Obsessive Compulsive Disorder

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Introduction
Obsessive Compulsive Disorder (OCD) is a psychological disorder that involves
repetition of specific acts based on repeated thoughts and ideas. This disorder is
characterized with lack of control over one’s obsessive thoughts and ideas that lead to the
repetition of the act. OCD patient is aware of his condition, yet he finds it almost impossible
to give up on his compulsive behavior for longer period of time. The examples of obsessive
behavior include washing hands and face, washing clean clothes, ensuring whether the
door is locked or not. It is interesting to note that these activities are quite ordinary in
nature but obsession and compulsion to do them repeatedly in a single time event make
them an abnormal practice. Some of the patients find it hard to give up on useless material
objects and as a result, there house appears a mess to outsiders. The obsessive behavior is
related to depression and anxiety. In some cases, the risk of suicide is also present making
OCD fatal at times.

The causes of OCD are not known to psychologists as it is purely a behavioral

disorder. However, a history of physical and sexual abuse or stressing life events can
trigger obsessive behavior which can form its permanent basis in patient’s mind. If drug
abuse or serious medical conditions prevail, the OCD will be ruled out as the compulsive
behavior can be an outcome of the former two factors.
The OCD Cycle

https://factsweek.com/40109/obsessive-compulsive-disorder-market-growth-opportunities-analysis-and-forecasts-report-2025/

The OCD cycle is the vicious cycle where people with obsessive compulsive behavior
cannot evade disturbing thoughts and ideas unless they perform an act repeatedly to
achieve the state of relief. Following are the steps in an OCD cycle;

1. Obsessions

Obsessions are intrusive thoughts, ideas, desires, fantasies, images, and beliefs that take
over the rational thinking of a person. For instance, a person who is obsessed with
washing hands has the obsessive thoughts of unclean hands. The thoughts prevent him
to do other things and make him anxious and even depressed.

2. Anxiety

Anxiety is an outcome of obsessive thoughts. It prevails and hinders in normal

functioning until the person decides to ‘act’. In above mentioned scenario, the anxiety
results in decision to ‘wash perceived unclean hands.’

3. Compulsions

Compulsion is the ‘mandatory’ action that people with OCD perform to relieve the
anxiety related to their obsessive thoughts. In example discussed above, compulsive act
will be ‘washing’ hands until they feel clean. Harsh chemicals from soaps and hand-
washing liquids can cause skin related problem due to an overuse. The side-effects of a
compulsive activity depend upon the nature of the act.

4. Relief
 Relief is the final stage in OCD cycle where the person feel relieved of obsessive and
intrusive thoughts. He is relieved until these thoughts start bothering him again, thus
starting an OCD cycle.

Symptoms
There are various signs and symptoms that are indicative of the obsessive compulsive
behavior. These symptoms do not occur in singularly as they rather occur in the form of a
group or cluster of symptoms. The tool used to assess the level and severity of symptoms is
known as the Yale-Brown Obsessive Compulsive Scale. This scale lets the practitioner
understand the presence of disorder according to symptoms. Various categories of signs
allow a psychiatrist to group up to five symptoms in one category. The nature of
compulsive behavior is observed by determining the type of symptoms. It is important for
the observer to understand what ‘Obsession’ and ‘Compulsion’ means in a case of OCD.

Obsession

Obsessions are ideas and beliefs that have deep roots in a person’s mind and despite trying
to give up obsessive mindset; it is hard to negate these thoughts permanently. A time
comes when the person has to listen to the thought and thus, perform the act. When these
obsessive thoughts take over one’s mind, the level of anxiety increases and the person faces
trouble in doing normal daily chores. Only carrying out the compulsive action instigated by
obsessive thoughts relieves anxiety in the patient. People can have clear directing thoughts,
for instance, washing hands is compulsory. They can have blurry and unclear thoughts or
feelings such as confusion, worry, anger, and melancholia. The commonality lies in carrying
out the act itself. In extreme cases of OCD, person relates death to himself or someone as a
consequence of ‘not’ performing the act.

Some of the obsessions are related to external entities or forces as God, Devil, a person, or
even a condition. The victim feels threatened about his family and himself by one of these
forces. Another form of obsession is the feeling of having bulge or growth on the body
while some people believe that non-living things have souls. The nature of obsessions can
be sexual as well where the patient cannot evade sexual ideas of any natural ranging from
normal kissing to incest. People having these obsessions can make sense that their
obsessions are unrealistic and abnormal. However, they believe that they must perform the
related compulsion as it’s their right. In some cases, obsessions do not result in any
compulsive behavior but the obsessive thoughts can lead to anxiety disorder and chronic
depression disorder.

Compulsions
Obsessive thoughts result in performing a related activity that is known as compulsion.
Compulsion acts as a necessary outcome for the person with OCD as there is an increased
need to alleviate anxiety and unrest. That individual may or may not believe that the
compulsion will save him from unwanted outcomes or events. For instance, people who are
obsessively talkative might have a fear of loneliness and depression when quiet. There may
be other insecurities related to their personality and against the insecurities, these
compulsion acts as a way of ‘saving’ themselves. The ideological mind frame of such people
is misshaped to the extent where they can completely justify their compulsive acts. Acts as
lip biting, scratching, hair-pulling, and even self-harm to some degree falls in the
boundaries of OCD. Many otherwise reasonable individuals indulge in such behavior to
ease their symptoms of unrest and tension.

Compulsions following obsessions can be related to cleaning, sexual, supervising or

physical activities. Cleaning acts include washing hands repeatedly, bathing several times a
day, cleaning the house over and over again in a day, and washing clean laundry until they
feel relaxed. It is however, important to differentiate between relaxation that we feel when
we clean out home once it requires work and relaxation that people achieve after cleaning
the already clean house. Sexual activities may include touching one, kissing, or engaging in
sexual activity with one’s partner or on a severe level, it can include rape, incest, child
abuse, and even killing the victim. For instance, rapists who are serial killers tend have an
extreme desire/fantasy to indulge in ‘forceful’ sexual activity with strangers. Once they
have committed the act, their tension is relieved and the cycle continues (Obsession-
Compulsion cycle).

Causes
The causes of OCD are not specific but may include;

Genetic Disorder

People who have a family history of OCD in first relations including mother, father, and
brother/sister are more prone to OCD than those who do not have a family history of OCD.
Studies indicate that twins develop OCD more than that are single born. The research can
explore more genetic aspects related to OCD to improve diagnosis.

Brain Deformities

Studies that involve brain-imaging indicate that there is difference in brain structure of the
people with OCD.

Abusive Past/Present
People with OCD may have spent their childhood with abusive parents or surroundings. It
includes violence, physical abuse and sexual abuse. Some youngsters are going through
abuse when they develop OCD, making it even more challenging for them to live a ‘normal’
life.

Diagnosis and Therapy

The most common method to treat OCD is based on medicines, therapy sessions, or both at
the same time. However, the effect of treatment varies in patients as some respond better
to the therapy while some continue to exhibit symptoms. If the patient has related
conditions including depression or anxiety disorder, he may need treatment for these
disorders to alleviate the signs and behavior of OCD.
References

https://www.anxietybc.com/parenting/obsessive-compulsive-disorder

https://www.psychiatry.org/patients-families/ocd/what-is-obsessive-compulsive-
disorder

https://iocdf.org/about-ocd/

https://adaa.org/understanding-anxiety/obsessive-compulsive-disorder-ocd

https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml

https://www.psychologytoday.com/conditions/obsessive-compulsive-disorder