This is a term paper from last semester for psychology. I rather like it.

You know you’re OCD when…

You have to do things in threes.

If you don’t wash your hands… ha, like that’d ever happen.

You wouldn’t mind living in a bubble- granted it was uber clean.

You freak out because when you’re writing in a notebook, it isn’t symmetrical with anything.

You have nightmares that you’re the Anti-Christ.

You don’t like a color red.

Obviously, the above is simply a bit of light humor before you start reading the rest of the paper. However, there is some truth in it. There are many different kinds of OCDs besides the stereotypical constant hand-washing, and several factors that are consistent with those who have it.

Obsessive-compulsive disorder is an anxiety disorder that messes with a person’s brain, resulting in problems with processing information. It consists of two parts (as you can tell by the name). First we have obsessions, and secondly, compulsions. Obsessions are thoughts that a person can’t stop thinking about, impulses, or disturbing images that won’t get out of a person’s head. These are caused by anxiety or distress, and they’re not just being overly worried about problems in real life. A person with OCD tries to ignore or eliminate such obsessions with another thought or doing something that will neutralize them. Compulsions are behaviors that a person has to do over and over again, which a person uses to try to eliminate the obsessive thoughts or in attempts to prevent something “bad” from happening. These might also be caused by obsessions that make them perform such behaviors. They make a large impact in a person’s life as they are time-consuming and interrupt the usual routine. They also take away concentration from school or work, or even relationships with friends and family. (Surgeon General) Individuals with OCD know that their obsessions are not realistic, but they can’t help themselves. (DSM-4) If they can’t complete their rituals, they are likely to become quite distraught.

In a 1980 study of twenty thousand people from New Haven, Baltimore, St. Louis, Durham, and Los Angeles, they found that 2.5 (five thousand) of those surveyed had OCD- and that was just in five cities twenty-seven years ago. According to the OCD Foundation, one in fifty adults has OCD, and one hundred have had it at some point in their life. There are several common factors between the obsessive-compulsive population. Education is shown as a factor; people who graduated from high school are more likely to become obsessive-compulsive than those who didn’t. Correspondently, intelligence seems to be a factor as well. Those who have above-average intelligence (any score above one-hundred) are more likely to have OCD. Other factors include genetics and serious psychological trauma.

Other mentally interesting disorders that may or may not come with OCD are depressions (or even major depression), anxiety or panic attacks, and Tourette Syndrome. (OCD Foundation) However, there are several other disorders that may be confused with OCD, such as schizophrenia, psychosis, and auditory hallucination. In schizophrenia, a person may have obsessive-compulsive behaviors, and in cases of psychosis, they lose touch with reality and their awareness becomes distorted. As for the auditory hallucination mix-up, if someone (particularly children) says that they have a voice in their head, even if it’s their own voice, it could be taken for auditory hallucinations. (Distinguishing OCD From Other Conditions, John Hauser) One other disorder that can be confused with OCD is obsessive-compulsive personality disorder. In OCD, the sufferer is aware that their behaviors aren’t logical, whereas in a person with OCPD, they will defend their behaviors and explain how they’re perfectly rational. Because, after all, needing to line things up so they’re perfectly symmetrical is very reasonable.

Like I said before, there are many different kinds of obsessions, such as contamination, exactness, safety, hoarding, and several other kinds of obsessions. Specific examples of obsessions include worrying about dirt and germs, concerns regarding health (having a disease), needing to have everything parallel or symmetrical, needing to have everything in place, fear of accidentally hurting someone, and worries about whether something valuable was thrown away. There are some obsessions where a person avoids a certain color or number because of association. For example, a person will avoid the color red because it represents blood, or avoiding unlucky numbers, like the numbers six (one short of seven, a lucky number) or thirteen (one short of fourteen). (Common Obsessions, Jim Haggerty)

There’s no cure for OCD as of yet, but there are several treatments. It’s typically treated with behavioral therapy, cognitive therapy, and or medication. Psychodynamic psychotherapy is also a method, but it’s not typically used. (Wikipedia)

Behavioral therapy, when used in treatment for OCD, is a form of reducing compulsive reactions to its catalysts, which include desensitization and relearning. The basic approach is that the patient is presented with a situation that would trigger a compulsive response, but they’re forbidden to react in their usual way. As their obsessions and compulsions reduce, it has the same effect for their anxiety. Cognitive therapy is used to help the sufferer identify why they have such obsessions and why they react the way they do to them. The person will make a list of situations that make them distressed, and they’re asked why they feel the way they do about those situations. They’re also asked to interpret their obsessions and what the obsessions say about them and why they think they have those obsessions. ( Psychodynamic psychotherapy is your traditional shrink-on-patient talk. It has almost the same motives as cognitive therapy, except it delves into a person’s unconscious to look for a reason for the behaviors and thoughts. (Wikipedia)

There are many different medications that can help obsessive-compulsive behavior. Some of these include Paxil, Zoloft, Luvox, Neurontin, Lamictal, and Seroqual. Paxil, Zoloft, and Luvox are selective serotonin reuptake inhibitors (for a clearer explanation, they’re antidepressants that treat depression, anxiety disorders such as OCD, and some personality disorders). SSRIs stop extra serotonin (a neurotransmitter that works in a person’s nervous system) from retreating into the neuron that released it. In turn, the serotonin can connect to the receiving ends of nearby neurons and then send chemical messages that help relieve anxiety and obsessive-compulsive thinking. They usually take longer to help OCD behavior than other disorders it can also help; it may take between two and three months for it to finally start working. As for the non-SSRIs, they’re equally useful, but you have to be careful with the dosage. At a low dose, they work quite well, but if the dosage goes too high, it (ironically) can make people who aren’t OCD start exhibiting obsessive-compulsive behavior.

OCD is one of the most stressful of the anxiety disorders with the constant urges to go spastic on little details and it’s even worse if a person is under stress. But it can be helped, given that it’s understood. In the meantime, please wash your hands.

Bibliography:

DSM-4

OCD (Obsessive-Compulsive Disorder page)

Surgeon General (Treatment of Obsessive-Compulsive Disorder page)

Common Obsessions by Jim Haggerty, MD

Distinguishing OCD From Other Conditions by John Hauser

Wikipedia (Obsessive-Compulsive Disorder, Treatment; Psychodynamic (Treatments for OCD page)

(Just in case you ever wanted to know stuff about OCD's) :)