Obsessive compulsive disorder (OCD) is a long-term condition characterized by routine intrusive thoughts (obsessions) or repetitive behaviors (compulsions). In most cases, clients experience an invasive thought followed by a compulsion. Clients may experience both sets of symptoms, which usually begin with obsessions followed by compulsions. Compulsions are certain behaviors that are ritualistic in nature. They are seen as ways of preventing a perceived threat from happening. These are extremely troubling due to the anxiety associated with OCD. For example, someone may feel they need to check every door and window five times each to ensure that the house is safe. In this case, the perceived threat of a break-in is being prevented by ritualistic checking.

Symptoms and Subtypes of OCD

Obsessive compulsive disorder has two parts. Part one consists of unwanted thoughts known as obsessions. The second part involves compulsions. These entail certain behaviors that happen in response to obsessions. Below is a detailed description of each one.

Obsessions

The first feature of OCD involves troubling thoughts, strong urges, or disturbing illusions that evoke moderate to intense anxiety. Examples of unwanted thoughts include:

• Obsession with order: Someone with OCD may feel an urge to place things in perfect order or symmetry. Some examples include anxiety over a lopsided picture or objects that are out of order.
• Fear of forgetting or losing something: Common fears include misplacing house keys or forgetting to turn the stove off.
• Germophobia: People with germophobia have an intense fear of touching anything that’s contaminated. This can include things like door handles, doorknobs, and garbage can lids.
• Fear of the loss of control: Typically, the loss of control is over one’s own behavior or actions.
• Unwanted thoughts of perceived threats or harm: Such thoughts can include a fear of having one’s house broken into.
• Unwanted thoughts that are taboo or forbidden: These include invasive thoughts about religion and sex.

Most individuals who have unwanted thoughts may feel a strong urge to take repetitive actions against them. These are known as compulsions.

Compulsions

Compulsions are the actions taken by individuals with the intention of getting temporary relief from troubling thoughts. A person may feel it’s necessary to commit an action to stand off a perceived threat triggered by such thoughts. Some examples of these OCD symptoms include:

• Uncontrolled handwashing and continuous cleaning as a reaction to germophobia.
• Rearranging items symmetrically or in chronological order to satisfy an obsession for perfect structure.
• Repetitive checking of things like doors, windows, or stoves to gain relief from anxiety. People may count the number of times these behaviors are repeated.
• Repeating words, phrases, or prayers to ward off unwanted evil or blasphemous thoughts.

Most people have thoughts and compulsions from time to time. These experiences are normal and are not a sign of a disorder. The main difference between these isolated incidents and OCD is the frequency and urgency of these thoughts and actions.

Subtypes and Symptoms of OCD

The combination and experience of OCD symptoms is diverse and varies from person to person. Most professionals recognize at least five different subtypes of OCD and their unique symptoms. It’s essential to bear in mind that most individuals with OCD will experience more than one subtype. It’s not uncommon for people to show symptoms of three or more.

Germ and Filth Obsessions and Compulsions

People in this subtype experience discomfort and anxiety when they are exposed to some form of contamination. People may wash their hands after touching a contaminated object. In other cases, people may take more than one bath or shower just to rid themselves of the discomfort of being dirty. Some may develop a compulsion to clean and disinfect their home, car, or office multiple times a day.

Harm Obsessions and Checking Compulsions

Any form of real or perceived harm evokes a fight-or-flight response in most people. It’s natural for most to want to take preventive measures to minimize harm. People will lock their homes and car doors, especially at night. Others may check to see if the stove is turned off in an effort to minimize fire risk. However, a person exhibiting this subtype of OCD double-checks things to the point where the behavior interferes with daily activities.

Obsessions With Mental Compulsions

People with this subtype of OCD may experience unwanted intrusive thoughts about religion or sex. An example would be a person who believes that they’ve committed a horrible deed that requires an act of penance. Those who think vulgar thoughts may follow up with prayers and incantations as a way of evading punishment from a deity. Sometimes, these acts bring temporary peace from impending anxiety due to these thoughts.

Obsessions With Order and Symmetry With the Compulsion to Count

People with this problem have an urgent need to make things “just right” in their environments. The excessive need for order stems from hidden fears of danger and losing control. An example is needing to arrange everything on the desk to ward off the danger of losing a loved one unexpectedly.

Coping with compulsions is challenging, especially when they’re preceded by unwanted, intrusive thoughts. Most people with OCD engage in repetitive behaviors as a means of warding off these fantasies. The trouble is that these same obsessions return with greater intensity. In general, such thoughts are completely irrational and are not founded in reality, yet they feel real to the person who experiences them on a daily basis, and this complicates their anxiety further.

The key to managing obsessive thoughts and other OCD symptoms is to seek help and support. With the right therapist, it’s possible to achieve enough mental clarity to keep symptoms at bay. If unchecked, OCD symptoms will negatively impact a person’s activities of daily living.

Impact on Daily Life

The pain and anxiety which result from persistent OCD symptoms permeates into daily life. Sleep, work, and free time are all vulnerable to disruption due to symptoms. The compulsive need to check all doors and windows at night can impact a person’s ability to sleep. Other common compulsions include disruptions to work, relationships, and personal well-being.

Sleep

Ordinary activities like sleep and rest are disrupted by a variety of intrusive thoughts. Individuals often report obsessing over the same thoughts. Some may think about something they did over 20 years ago to offend someone. Other thoughts revolve around events at work, monthly bills, or social events. It’s not uncommon for people to reminisce over a conversation that they felt went wrong or something they regret saying to another person. Those who experience other subtypes may find the act of going to bed extremely painful. They may check doors and windows several times to ward off potential danger.

Work

Some people complain of a decline in work performance due to OCD thoughts. It’s not uncommon for people to overthink daily tasks to the point where they cannot get much work done. Some people may spend a lot of time reading emails, or they may worry about a problem that has nothing to do with their jobs. Any invasive thought that impedes one’s ability to carry out tasks at work is a sign of OCD.

Relationships and Personal Well-Being

It’s easy to fall into the trap of obsessing over work for people with OCD. Relationships get strained as people delay their social lives in favor of working too much. For example, working at the office late every night can cause harm in personal relationships. Couples could face divorce due to a lack of communication and understanding. Staying late at work rather than spending quality time with a partner may also be misinterpreted as an extramarital affair or lack of interest in the relationship.

OCD symptoms also impact personal well-being on a few levels. People may suffer from embarrassment or shame. Social avoidance is not uncommon, especially as an individual’s self-esteem may be low.

Diagnosis and Seeking Help

Popular culture looks at obsessive-compulsive disorder through a lens that may not be helpful. In movies and TV sitcoms, people who engage in ritualistic compulsions are often laughed off as odd or eccentric. But the real struggles of OCD sufferers are far from funny. People can lose their jobs due to poor productivity and time management. Checking behaviors may take anywhere from 10 minutes to an hour. It disrupts work life and can lead to termination. It is also disruptive when forming intimate relationships and maintaining your social network.

Diagnosis for OCD may involve a psychological evaluation and a physical exam. The psychological assessment will require a visit with a mental health provider. During this appointment, a professional can determine if your symptoms adversely affect your life. The purpose of the physical exam is to check if your symptoms result from a medical condition, not a mental one.

It may be helpful for people diagnosed with OCD to research OCD resources. Here are a few:

• Understanding Unhelpful Perfectionism
• To Be or Not to Be, That Is the Obsession: Existential and Philosophical OCD
• How Do I Stop Thinking About This? What to Do When You’re Stuck Playing Mental Ping Pong

OCD support groups can also be helpful. There is most likely a support group you can participate in near you, but here are a few online ones to get you started:

• OCD New Hampshire – Several support groups for adults, parents, and teens
• OCD Rhode Island – For adults.

OCD Treatment Options

If you have been diagnosed with OCD, Granite Recovery Centers can help. One of the best treatment options for OCD is cognitive behavioral therapy (CBT). Our therapists use a variety of techniques to help clients identify specific stress triggers that lead to OCD behaviors. Individual and group therapy at our centers can help clients learn better strategies for living with OCD.

Unfortunately, it is not uncommon for people who suffer from OCD to struggle with substance abuse. At Granite Recovery Centers, we combine traditional therapy with a 12-step program as a balanced approach to treating substance abuse and OCD. Our clients can take advantage of our 12-step approach to regain control of their lives. Through sharing stories and coping strategies, our clients will learn new ways of living with OCD and embracing a sober lifestyle.

Coping Mechanisms for OCD

Stress is a major trigger for OCD. Recent life events such as moving, the death of a loved one, or changes in employment status can trigger a variety of symptoms. The habit of compulsive behavior is difficult to break, but it’s not impossible. At Granite Recovery Centers, we encourage our clients to find ways to redirect themselves from their obsessions. Some good coping mechanisms include using fidget toys, humming a tune, or walking around. Clients can also consider journaling as a way of coping. Getting unwanted thoughts on paper allows the clients to free themselves of obsessions. Writing a short story or a poem may be a positive outlet for troubling emotions.

To learn more about our programs, visit Granite Recovery Centers today.