Reviewed by Aaron Horn, LMFT
Obsessive-Compulsive Disorder is a well-known term with plenty of familiarity in the general public. Far less well known, however, are the ins and outs of OCD—the people it affects, the many ways it can manifest, and the risk factors that can increase the likelihood of receiving an OCD diagnosis. What exactly does the term “Obsessive-Compulsive Disorder” mean?
Obsessive-Compulsive Disorder: A History
Learning more about OCD is important for people who are suspicious of their symptoms. Learning more about your self can be empowering and can help you more fully engage in treatment. The history of OCD is unusual and long and has beginnings in religious texts. The dual symptoms of obsessions and compulsions were once tied to religion and seen as an indicator of religious excitement or zeal. These symptoms were typically acknowledged but not treated and can be found in many sermons delivered by priests in the 1600s.
Modern OCD symptoms and treatments can be found in tomes from the early 1800s, where symptoms of OCD were described as neuroses or, in some cases, partial insanity. During the 1800s and early 1900s, different parameters for anxiety disorders began to be identified and sorted through. Lines that are more distinct were drawn between different disorders, such as panic disorder and various phobias. Because many anxiety disorders share similar symptoms, early mental health professionals experienced some difficulty in teasing out the differences observed in anxiety symptoms. They were more likely to create a single, broad category for an illness than the nuanced disorders and identifiers used in psychiatry and psychology today.
The current definition of OCD has come about after a hundred years of symptoms being studied. Although psychologists may not yet have all of the answers about Obsessive Compulsive Disorder—its origins, a suitable cure, and its exact cause—a continued investigation into OCD has yielded a great deal of additional information, including more effective treatment options, the different ways it can manifest, and the many different ways it can impact an individual’s life.
What Is OCD? An OCD Definition
Obsessive-Compulsive Disorder is a specific type of anxiety disorder, characterized by two central tenants: the presence of obsessive thought patterns or processes and compulsive behaviors relating to those obsessions. OCD can be traced to family histories, environmental triggers, and other genetic probabilities, but the exact cause of the Disorder is as yet unknown. Treatment options for the Disorder can include different types of psychotherapy and pharmaceutical medication, in addition to other lifestyle alterations, such as dietary changes (removing or limiting caffeine), changes to exercise routines (limiting or raising intensity levels), and the implementation of self-care routines. Because the symptoms of OCD can be easy to miss or attribute to other issues, an online quiz can help people clarify their symptoms.
For OCD symptoms to qualify as disordered symptoms, they must cause some degree of distress to the person experiencing them. A compulsion to habitually knock on wood following a potential “jinx,” for instance, would not qualify as a symptom of OCD or an indicator of OCD unless it began to interfere with daily function or caused the person exhibiting the symptom distress. Because two general symptoms of OCD must be present for a diagnosis, there are hosts of symptoms within those two categories that indicate the presence of OCD. Deciphering the difference—obsession vs. compulsion—is an important part of understanding and managing OCD symptoms.
Obsessive symptoms often include one or more of the following:
- Thoughts that feel caught or “stuck.” Obsessive thoughts often seem to be caught or stuck in someone’s brain, and they may be difficult or impossible to dislodge.
- Intense self-doubt. Self-doubt can descend into a spiral of a seemingly unending cascade of self-doubt. Doubts about sanity, safety, and ability are all common.
- Fear of contamination. People with OCD may struggle with the constant fear of contamination. For some, contamination is from germs, but others may fear their thoughts, ideas, or feelings and may exert extreme control over incoming media and ideologies.
- Fear of losing control. People with OCD may constantly fear losing control. This can be the fear of accidentally disclosing their obsessive thoughts and compulsions, fear of losing control and acting on frightening thoughts, or fear of behaving in a way that deviates from the norm.
- Unusual sexual, aggressive, or violent thoughts. Frightening sexual, aggressive, or violent thoughts sometimes occur in OCD, and people with untreated OCD may fear that they will act out these thoughts and struggle to keep them suppressed.
- Intrusive thoughts. Intrusive thoughts are thoughts that cause distress and arise unintentionally or of their own volition. Intrusive thoughts can include focus on ideas, fears, or memories that someone prefers to avoid or forget.
Compulsive symptoms can precede or follow obsessive symptoms, though they are most commonly observed after an obsession has arisen. Compulsive symptoms may or may not include the following:
- Having strict routines. There is a significant difference between routines and habits. Habits are typically done without thinking and do not usually cause pain or distress when they are not followed. Conversely, the strict routines of OCD are intentional and can cause distress if they are not adhered to.
- Seeking reassurance. People with OCD often seek reassurance, whether that reassurance comes from themselves or someone else. In relational OCD, reassurance may be sought externally, and in other forms of OCD, reassurance can come from within.
- Checking and double-checking. People with OCD may need to constantly check and double-check to make sure that everything is in place. They may double-check to make sure a store’s hours are what they think they are or re-check to make sure the stove is turned off each day before leaving the house.
- Making things orderly. People with OCD may not feel as though things must be clean but may have their systems and orders that things must be to feel safe. These “orders” are often checked continually to make sure everything is as it should be.
- Counting is also a common compulsion in OCD, but the exact reason and method behind counting can differ dramatically. Counting steps, counting the flips of a light switch, or even counting seconds with no particular end can all be symptomatic of OCD.
There are far too many compulsions involved in OCD to create a comprehensive list of them, but the compulsions above can cover many compulsive behaviors common to OCD.
Risk Factors For OCD
The risk factors for Obsessive-Compulsive Disorder include genetics, environmental triggers, and personal health histories. These triggers might include:
- Family and personal health history. People with family members who have Obsessive Compulsive Disorder are more likely to develop the condition themselves. Having a personal or familial history of anxiety and depressive disorders can also increase Obsessive Compulsive Disorder risk.
- Age has been considered a potential risk factor, as cases of Obsessive-Compulsive Disorder are considered highest between the ages of 4 and 40.
- Strep infections. A link has recently been identified between PANDAS, a childhood illness related to strep throat, and OCD. Having repeated streptococcus infections and a subsequent PANDAS diagnosis can serve as a risk factor for Obsessive-Compulsive Disorder.
- Significant life changes. Large-scale life changes are also tied to the onset of OCD. Having recently gone through a significant life change—a divorce, the loss of a loved one, or even the birth of a child—can all increase the risk of developing the symptoms of Obsessive-Compulsive Disorder.
What OCD Means
Obsessive-Compulsive Disorder is often discussed but frequently misunderstood as an anxiety disorder. What is OCD behavior? Symptoms of OCD follow a distinctive pattern involving both obsessions, typically in the form of thoughts and images, and compulsions, which are generally tied to obsessions. Obsessive-Compulsive Disorder can affect people of all ages and backgrounds but have some risk factors linked to family history and past incidences of anxiety or depressive disorders. Obsessive-Compulsive Disorder can be a debilitating condition and prevent people from functioning and carrying out necessary daily tasks. While it can be debilitating, it can be managed with little to no resurgence of intense and uncontrolled symptoms.
What OCD means will differ from person to person. For some, the condition requires weekly psychotherapy sessions and dedicated medications, while for others, symptoms are managed primarily through tools learned from past therapy sessions. The symptoms of OCD can rise and fall throughout someone’s life and may leap up in response to new stressors or tense situations before falling again once those situations have calmed down. OCD is a highly treatable condition, but many people who begin exhibiting symptoms do not recognize that their thought processes are disordered and don’t seek help due to a fear of repercussions. Although seeking out help can be frightening, due to the highly treatable nature of the disorder, people with OCD can live healthy, robust lives.