Why OCD is a lot worse than you thought cover image

Why OCD is a lot worse than you thought

Dorian Minors • May 6, 2015

This is an archived article from our predecessor website, The Dirt Psychology. The idea there was to take psychological scholarship and turn it into wisdom. The Armchair Collective tries to go a little further than just psychology. As such, these articles live here in archive form, until they're updated.

Anxiety is a normal healthy emotion. It's thought to be a function of our survival instinct. When we become anxious, our brain gets a bit more active and certain types of anxiety can actually increase our performance in sport or test-like situations. Why? Because anxiety helps us get 'psyched up' in response to some kind of threat. When the bushes rustle, our brains needed something to get it focused and figure out whether we're about to fight some kind of jungle cat. Unfortunately, sometimes our brains get it wrong. For some reason, almost one in five of us (about 14% of adults and 3-5% of kids have an anxiety diagnosis every year) will turn this normal emotion into a disorder. This mini-series will show you how and why.

This is not OCD. This is just quality organisation. However, if you did it because you're worried that IF THE PEN GOES MISSING I MIGHT NOT BE ABLE TO WRITE DOWN THE DETAILS THAT WOULD SAVE THE LIFE OF MY FAMILY, then that could be OCD. This is not OCD. This is just quality organisation. However, if you did it because you're worried that IF THE PEN GOES MISSING I MIGHT NOT BE ABLE TO WRITE DOWN THE DETAILS THAT WOULD SAVE THE LIFE OF MY FAMILY, then that could be OCD.

Obsessive Compulsive Disorder (OCD):

What:

One of the most misunderstood forms of anxiety disorder there is! I bet you didn't know psychologists consider OCD an anxiety disorder. The majority of people I speak to think that OCD is just a need to be neat and tidy, or for things to be in a certain order. OCD has actually slipped into every day jargon. Everyone's a 'bit OCD' about something right?

Well, OCD is actually really distressing. If your 'bit of OCD' doesn't make you want to break down and cry, you're probably just a bit retentive. OCD is characterised primarily by obsessions: repetitive thoughts that are of the exact same thing every time. It could be a thought, image or impulse that happens in the same way every time and the person with OCD struggles to avoid this mental phenomenon as seriously as we'd avoid the plague.

These aren't just irritating. It might be the thought that by your carelessness your house will burn down and your whole family will die. Or a new mother having the repeated image of her stabbing her baby. It's awful and often those suffering from obsessions think it's the result of them being an awful person as opposed to a brain malfunction. So, despite there being no actual likelihood of these events occurring, the person avoids it desperately. But there's a problem there. Every been told not to think of something? It's a joke right? Get told 'don't think of ice cream' and the first thing you think of is ice cream. A paradox. Try to avoid a thought and by definition, you're thinking about it. Well those with OCD have to fight that battle every day. In their head. All the time. This is where compulsions come in. Compulsions are usually formed in response to this obsession.

How:

When someone with OCD has an obsessive thought, they might try various things to distract themselves. Eventually, it's likely that they will and the thought will go away momentarily. What tends to happen is since a particular action happened at the same time as when a thought went away, those with OCD repeat that same thing to try and get rid of the thought in the future. That's why you hear of compulsions  being so specific. Walk into a room five times. Check the lock sixteen. It becomes a ritual, almost a superstition. It happened when exactly this action happened this way, this many times so it has to be repeated like that to work.

Certain obsessions are more common. Symmetry accounts for the most, more than a quarter. This obsession relates to doing something in a specific way.  These often lead to the classic 'neat and tidy' compulsions we often think about.

Second most common are 'forbidden thoughts or actions' obsession, a fear of doing something aggressive and taboo. They might worry they are going to punch a particular person, or do something overtly sexual on the bus. Although these actions are completely unlikely to happen, they lead the person to compulsive checking habits. Mostly, these are logical, like constantly checking the stove. But sometimes, it's completely illogical, like checking behind you every few steps to make sure something terrible doesn't happen to your family.

The third most common are cleaning and contamination obsessions (with obvious compulsions) and hoarding obsessions which is such a weird phenomena that psychologists are considering a brand new disorder for it.

Why:

You can read hundreds of articles on the subject and you'll basically end up with an 'it's complicated'. You can read hundreds of articles on the subject and you'll basically end up with an 'it's complicated'.

Well, it's mostly biological. About 85% of it, according to studies done on (near) 'identical' (monozygotic) twins. Although, it doesn't seem to come from the immediate family (only about 10% of parents will share the disorder). Which suggests it's a kind of build up of unfortunate genes, likely similar to those involved in anxiety.

This biological mix appears to result in a peculiar use of the brain chemical seratonin (involved in mood, social behaviour and memory among other things)  as well as a strange and very hyperactive loop in the brain that creates a excess of 'worry inputs' and a lack of (subconscious) control over an area of the brain that has a hand in the areas involved in OCD. Essentially, the brain is behaving decidedly oddly and in such a complicated way that we're not really sure what's going on.

What can we do?

OCD sucks. It's super complicated and we don't really understand it. But, as a brain malfunction, it can be treated. As Stanford have carefully put it a "modest proportion of patients will achieve freedom from significant symptoms". Reading between the lines - it's not really 'cureable' as such yet. Although there are cases where people have ended up free entirely, usually it's a case of being free of a lot of the symptoms and being able to MANAGE it.

However, it's an intensive process and it very (very) likely won't go away on it's own. One must find a psychologist and a psychiatrist that you can trust (which can be time consuming)) and then be 100% honest. The obsessions and compulsions are probably extraordinarily embarrassing but any clinician worth their salt will not only take it in stride; they'll use that information (the detail, the frequency, the kind) to help you manage them.

More importantly, since OCD often coincides with other kinds of anxiety and depression, both because they are related biologically but because OCD is awful, you being honest will allow them to help you with those as well.

If you know someone with OCD, be someone they can trust. Understand just how debilitating it can be and encourage them to seek the help they deserve. Because they do deserve it.

Anxiety is a complicated issue and one that rears it's head in a number of ways. One in eight have it and there's an 80% chance that's you or someone you know. Learn what an anxiety disorder is and why you should care here in part one of thise mini series. And while we're on the topic of (sometimes) negative emotions, why don't you learn the difference between anger, hurt and hate here. Giving you The Dirt on your search for understanding, psychological freedom and 'the good life' at The Dirt Psychology.

Turning scholarship into wisdom we can use at The Armchair Collective.

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Dorian Minors

I mostly do brain science. Sometimes I train honeybees. I promise they're related. I made this site because there's no reason why scholars should be the only ones to own knowledge. My special interests are interpersonal relationships, the science of community, spirituality and the brain, and the neural basis of complex behaviour. I hope this stuff is as interesting to you as it is to me. You can find out more about me here.