stuck on repeat: OCD

Obsessive Compulsive Disorder, OCD 

“Why are there always so many socks in the laundry?”  John’s wife asked him this after they got married.   

There are so many socks because when John gets dressed, he always puts on two pairs.   John has lived much of his life with a diagnosis of obsessive-compulsive disorder, OCD, a type of anxiety disorder. 

In pop culture, OCD is used as a shorthand term for fastidiousness and neat freaks; Oh, you’re so OCD!   Actual OCD means much more. People diagnosed with OCD experience obsessions and compulsions that feed each other in recursive, hard-to-escape loops and the experience can be torment for the individual and their family. 

Obsessions are intrusive and unwanted thoughts, images, or urges that cause distress or anxiety.   

Common obsessions include concerns about contamination, harm, cleanliness, aggressive impulses, or the need for symmetry. For instance, a child worries nightly that their family will die. Or a policeman imagines stealing from a shop.   Or an animal-lover has an urge to hurt their dog. Obsessions are always unpleasant and distressing. 

Compulsions are behaviours that a person feels compelled to perform, to ease their distress and suppress the ‘obsession’.

Compulsions are like an antidote, offering temporary relief from the obsessions.   Some compulsions are visible actions like checking, cleaning and arranging.  Others are mental behaviours, things people do in their head that nobody else is aware of, like counting each step when they walk.

Some ways OCD can manifest.  A man worries an electrical fire will destroy his house. So, every time he leaves his home, he checks and then rechecks that all power points have been turned off.   A girl fears germs could invade her body.  So, she washes her hands over and over and over again, sometimes so much that her skin becomes red and sore.  A woman worries her beloved cat might accidentally overdose on medications she keeps at home.  So, she locks the medicine cabinet, but has to lock and re-lock it 9 times in a row because that is her ‘system’ to ensure her cat comes to no harm.

There isn’t always a logical connection between obsessions and compulsions.  For instance, a boy may worry his mother will get cancer unless he taps the door frame each time he passes through.  While John wears two pairs of socks every day to stop something ‘bad’ from happening.

OCD is much more than a set of idiosyncrasies, superstitions or difficult to manage quirks.

Many people with OCD know their symptoms are not rational. Nevertheless, they feel a strong need to perform their compulsive actions.   OCD can begin in childhood and unlike adults, children and teens may not recognise that their symptoms are excessive.  OCD tends to ebb and flow over the course of a lifetime, sometimes with periods of remission. 

The condition has no single common form and can be hard to recognise and diagnose.  Any two people with OCD can have very different experiences, but help is available to understand and manage symptoms.  Clinical psychologists and psychiatrists provide two effective treatments for OCD, either alone or in combination: exposure therapy and medication.   While there is not a total cure, many people with OCD can learn to manage their symptoms and live well.

by Lydia Rigano

article in DUOmagazine February 2018