Compulsions are behaviors that are repetitive and that are often ritualistic in the way that they are performed.  These behaviors are intended to help suppress the anxiety that accompanies OCD.  Again, patients exhibiting these behaviors know that they are irrational, but because performing them offers relief from anxiety, they are seen as the only way to make the thoughts stop.

OCD compulsions

Some common compulsions experienced by people with OCD include the following:

• Constantly asking others for assurance

• Avoiding certain places and situations

• Constant cleaning, even after an object has already been cleaned or sanitized

• Constant counting

• Doubting and checking (common with stoves, locks, etc)

• Hoarding of possessions

• Constantly ordering, arranging, and rearranging

• Repeating behaviors, such as tapping or saying the same word or phrase

• Repeated praying or ritual

• Excessive bathing or hand washing, such as washing hands until they are raw

• Following a meticulous and deliberate order for certain tasks

With compulsive behaviors, the defining factor is that they are done to an extreme degree.  While checking to ensure that you have locked the door is a perfectly natural behavior, someone with OCD may return home frequently to check the locks.  People with OCD may also spend countless hours cleaning a single space, such as when preparing the bathroom for a shower, and will do so with a very meticulous order.  It is also not uncommon for patients with OCD to shower for hours at a time or to have to repeat certain words, phrases, or prayers a specific number of times.

It is common for people to dismiss people with OCD as perfectionists or superstitious, but the truth is that the behaviors exhibited feel as though they must be done.  Unless a patient with OCD gives in to compulsions, the amount of anxiety and fear experienced can be crippling.  Unfortunately, while the behaviors are performed to help alleviate anxiety, they often cause greater disruption and distress for the patient.

What Causes Obsessive Compulsive Disorder?

There is no clear answer to what causes OCD.  Studies show that there can be a genetic link, though whether these links are based solely on genes or whether a child being raised in an environment where OCD actions and behaviors are part of everyday life plays a role is not entirely known.  If one identical twin has OCD, there is a 75% chance that the other twin will also have the condition, and the chances are around 50% for fraternal twins, lending some credence to the notion of a genetic link.

Obsessive-compulsive disorder is also common for women who are in the postpartum period.  Studies show that up to 30% of women may exhibit symptoms of the condition in the months following the birth of a child.  This often presents in frequent washing or checking the baby, constantly rearranging the baby’s crib or room, or repetitively calling the physician to ensure that the baby is okay.

Environmental factors can also play a role in causing or triggering obsessive-compulsive disorder.  Trauma, abuse, relationship, work, or school problems, illness, and changes in living situation can all cause or worsen OCD symptoms and behaviors.  It is also believed that a deficiency in serotonin can cause OCD and that regulating serotonin production can help to alleviate the condition for some patients.

How Is Obsessive Compulsive Disorder Treated?

Treatment for obsessive-compulsive disorder is most successful when behavioral therapy is used.  A form of therapy known as exposure and response prevention therapy is the most effective for patients with this condition.  With this method, a therapist will work with the patient to help identify unreasonable obsessions or compulsions and then prevent the patient from acting upon them to show that there will be no catastrophic results or effects.

A common example of this form of therapy would be to shake hands with someone who is afraid of germs or forcing them to touch money without allowing them to immediately wash their hands.  Over time, this therapy can help a patient learn to control anxiety without giving in to their obsessive thoughts or compulsions.  Not only can this force patients to learn new ways to deal with their anxiety, but it helps them to learn that their obsessions will eventually disappear if they are ignored or not catered to.  The therapy can take some time, but has proven to be incredibly effective.

Relaxation techniques are also a common treatment for obsessive compulsive disorder.  Studies show that these techniques are at least partially effective for between 60% and 70% of patients.  With these techniques, patients are often able to help control the panic or anxiety response to obsessive thoughts or compulsions.

Pure Obsessional OCD

Pure Obsessional OCD

Before concluding this chapter, it is important to note that it is possible for some patients to exhibit what is referred to as pure obsessional OCD.  With this form of the condition, a patient will experience obsessive thoughts in the absence of compulsions to perform certain acts or behaviors.  With obsessional OCD, a patient will likely have thoughts or mental images of committing acts of violence, sacrilege, immorality, or sexuality without the observable compulsion to act on them.

Summary

OCD is one of the more common anxiety disorders.  It can present in a very wide variety of ways, including a vast number of different thought patterns and behaviors.  If you believe that you or someone you know may have obsessive compulsive disorder, therapy can be incredibly effective at helping you break free of these thought patterns and urges.

Could I Have Obsessive Compulsive Disorder?

Determining whether or not you may have OCD can be difficult.  The following questions are not intended to diagnose you, but to help you know whether it may be a good idea to bring up the idea of the disorder with your physician or mental health professional.

Do you have recurrent and persistent thoughts, images, or impulses that are felt as inappropriate or intrusive and that cause distress and anxiety?

Are these thoughts, images, or impulses more than just excessive worry about real life problems?

Do you try to ignore or suppress these thoughts, images, or impulses or to neutralize them with other thoughts?

Do you know that these obsessional thoughts, images, or impulses are a product of your own mind?

Do you feel driven to perform repetitive behaviors or mental acts in response to your obsession or in accordance with rules that need to be rigidly applied?

Are these behaviors or mental acts aimed at preventing or reducing distress or a dreaded situation or event?

Are these behaviors or mental acts excessive or not connected to what they are supposed to neutralize or prevent?

Have you ever recognized that these thoughts, images, impulses, or actions are excessive or unreasonable?

Do these thoughts, images, impulses, or actions caused marked distress, consume more than one hour per day, or significantly interfere with your routine, your job, or your social activities?

If you have answered yes to most or all of these questions, it is important that you speak with someone about obsessive compulsive disorder.  A physician or mental health professional can help you learn if this condition might be the cause of your symptoms and can help you find a treatment that will work for you.  Learning the cause of obsessions and compulsions can help you go a long way towards breaking them once and for all.