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5 Things You Should Know about OCD

For starters, it’s a lot more than just quirky mannerisms.

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A young woman with dark curly hair is using mobile phone. Female is smiling while holding smart phone. She is lying on sofa at home.

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  • Your best friend takes forever to get out of the house because she needs to go back to check, and then re-check, that the oven is turned off.
  • Your “neat freak” child arranges all the shoes in his closet so that they’re all lined up exactly the same distance from each other. 
  • Your husband insists on washing his hands all day long.

To the casual observer, all three of these scenarios might be called obsessive compulsive disorder, or OCD. But true OCD involves a lot more than just quirky behaviors. While the main characteristics of OCD are repetitive and unwanted thoughts (obsessions) that lead to irrational urges to do something (compulsions), the behavior must also take up so much time (often an hour a day or more) that it interferes with a person’s ability to function. Another distinguishing characteristic of OCD is significant distress. People with OCD are filled with fear and anxiety over their thoughts and are convinced that the only way they’re going to feel better is to continue their compulsive behavior. 

Here are 5 other things you should know about OCD:

1. While OCD occurs in equal numbers of men and women, there are gender differences

The disorder usually begins to develop during older adolescence or young adulthood, but people can first show symptoms as young as 9 or 10 years of age. Also, for reasons that are not entirely clear, boys with OCD are more likely than girls to also have attention deficit/hyperactivity disorder (ADHD) or tics, which are rapid, repetitive movements or vocal utterances.

2. OCD is often hidden

The most common kinds of obsessions with OCD usually involve fears of contamination. Someone is constantly worried about getting infected with germs or being exposed to an illness, and that leads them to compulsively wash their hands so much that their skin becomes red and raw. Another type of OCD involves a need for symmetry, spending hours ordering or arranging their belongings in order to achieve a feeling of relief.

But not all OCD symptoms are outwardly evident. Sometimes, a person may have unwanted sexual or aggressive thoughts, or they may feel the need to compulsively count things, like the number of tiles on the ceiling or steps on a staircase. We’re also now seeing some kids with OCD who are using their smartphones compulsively. For instance, a child may be constantly swiping their phone, or taking hundreds of pictures all day long. And one person can suffer from many different obsessions and disorders at once without others knowing it. 

3. Some people are more at risk than others

While we don’t really know why OCD occurs, we suspect that it may be partially genetic. OCD is more likely to show up in families that have more anxiety traits and inhibited temperaments. Kids and adults who are shy and slow to warm up, and who are prone to having exaggerated worries and fears, are more likely to have OCD. Additionally OCD is more likely to occur with those who have other mental health conditions such as depression or substance abuse. OCD may also be triggered by significantly stressful or traumatic life events, or in rare cases, by autoimmune reactions to strep throat or other infections.

4. OCD and anxiety overlap, but there are key differences

With OCD, the obsessions cause significant anxiety, and people feel the need to assuage those feelings with irrational and repetitive behaviors. With other types of anxiety such as social anxiety, panic disorder, or separation anxiety, the feelings of distress are usually connected to just one source, and they’re not associated with compulsions or behaviors to fix those feelings. Someone with anxiety might start avoiding situations—for example, skipping parties—and they may become more obsessed with worries over social interactions, but it doesn’t reach the level of repeated behaviors such as checking, counting, or performing rituals.

The other difference is that, while the fear is exaggerated, anxiety disorders are usually based in reality. For example, a child who is anxious about their mother dropping them off at preschool might fear that their parent will not come back to get them. But with OCD, the fears have no connection to real life—a child will think, “If I don’t turn my pillow around 18 times, my mother is going to die in her sleep.” 

5. Treatment is a two-step process

The most effective way to treat OCD is with a therapy known as response prevention, which involves exposing patients to the situations that trigger their obsessions and compulsions. Then therapy focuses on helping the person learn to avoid performing any rituals in response to their feelings. It’s almost like we are re-wiring their brain to respond differently and break the cycle. It can feel very uncomfortable at first, but with each success comes less anxiety.

If someone’s OCD symptoms are severe or they’re not responding well to therapy, a consultation with a psychiatrist, and possibly medication, may be in necessary.

“While the main characteristics of OCD are repetitive and unwanted thoughts (obsessions) that lead to irrational urges to do something (compulsions), the behavior must also take up so much time (often an hour a day or more) that it interferes with a person’s ability to function.”
Dr. Peter D’Amico, child and adolescent psychologist

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Published August 13th, 2019
A young woman with dark curly hair is using mobile phone. Female is smiling while holding smart phone. She is lying on sofa at home.

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