When the Thoughts Won’t Stop: Getting Help for Obsessive-Compulsive Disorder
TV shows like Monk depict a classic case of obsessive-compulsive disorder. Adrian Monk is a freelance detective whose OCD is presented as a need to keep his hands clean and everything in his environment straight and neat. When life intervenes with his sense of order, Monk experiences intense anxiety.
While OCD is certainly associated with ritual hand-washing and a compulsion to keep everything in its place, that simplified view alienates many different and subtler ways that OCD can affect a person’s well-being.
What is Obsessive-Compulsive Disorder?
Obessive-compulsive disorder is classified as a type of anxiety disorder. The definition of OCD in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), is as follows:
“Recurrent and persistent thoughts, urges or images that are experienced, at some time during the disturbance, as intrusive, unwanted, and that in most individuals cause marked anxiety or distress.The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some thought or action (i.e., by performing a compulsion).”
The DSM-5 adds that the obsessions or compulsions are time-consuming or cause significant distress or impairment in day to day functioning.
Because other disorders can mimic OCD, someone diagnosing a patient must ensure that the patient’s symptoms are not caused by another disorder. Generalized anxiety disorder, body dysmorphic disorder, and eating disorders are just three of the many disorders that can look, on the surface, like OCD because they involve high anxiety and an attempt to strictly control that anxiety through compulsive or ritualistic behaviors.
What Does OCD Look Like?
Contrary to popular understanding, OCD is not always easy to recognize. Not everyone who has OCD expresses their anxiety through obviously compulsive behavior. Sometimes OCD takes place primarily on a thought level. Instead of using a certain behavior to “neutralize” an unwanted thought, some people may use another thought.
For example, if I have a lot of intrusive thoughts that make me feel like I’m a bad or dirty person, I may wash myself compulsively…OR I may try to push out the “bad” thoughts by obsessively reciting a prayer or chant.
But wait, you might say. Isn’t repeating a prayer a great solution to stopping unwanted thoughts? It’s true that sometimes mentally repeating a prayer can be calming or heartening in someone who does not have OCD. But when OCD is present, the repetition itself will become excessive and cause anxiety. The person is afraid to stop repeating the prayer. That’s very, very different from using a prayer for comfort.
What are Common Obsessions and Compulsions?
According to the Mayo Clinic, obsessions often have several main themes, listed below verbatim:
- Fear of contamination or dirt
- Doubting and having difficulty tolerating uncertainty
- Needing things orderly and symmetrical
- Aggressive or horrific thoughts about losing control and harming yourself or others
- Unwanted thoughts, including aggression, or sexual or religious subjects
Someone might have intrusive thoughts, for example, about being tortured. These thoughts just appear out of nowhere and cause significant distress. This is where compulsions come in. Sadly, compulsive behaviors or thoughts can offer only temporary relief and can end up causing even more anxiety. The Mayo Clinic lists some examples of common themes that compulsions can take:
- Washing and cleaning
- Checking
- Counting
- Orderliness
- Following a strict routine
- Demanding reassurance
Some specific behaviors someone with OCD might engage in include arranging one’s shoes or closet in a certain way (by color, theme, purpose, etc.) or creating a simple ritual that must be performed before starting the car, going to bed, or any number of things.
Many people enjoy having routines and order in their lives, and such things can make life more efficient and convenient. The sense of orderliness becomes a problem when it begins to interfere with one’s ability to function at work, school, or in relationships. Being orderly out of fear versus being orderly because you find it helpful and enjoyable are very different things.
How is OCD Treated?
If you think that you or a loved one might be suffering from OCD, help is available. Depending on the severity, OCD is typically treated with a combination of medication, therapy, and self-care. It’s not a condition that will disappear, but it can be managed well enough to allow you to function with greater ease and well-being.
Cognitive-behavioral therapy is particularly helpful for OCD, because of its focus on being aware of one’s automatic thoughts and questioning their validity. This kind of therapy teaches clients how to observe their obsessive thoughts without being triggered by them into thinking or behaving compulsively. It teaches clients that a thought is just a thought; it has no magical power to cause harm on its own.
The main medication used for OCD is an SSRI (selective serotonin reuptake inhibitor) antidepressant. This increases the level of serotonin in the brain, which can ease symptoms of OCD.
When the Thoughts Won’t Stop, Think Miramont Behavioral Health
Our facility in Middleton, Wisconsin, offers compassionate, professional treatment for all anxiety disorders, including obsessive-compulsive disorder. Our treatment program includes therapeutic groups and educational classes for adults and adolescents focused on addressing each client’s individual needs. When inpatient or outpatient treatment at Miramont comes to an end, we help you connect with ongoing care in your community.
