OCD (Obsessive Compulsive Disorder) Treatment

Compulsions can have a seemingly logical connection to the topic of someone’s obsessions, like hiding knives because of a fear of stabbing someone. They can also be completely unrelated, though, like wearing matching clothes to reduce the likelihood of one’s house burning down. It helps to remember that a feeling of responsibility and doubt drives compulsions, not logic. Even if the compulsion seems logical, the person will not stop until they have fulfilled a certain requirement or feel exactly right. This might take several hours into the ritual. No matter how rational or irrational someone’s worries or safety behaviors seem, logic will not break the cycle.

Like many other conditions, OCD is a mix of genets, psychological factors, and life experiences.

Psychological – Individual tendencies like being vulnerable to stress and anxiety, feeling overly responsible, or a sense of perfectionism could be tied into why a person gets so stuck in the OCD cycle.

Environmental – The experiences and societal values someone is exposed to in their life can inform assumptions or pressures that become a part of the person’s OCD cycle.

Sometimes when our mind is filled with very upsetting thoughts, we can try to take actions that will bring us relief and make the thoughts go away. We might start to believe that these actions will get rid of our anxiety or make these thoughts go away. Sometimes having rituals that calm us down helps. But when these rituals or habits become ‘compulsions’, we think we must do them. We might start to believe that if we do not do them, something bad will happen to us, or to the people around us.

With OCD, often our compulsive habits or rituals end up making us feel worse. This is because once the ritual is finished, anxious thoughts come rushing back again, sometimes even more extreme. This is how some people get trapped in a cycle of doing the same action again and again, unable to stop.

OCD rituals can be obvious to other people (like checking if doors are locked) or they can happen inside your head (like counting things or trying to counteract negative thoughts with positive ones).

There is a misconception that ‘being OCD’ is just about being tidy and ordered. Wrong!

OCD thoughts can come in all shapes and sizes and involve different types of habits and rituals. They often revolve around things like danger, dirt, pollution, or worries around sexuality and religion. Some people feel guilty, or even ashamed of their thoughts. Substance use disorders like drinking cause extra shame and guilt on top of the physical and cognitive effects.

Previous definitions of OCD included that some people might experience only obsessions or only compulsions. It is now better understood that all people living with OCD experience both, albeit in less obvious ways.
Someone might perform compulsions that are not directly triggered by intrusive thoughts or obsessions, but this is because of the cycle becoming more automatic in the brain. In these cases, the obsession is no longer a fear of harm, for example, but a fear of the harm-based intrusive thoughts in themselves (obsessing about obsessing). The goal of the compulsions, in this case, is not to relieve anxiety but to avoid it coming up at all.

Even though OCD ranges from mild to extreme, each person’s distress is genuine. Everyone experiences obsessions and compulsions occasionally, but for the experience to be labeled disorder, they must cause pain and impact noticeably on the person’s quality of life.

When someone lives with OCD, they do not experience their worries and rituals as quirks or annoyances, as they might look outside. The intensity of the anxiety and doubt felt on the inside is debilitating, exhausting, and chronic. The irrationality of the cycle gets confusing and horrifying. Furthermore, it can feel ashamed and isolated, or like you are losing touch with reality.

People living with OCD tend to hide symptoms because of the embarrassment someone feels about their irrational worries and behaviors and fear that their intrusive thoughts might be misunderstood. Being aware of what is rational and what is not does not help reduce the anxiety of the OCD cycle, but it allows them to choose what they show to others. 

You might stick to invisible compulsions when around other people as much as possible, have an easier time holding back while you are out, and then get overwhelmed by anxiety and the need for compulsions when you get home. OCD is often referred to as the ‘hidden’ or ‘secret’ condition, and people who struggle with it might even wait decades before seeking any support. Victims are told there is no help available or just need to learn to live with it. 

Some disorders related to an obsessive-compulsive disorder like body dysmorphic disorder, hoarding disorder, social anxiety disorder, excoriation disorder, or trichotillomania are considered separate disorders that require different and specific treatment.