Obsessive-Compulsive Disorder (OCD)
How are we going to approach this post? As I said in the first post, we will look at the specific disorders from an inside-out
perspective.
Therefore, we'll look at the following questions.
First what the specific disorder actually is. A definition in other words. A quick outside view of it.
Then we'll look at how that disorder actually feels like. What it is like, living with it. This will probably be the biggest part of every post, since it's what my
goal with this thread is. To help you better understand it.
Then we'll go through the differen treatment options and to end the post, list further resources on that topic.
Let's jump right into it.
What is OCD?
Obsessive-compulsive disorder (OCD) is an anxiety disorder. It has two main parts: obsessions and compulsions.
- Obsessions are unwelcome thoughts, images, urges, worries or doubts that repeatedly appear in your mind. They can make you feel very anxious (although some people describe it as 'mental discomfort' rather than anxiety).
- Compulsions are repetitive activities that you do to reduce the anxiety caused by the obsession. It could be something like repeatedly checking a door is locked, repeating a specific phrase in your head or checking how your body feels. (source)
Maybe you have heard someone say the phrase "I'm so OCD" or "that's so OCD" reffering to them being a little bit too tidy (like sorting their wardrobe by colors).
OCD, though, is not determined by things you
like to do, or things that make you
slightly uncomfortable (like turning the car radio to an even number or one that contains a 5).
The
D in OC
D is for
disorder, meaning it causes significant distress or impairment of personal functioning
(source).
What does it feel like, living with OCD?
Imagine yourself being, let's say, 12 years old.
You're driving with your mother to an electronic shop. You're nervous. And for a good reason. You're about to get your first mobile phone.
Excited you stand by your mom during the whole process. Looking for the phone you've picked beforehand. Waiting in line.
You're 12, so of course the contract has to be in your mom's name.
She signs and everything and then, finally, handles you the box that contains your new and very first phone.
You look up to your mom, smiling, thankful, excited.
When suddenly a thought strucks you.
"Whew, everything worked, I got the phone. Now you can die, mom."
Your smile evaporates. You're horrified. Was that... was that your thought? Did you just... did you think that?
The whole drive back home the phone lays in your lap, while you stare out the window. You think. You analyze. You try to neutralize the thought.
You'd never think such a horrific thing. You love your mom! You'd never want to see her suffer, not to mention die.
You feel like this guilt will never go away.
But soon you'll realize, that you are having more thoughts like that. Not just those, that make you feel guilty. You also start to feel responsible.
What if you don't turn that light switch on and off until it... just feels right? Mom and dad are away at friends. They could have a car accident. Better turn it on and off one more time, and one more time, and one more... until it feels right.
Why are you having those thoughts? Those feelings?
You have no idea.
All you know is, that they are not normal. So, you can't be normal, right?
You know that they make no sense. No amount of turning that F*cking switch on and off will cause or prevent an accident.
But that rest of a doubt, that what if, holds you in its tight anxiety soaked grasp.
If you'd just turn that switch again. If you'd just explain to yourself one more time, why you'd never wish harm on your mother. All the pain inside, the anxiety, the uncertainty will go away.
So you turn it again. You explain in your mind how much you love your mom. And the anxiety, the worry, the uncertainty eases its grasp and you feel relieved.
Until it starts all over again.
That's quite a long, but still a little insight into two of the first intrusive thoughts I experienced as a child/teenager.
OCD varies widely from person to person. Usually attacking what's most important to one. The parents. The partner. Ones self-worth. Ones child. Ones morals. And so on.
To explore even a little bit of a wider range of experiences, let's have a look at how others, suffering from OCD, describe the disorder in their words.
OCD is not quirky or goofy. Being a germaphobe is just a small aspect of having the disorder; it affects things you wouldn't even think of. Shit like "Monk" portrays the disorder disingenuously.
What most don't realize is there is also an internal aspect of OCD that you can't see. It's terrifying sometimes.
Ever have a horrible intrusive thought enter your mind randomly? It's pretty normal, and most people brush it off. When you have OCD you can't do that. The intrusive thought goes on a loop in your head because your mind perceives it as a real threat. These thoughts can lead you to believe you are a horrible person, when you know you are not. (source)
This...
Pure-O OCD (officially Primarily cognitive obsessive-compulsive disorder). A lot of people don't even really know it exists. Very few observable compulsions, most of it just takes place in your head.
I constantly have intrusive thoughts of severe self-harming. Doing dishes near a garbage disposal? Thoughts of jamming my hand into it and turning it on. Cutting vegetables? Slamming the knife down on my fingers. Mowing the lawn? Running the lawn mower purposefully over my feet.
It's exhausting. And people don't believe I have OCD, because I'm not constantly flipping light switches on and off, checking my door over and over, etc. (source)
And this...
Mine was so hidden as a child that my parents never knew about it. Routines can look like quirks or fear when they’re contained to specific things. My intrusive thoughts will sometimes play the same one line of a song or a phrase over and over and over till I feel like screaming. But no one can truly understand that feeling unless they’ve had it. (source)
If you type "what does OCD feel like?" or "OCD experiences" into Google, Reddit, Quora, you'll get hundreds, probably thousands of personal experiences and descriptions of how it feels for the specific person writing about it.
Here is one, although fictional, quote from a Stephen King short story on OCD:
“I have seen many cases like N. during the five years I've been in practice. I sometimes picture these unfortunates as men and women being pecked to death by predatory birds. The birds are invisible - at least until a psychiatrist who is good, or lucky, or both, sprays them with his version of Luminol and shines the right light on them - but they are nevertheless very real. The wonder is that so many OCDs manage to live productive lives, just the same. They work, they eat (often not enough or too much, it's true), they go to movies, they make love to their girlfriends and boyfriends, their wives and husbands . . . and all the time those birds are there, clinging to them and pecking away little bits of flesh.” - Stephen King, N. a story from Just After Sunset (
source)
Okay, we looked at a basic understanding of what OCD actually is aswell as some personal perspectives on what it feels like to live with it.
I think this will give you quiete a good, even if still simple, understanding of this disorder.
Let's summarize it, before we move on:
An OCD cycle usually starts with an intrusive thought. It may be one of harming oneself or others. One of doubt (about your feelings for your partner, your sexual orientation, your morals, etc.) One of uncertainty ("did I really put the stove off?"). Or pretty much anything.
This thought, image, urge or feeling will cause anxiety, discomfort and/or a feeling of dread within the sufferer.
Though he or she knows, that it's illogicial, the sufferer will feel the need to do a compulsion (phsysical like touching something with your left hand if you touched it with your right before, or mental like counting, analzying a thought, trying to neutralize it) to alleviate the pain the anxiety creates within this person.
The complusion will indeed relieve him or her for a while. But only until the next intrusive thought comes. Basically making it worse and worse with every compulsion.
Alright. With all this in mind, let's move on to the next question.
What help is available for OCD?
We now know, that doing the compulsions will not relieve the sufferer from his or her anxiety and pain inside for long. Actually, the more one engages in compulsions, in other words, the more importance one gives his or her thoughts, the more confirmation this will be for the brain, that it's working the right way, when clearly it does not.
Somewhere I read the metaphor, that when you suffer from OCD it's like your brain's danger detectors are not working correctly.
Pretty much everybody gets those intrusive thoughts.
People without OCD will just shrug them off as thoughts. Basically, what they are.
With OCD, though, the brain detects those thoughts as a thread. Like a submarine sonar detecting fish swimming by as enemy submarines.
So, how can we treat this disorder? Or, is there treatment available at all?
While there is no cure to this day, OCD can be treated. And that pretty good.
It would blow up this post to go into the details of the available treatment forms, so let's just list them with the proper links for more information on them.
There is medication available for treating OCD, they treat only symptoms though, not the disorder itself.
While there's no cure for OCD, one can learn to live with it and alleviate his or her anxiety and pain.
Two approaches that are proven to be of tremendous help for sufferers are
Cognitive Behavioural Therapy (CBT) in connection with
Exposure and Response Therapy (ERP).
One comment on ERP...
To anyone with OCD reading this, there is a way out. Look up OCD exposure therapy. ... I was super sceptical because I've had OCD since I was a child and tried to get rid of it myself many times, but by God did it work. I haven't done any mental or physical rituals since January and I couldn't be happier.
In principal it sounds really simple. You know that feeling when the discomfort sets in and you have to complete a certain set of rituals? That's the alarm center in your brain telling you that something is off and the only way to get rid of the discomfort is to perform your ritual. The point of the therapy is to let the discomfort come to you and not perform your rituals until the alarm center calibrates and says to you, huh, nothing bad happened even though I didn't perform my ritual. ... (source)
Further links on
CBT and on
ERP.
So, alright. I feel like this post is pretty long already, so we should probably wrap things up, even though it feels like there's a lot of things to say about OCD still.
Therefore, I'd like to point you into the direction of further resources, if you are interested in understanding this disorder.
More posts on what it feels like to suffer from OCD on
Quora and on
Reddit.
An AskReddit thread called:
"I often sit by my window and think "I could get shot in the head right now by a sniper". Reddit, what odd thoughts do you have on a daily basis?"
Sounds kinda silly? Not for an OCD sufferer. It can be quiete eye opening to see what random and weird thoughts people not suffering from OCD are having, to get a better understanding of intrusive thoughts.
A forum dedicated to OCD and dealing with it:
OCD Action.
This book here:
The Mindfulness Workbook for OCD: A Guide to Overcoming Obsessions and Compulsions Using Mindfulness and Cognitive Behavioral Therapy (New Harbinger Self-help Workbooks)
Alright. I think that's it for this post.
I hope it is helpful for you. Either in dealing with this disorder yourself, knowing someone who does and wanting to better understand it. Or just out of curiosity on the subject.
The next post will be on PTSD.