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Obsessive compulsive disorder is an anxiety disorder with distinct characteristics, affecting up to 3 percent of the general population. The “obsessive” part of the disorder refers to uncontrollable and repetitive thoughts, while the “compulsive” component refers to uncontrollable and repetitive behaviors. This common anxiety disorder may range from mild to life cripplingly severe.
There are two types of obsessions: autogenous and reactive. The Journal of Anxiety Disorders discusses autogenous OCD and its treatment with cognitive therapy. A person with autogenous OCD has thoughts which will pop into his head that are often something he might feel guilty about, such as sexual thoughts. These thoughts might also be violent in nature, such as having a sudden image flash in their mind of raping or punching someone. While certainly distressing, these thoughts are rarely acted upon.
Reactive thoughts in OCD are prompted by some real external stimulus--something someone sees or hears. For instance, seeing some trash on the ground might elicit thoughts about the danger of germs. People are more likely to react to reactive thoughts; for instance, constant cleaning might result if one perceives his environment has been exposed to germs.
Types of Compulsions
A person might develop a compulsive behavior about anything, any idea, any procedure. Anything that can be done, can be overdone. There are some compulsions that are more common than others. The top two are washing/sanitation and aggression/harming.
These people might be considered “germophobes,” and their compulsive behavior would be to wash their hands or surfaces over and over. No amount of scrubbing brings them relief, or if it does, it's temporary as they soon perceive more germs infecting the area.
It is not uncommon for someone with OCD to be concerned about safety. This is at the core of many of the obsessions and can manifest in a number of ways: Some are afraid that they will hurt other people, some are afraid something bad will happen to them. They have violent images pop into their minds. These people usually have no history of violent behavior and typically do not act on these ideas, but they fear that they will suddenly lash out at someone.
In small doses this might be a very useful trait in an employee, but the arranging, grouping and other behaviors when continuous can be disruptive. For instance, this person might feel compelled to lay their pencils down according to length, and keep them in perfect order. This person may be obsessed with numbers or colors.
It’s normal when leaving the house for a vacation to “double check” that the door is locked, or the light is off, or that the stove is not on. If, however, after that double check the door is checked again, and then again, there might be problem. Checkers perceive an exaggerated risk if the door is left unlocked or the lights are left on. They may have an exact number of times they feel they need to “check,” or they may have a procedure they need to follow for the “check” to be valid in their mind.
Chronic overeating is sometimes referred to as “compulsive overeating.” Although the psychology behind overeating is somewhat different than the other compulsions, it can have an equally devastating effect on a life. Simple overindulgence does not qualify as OCD; the problem is more when the person must be chewing at all times or goes from one meal to another, even when satiety is reached, or, if they have certain peculiar beliefs and rituals about the eating. These may be that they count calories relentlessly, or do things that don’t make sense to the rest of us such as eating the food on the right side of the plate first, or chewing a certain number of times.
Those who lose excessive amounts of weight may have anorexia nervosa (not a type of OCD); however, a person might also not eat because they think the food is tainted, which could be a symptom of OCD.
Another atypical compulsion regards religion. Though it is relatively rare, perhaps 5 percent of those suffering with OCD have what is sometimes called “scrupulocity.” Some people are so afraid of falling from the graces of their perceived god that they can become obsessed with prayer. This is the person who prays or reads the bible much of the day, feeling anxiety the whole time. They may be wracked with guilt over minor transgressions and confess over and over for the same small misbehavior. They may also have rituals of a religious nature that they perform over and over, not as prescribed by the religion. These rituals are likely to be personal in nature, but may include continually lighting candles and praying at the least provocation. The person with a religious OCD may be less likely than other sufferers with OCD to self report. They are less aware that there is something wrong.
Hoarding is considered a specific type of obsessive compulsive disorder and is characterized by an inability to get rid of possessions, even when they become defunct or useless. Hoarders may have stacks of newspapers or other useless items, and may fill their personal living space to the point of creating an unsanitary living situation.
OCD symptoms respond fairly well to the treatments for other anxiety disorders. Psychiatrists prescribe antidepressants, especially those which make more serotonin available in the brain. Cognitive behavioral therapy is also an effective treatment, especially with a therapist specializing OCD.