Obsessive Compulsive Disorder (OCD) is a term that is used pretty often colloquially, but many people overlook the nuances, complexities, and various shapes and forms that this condition can have. People often associate OCD with someone who likes organization and structure and cleanliness. While these are sometimes characteristics of OCD, it is not the only form.
People with OCD have obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, that usually lead to anxiety. Compulsions are behaviors that are performed in an attempt to reduce the anxiety caused by the obsession. Compulsions can be physical actions, but can also be mental rituals, like counting, repeating mantras or prayers silently.
While it’s true that some people with OCD feel anxious when things are out of place (and try to restore order to reduce that anxiety), there are actually a variety of subtypes.
- Contamination – involves fear of germs, contamination, and dirt. Some people are concerned about getting sick, others may worry that they could spread their germs to others. Compulsions often include things like frequent handwashing, use of hand sanitizer, excessive worry about things like dirty doorknobs, bathroom sink faucets and the like.
- Harm – Another subtype of OCD involves frequent, unwanted, intrusive thoughts and images about harm happening to yourself, your belongings, or to others, often loved ones. This can even include images of yourself doing things to harm others. For example, some new mothers have post-partum OCD symptoms, and envision harming their own child, even though this is the last thing they would actually do. However, you can see how this would cause a tremendous amount of distress. This could also include worry about hitting someone while driving a car, and every small bump or pothole might be perceived as possible evidence of hitting a pedestrian. This can also include fear of something happening to your house, e.g. if you are leaving for the day, is the oven off? Did you lock the windows? Doors? The compulsions that are frequent with this subtype of OCD are checking rituals. Checking to make sure the baby is still breathing, circling the block to check to make sure there are no bodies, checking and rechecking the stove and locks, etc.
- Obsessions without outward observable compulsions – Sometimes also called Pure-O, or obsession only OCD, this subtype is less well understood because it does not look exactly like the other forms of OCD that have compulsions. Some thoughts that are common with Pure-O OCD are things like:
- Do I really believe in my religion?
- Am I a rapist?
- Am I a pedophile?
- Am I gay?
These obsessions often cause a lot of distress and are usually not indicative of the underlying fear being true. Keep in mind that exploration and questioning are normal, and that everyone has unwanted intrusive thoughts from time to time, but when they start to interfere with functioning and / or cause distress, it could be useful to reach out for help. This is also not an exhaustive list, so definitely don’t be embarrassed about reaching out for help for any kind of troubling thoughts you might be experiencing.