and ordering things, and checking.
Mental acts can be praying repetitively, counting, or repeating words silently. These compulsions are driven by the obsession or rules they need to rigidly follow. The compulsions are performed as an attempt to prevent or reduce the anxiety that the person is feeling or to prevent something dreaded from happening.
It is important to remember that these compulsions are not tied to anything connected to reality. For example; a person with OCD might have the rule to switch the light switch on and off three times every time they leave a room to prevent their house from burning down. In order to meet the criteria, these symptoms of obsessions and compulsions need to be time consuming, taking more than an hour a day and need to interfear with normal functioning.
If the person has only obsessions, or only compulsions, or does not meet the other criteria for a diagnosis, then they most likely do not have OCD but might meet criteria for another mental health condition. In the diagnostic book that mental health professional use, the Diagnostic and Stitistical Manual, or DSM, there is a differential diagnosis for each mental health condition.
Diferential diagnoses are suggestions for the mental health provider of other diagnoses that might be similar or might explain the persons’ symptoms better than the diagosis they looked up. For example, for OCD, the differential diagnoses that are suggested to look into are anxiety disorders, major depression disorder, other obeseeive-compulsive and related disorders, eating disorders, tics, and stereotyped movements, psychotic disorders, other compulive-like disorders or obsessive-compulsive personality disorder.
Anxiety disorders such as specific phobias and social anxiety disorder are different than OCD due to being focused more on the fear of objects and situations and their avoidance in order to reduce anxiety. If your symptoms don’t fit OCD they might be explained by another obsessive-compulsive disorder.
These could be body dysmorphic doisorder (which only includes obsessions and compulsions dealing with physical appearance), trichotillomania (which is limited to hair pulling), and hoarding disorder (which is a consistant distress with discarding items). Tics can look like OCD because of repetitive movements, but these movements are not compulsions and are not associated with obsessions.
Psychotic disorders may look like OCD because of poor insight or delusional thinking, but in OCD there are no other psychotic symptoms. Other compulsive-like behaviors like sexual behavioral, or substance use may look like compulsions, but the difference is that people gain pleasure from these activities rather than being driven by anxiety like compulsions in OCD.
Obsessive-compulsive personality disorder has a similar name but is completely different in presentation. Unlike OCD, obsessive-compulsive personality disorder does not have intrusive thoughts, images, urges, or repetitive behaviors. The personality disorder is characterized by an enduring and pervasive maladaptive pattern of excessive perfectionism and rigid control.
Signs and symptoms
There are physical symptoms that are present in people that are diagnosed with OCD. Some of them include complusions, agitiation, hoarding, implusivity, repitition of words or movements, ritualistic behaviors, and social isolation. Complusions, as defined earlier, can take many different forms, but are usually consistant for the person, and are things that the person needs to do in order to reduce anxiety.
A person with OCD can appear to be agitated if they are stopped from completing their compulsions for any reason. Hoarding can also be a sign of OCD if the person believes that something horrible will happen if they throw anything away. Repeating words, movements and behaviors can all be physical manifestations of the person’s compulsions.
Social isolation is also a good indication of a mental health condition in general. In OCD, social isolation could mean that the person my have an obsessive thought that if they go outside, or drive anywhere something catastrophic will happen to them or someone else. This symptom can also lead to depression if their OCD is not worked on.
There are some common moods that people with OCD share. Anxiety is a huge factor in this disorder. The person experiences anxiety when there is something blocking them form performing their rituals or compulsions. This aniety can be disabling for the person and can surface as a physical symptom or a psychological symptom.
Anxiety can stop a person from performing everyday activities like keeping a job, walking down the street, driving, even leaving their home. Anxiety can also lead to panic attacks when the person cannot soothe their anxiety by completing their compulsions.
Guilt can also be something that a person with OCD can feel. They might have the obsession that their mother will become sick if they do not call her everyday. If the person doesn’t get to call their mother one day and she happens to get sick, the person will most likely think that it was their fault that their mother became ill.
Psychologically, people with OCD may experience depression, fear and ongoing and repeative thoughts that they feel they cannot control. These are the symptoms that are harder to detect in people because they are more internal than external.
These internal feelings may surface as behaviors and my present as aggitation or anger. It is important to keep an open line of communication that is non-judgmental and supportive so that the person is comfortable sharing these internal struggles.
What can I do about it?
If you are thinking that you might have OCD based on the information presented, ask your doctor for more information. Having a conversation with your doctor about how you are feeling and what syptoms you have is the first step to being able to function the way you would like to.
When speaking with your doctor, ask if a referal to a psychiatrist is appropriate for you. Your doctor might even have information about therapists in your area if it is important for you to see a therapist on a regular basis to work through the harships that come with OCD. Some other options might be finding a support group and doing research on anxiety, OCD and mindfulness.
If you are a parent, the most important thing that you can do for your child with OCD, or suspected OCD, is to be open, understanding, supportive and non-judgemental. Your child is dealing with anxiety and obsessions that they might not be able to find the words to explain. They might present with irritating and irrational behaviors that are an inconvience for you.
Being patient with them and validating their feelings will increase your child’s chances to overcome their anxiety. A crucial step that parents can take is early intervention. Early intervention can look like taking your child to your primary doctor or a psychiatrist. It will be important to find a therapist trained in Cognitive Behavioral Therapy, CBT, or Exposure and Response Prevention ERP. These are the evidenced based treatments for someone with OCD.
If you are a teacher that is observing some signs and symptoms you think might be OCD, what can you do? The best step is to talk to your school psychologist. Reporting these symptoms starts the process of getting the child the help that they need.
Being patient and being a safe person for the child to come to when experiencing symptoms can help greatly as well. They might display disruptive classroom behaviors, so talking to your school psychologist on suggestions on how to react to these behaviors in a therapuetically benifical way will be important.
What are the recommended treatments for OCD?
There are a few different Evidence Based Treatments (EBT) that are used for someone who has been diagnosed with OCD. These EBT’s are Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), and support groups that are for people with OCD.
Cognitive Behavioral Therapy focuses on changing thoughts and therefore changing emotions and behaviors. This is effective for OCD because it targets the irrational obsessions. It allows for a changing in thoughts to create healthy and helpful thoughts that are based in reality. In doing this, the person will have the ability to change their emotions as well as their behaiors and compulsions.
Exposure and Response Prevention therapy (ERP) is exactly what is sounds like. The therapist trained in ERP will expose the person to a stimulous that is anxiety prevoking and have them respond in a healthy and productive manner rather than with their compulsions. This process happens a little at a time after the person has learned skills to help calm their anxiety in the moment.
For example, if a person has the belief that whenever they park a car they need to back in and out of the spot three times before turning the car off or they will kill someone the next time they drive.
ERP would teach something like coping skills first, and then starting off small such as turning the car on and then back off without moving it. The therapist will then assess for the person’s anxiety level and prompt them to use their coping skills until their anxiety is at a manageable level. The final step in this will be to drive into a parking spot and turning off the car right away.
Support groups are a good resource for people with OCD as well. Support groups provide the support people need to feel included and not alone in their struggles and to learn how other people are functioning with OCD. When people feel supported, they feel more hopeful and have the support and accountablilty of other people that are going through the same struggles as them.
Besides therapy, talking to your psychiatrist or primary doctor about possible medications is an option. Medication might be helpful depending on different factors for each person. Talk to your doctor to see if you might be a good candidate for medication that is helpful for treating symptoms of OCD.
Now what?
If you are searching for a place to help with your OCD or know someone that is struggling with this anxiety disorder, consult with your doctor and seek out a therapist trained in one of the Evidenced Based Treatments. Being able to walk through this healing path with the support of a therapist is a powerful experience.
You will be able to heal and change and grow with the presence of God and your hard work. There are also options for secular therapists and therapists that are part of a clinic if you are on state insurance and cannot afford private practice fees. You can also call your insurance provider and they will give you a list of the therapists you are covered for.
If you are looking for a Christian based therapist, make an appointment with one of the CBT or ERP trained therapist at Seattle Christian Counseling. Call or email them today for your first, risk free, initial appintment. Don’t be afraid to make a few risk free appintments with different therapists. It is important for you to feel like your therapist is a good fit for you.
“Paranoid”, Courtesy of Hunter McGinnis, Flickr.com, CC BY 2.0 License; “Day 021” Courtesy of Holly Lay, Flickr.com, CC BY 2.0 License; “Sunny Storm”, Courtesy of Danny Norodo, Flickr.com, CC BY 2.0 License; “Fear”, Courtesy of Noemi Galera, Unsplash.com, CC0 License