Obsessive-Compulsive Disorder

OCD is characterised by repetitive and persistent thoughts, often accompanied by repetitive behaviours the individual feels compelled to perform in order to relieve the obsessive thoughts.

OCD means an individual must be experiencing either obsessions, compulsions, or both.

Obsessions are intrusive and unwanted thoughts, urges, or images that occur often and repeatedly, which cause discomfort or distress for the individual.

Compulsions are repetitive behaviours or thoughts that a person uses with the intention of neutralising, counteracting, or making their obsessions go away. People with OCD realise this is only a temporary solution, but without a better way to cope, they rely on compulsions, nonetheless. Compulsions can also include avoiding situations that trigger obsessions. They are time-consuming and get in the way of important activities the person values.

Although all forms of OCD have symptoms in common, the way these symptoms present themselves in daily life differs a lot from person to person.

OCD often fixates around one or more themes. People with OCD can have more than one subtype, and their subtype can change over time. Regardless of the OCD subtype, the treatment is the same. The gold standard of treatment for OCD is ERP.

Below are some of the OCD subtypes:

• Relationship OCD (ROCD): This is when you have obsessive doubts about your romantic relationship, leading to constant questioning of your love, attraction, or compatibility with your partner.

• Harm OCD centres on intrusive thoughts or images about harming yourself or others, which understandably cause distress, as well as behaviours like checking or avoiding situations that trigger these thoughts.

• Contamination OCD is an obsession with being contaminated by germs, diseases, or toxins, leading to compulsions like excessive washing, cleaning, or avoiding perceived sources of contamination.

• Perfectionism (’Just Right’) involves has to do with obsessions, urges and compulsions for things to be done perfectly. It’s more about feeling like things are “off” or “not complete” if they’re not done in a particular manner. This can cause compulsions such as excessive checking, organising, or redoing tasks in order to feel ‘just right’.

• Suicidal OCD involves fears that you will harm yourself, and worrying that because you are experiencing suicidal thoughts, you are more likely to act on them.

• Magical thinking OCD — fearing you will be responsible for something bad happening if you do not perform certain actions or rituals. There is often no logical connection between the fear and the action performed.

• Sexual Orientation/Gender OCD is obsessive thoughts about your sexual orientation or sexual identity, often leading to significant anxiety and compulsive behaviours aimed at finding reassurance.

• Existential OCD: This is when you have obsessive thoughts about deep philosophical questions, like the meaning of life, death, or existence, that lead to significant distress and often compulsive overthinking or seeking reassurance.

• False Memory OCD involves an obsession with the fear of having done something bad in the past, with compulsions including ruminating or seeking reassurance about these potentially false memories or events.

• Pure OCD (‘Pure O’) is characterized by distressing and intrusive thoughts that don’t have visible compulsions; the compulsions are usually mental, like reassurance-seeking or mental reviewing.

• Perinatal/Postpartum OCD) usually (but not always) revolves around significant fear of harm coming to the infant, with worries frequently focused on harming the child or the child becoming ill. It is important to note that the occasional experience of all of these worries is absolutely normal and indeed very common in mums and mums to be. However, some people find themselves so distressed that they will take measures to manage their anxiety or prevent their fears coming true. Depending on the worries, this could involve compulsive behaviours such as cleaning, praying, rumination or avoidance of activities or even of spending time with the baby.

• Religious OCD (Scrupulosity) involves intense worry about sinning or violating religious principles, often with compulsions like excessive praying, confessing, or seeking reassurance from others.

• Sensorimotor OCD: If you have a hyper-awareness of certain bodily sensations or processes, such as blinking, breathing, swallowing, you may have this subtype of OCD. The symptoms may go unnoticed by others, but cause distress and difficulty focusing on anything else.