I've been trying to explain OCD to people for over ten years, and I'm pretty sure one of the main reasons it's so surrounded by stigma and misconception is that there just isn't a simple one-sentence answer.
The shortest I can get it down to is this:
"OCD is an anxiety disorder which causes someone to have intense fears which they try to lessen by using certain internal or external behaviours."
It'll do at a push, but it's not going to be particularly useful in helping people REALLY understand the condition and get a diagnosis.
For that, we need a little more information.
Let's go!
So, just what is OCD?
OCD is an anxiety disorder. It is a condition that is surrounded by tons of misconceptions, and this is a problem because misconceptions can get in the way of people getting adequate support, diagnosis and treatment. OCD can be a seriously debilitating condition so it's important people understand what it really involves!
At its core, OCD involves:
Obsessions
An obsession is a fear. Very often in OCD, these fears involve thoughts of harm coming to loved ones or something happening that goes completely against the values of the individual experiencing the obsession. Obsessions can be thoughts, feelings, bodily sensations, urges, complete word-based sentences (including commands), or thoughts in pictorial form, including still and/or moving images. They can also include intrusive thoughts, which often include extremely upsetting and difficult-to-discuss themes. You can find out more about intrusive thoughts here.
OCD obsessions often focus on the things you hold most dear. If your religion is important to you, it'll often focus on that; if your children are everything to you, OCD will probably centre itself on them. This can feel extremely painful and personal and I find it helpful to think of OCD as trying - in a REALLY unhelpful way - to protect me. And if that's the case, it kind of makes sense it would focus on the things I value most.
Compulsions
Compulsions are designed to lessen the amount of anxiety caused by obsessions.
They are behaviours that can be external or internal, meaning that some can be observed and others are hidden from view. This is important because a lot of people assume OCD is just about physical actions.
Compulsions are designed to stop the content of the obsession from happening; they involve checking, avoiding, counting, reviewing, hunting for certainty, and asking for reassurance. This list, just like the list of obsessions, has no end, but compulsions generally fall under the main areas of checking, avoiding, and/or looking for certainty. There is a link to a blog listing some of the compulsions shared by the OCD community at the bottom of the page. You might be able to recognise a few of your own on there, too!
Together, obsessions and compulsions form part of the OCD Loop...
The OCD Loop
This is the OCD Loop! It is always present in OCD, even when it's tricky to identify specific parts of it. The longer OCD cycles around the loop, the more distressing, time-consuming, and impactful it becomes.
I have written about the OCD Loop in a lot more detail here. Be sure to check it out after this post because understanding how the OCD Loop works is extremely helpful in identifying and addressing OCD symptoms!
The 'D' in OCD
The D in OCD is important! Many people describe themselves as having OCD when they don't. Most people have the odd quirk or superstition that could sound a little like OCD to the untrained ear, but it isn't, and this is where the 'D' in OCD comes in handy. The 'D' in OCD stands for disorder. Behaviours/actions/symptoms become OCD when they start to impact day-to-day living. A rough ballpark figure given by professionals is that if your symptoms are taking up more than an hour a day - you are experiencing OCD. This figure includes all symptoms, internal ones too, and not just the physical behaviours.
You may believe you're not taking part in OCD for an hour, but after learning about OCD and the OCD Loop, you may discover that OCD is taking up more and more of your time every day! Having a true reflection of the extent of time your OCD is taking up is a great first step toward getting support!
Additional facts about OCD
It’s reported that OCD affects 1-2% of population (16 million people worldwide). It is suspected that this number could be much higher because fear, shame and misinformation stop people from looking for help.
There is no definite answer about what causes OCD although studies have suggested factors ranging from genetics to behavioural causes to social factors and beyond! It is also thought that stress and trauma can increase the likelihood of you having OCD and/or exacerbating pre-existing OCD symptoms.
The good news is that new studies are happening all the time in OCD research, and we are finding out more about the condition all the time!
OCD often exists alongside other conditions such as body dysmorphic disorder, disordered eating, depression, generalised anxiety, addiction, substance misuse, and focused repetitive behaviours. Some of these conditions, such as substance misuse, may be caused by self-medicating as a way of dealing with distressing OCD symptoms.
OCD is often referred to as a Doubting Disorder because of how much doubt it causes.
People sometimes refer to the type of OCD that involves a lot of intrusive thoughts and has less visible compulsions as Pure O. There are both plus and minus points to using this term, so please have a little read of this post here to help you find out more.
Treatment for OCD
Good OCD treatment involves learning how to interrupt the OCD Loop. This tends to be cognitive behavioural therapy (CBT) and exposure and response prevention (ERP) with or without medication running alongside.
Traditional talk therapy, where you talk about things that are bothering you and discuss things from your past, may help as part of a holistic approach, but itis not advisable as the only approach to treatment. In fact, traditional talk therapy may make OCD symptoms worse because it can play into compulsions such as rumination and reassurance seeking and keep the OCD loop strong. This is especially the case if you are having therapy with someone who doesn't fully understand the mechanisms of OCD. You can find out how to find a reliable OCD therapist at the bottom of this post here.
You can also read LOADS more about this topic, including new forms of treatment and general treatment for OCD, in this post here.
To end...
I started this post by saying that OCD can be tricky to understand, but I want to end by saying that this absolutely doesn't mean that you can't get help and get better! My life improved so much when I read everything I could about OCD from reliable sources and when I spoke to the OCD charities before eventually going to see my GP.
OCD can be challenging to deal with, but we're tough, too, and there are loads of things we can do to help us feel better. You can find many of these ideas through the Taming Olivia website.
Please let me know if you have any more questions about OCD. You can ask via the comments below or private message, and I'll do my best to answer them.
I really hope this post has helped shed a little light on OCD!
Sending you loads of love
Cat xx
Further reading
Taming Olivia Newsletter
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Updates about Taming Olivia and Waving, a film about OCD and Intrusive thoughts that was recently released.
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