Kevin Huang, BSc Pharm Candidate
Intrusive Thoughts
Imagine yourself walking along a street when you’re suddenly interrupted by an intrusive thought of losing someone precious. Like anyone else, you try to reason with yourself – you know it’s just your mind making you worry over something that isn’t real, but it keeps coming back. You’re afraid, anxious, and scared. The only thing that seems to help with your anxiety is counting to 10. Not 9, not 11, but 10. It has to be “just right”. You begin to feel better for a moment, but the anxiety never fully goes away. So you begin to count, again and again, hoping this thought will just go away. For many people with OCD, these thoughts never fully disappear.1
This is one of the many struggles people with OCD may face. Unrealistic intrusive thoughts drain their energy, forcing them to find “rituals” to mitigate their anxiety. Obsessive-Compulsive Disorder (OCD) is a mental illness which can affect anyone. Although it may be challenging, there are many ways to manage the condition. The best way to start is to learn what it’s like to live with this condition, and how it works.
Mythbusting
OCD is one of the most misunderstood mental illnesses. Like any mental illnesses, there are many myths around the subject. Some of them may be true, but many are inaccurate. Today, we will dive right in and debunk these myths to help you better understand this condition.2,3
- Myth 1 – They are just stressed, overreacting, and need to relax: For healthy individuals, stress management can be as simple as taking a long, deep breath. However, people affected by OCD are dealing with uncontrollable fears or worries. Furthermore, stress can worsen their symptoms, making it extremely difficult to cope. Only through certain actions, often termed “rituals”, can they start managing the anxiety.
- Myth 2 – People with OCD are just really organized: For people who compulsively clean because of OCD, it’s often due to an underlying obsession that bad things will happen or certain fears will come true unless they organize everything. By cleaning and organizing, some people with OCD feel like they have some control over their obsessions.
- Myth 3 – People who have OCD are germaphobes: Through media representation of people with OCD, it’s often perceived as a disorder associated with cleanliness or germaphobia. These can be parts of OCD, but not all people with OCD suffer from them. OCD comes in many forms, some of which may be more evident than others.
- Myth 4 – OCD is a useful trait: Double checking your work to make sure it’s right is a good trait. The difference between that and OCD is that “double checking” is much more than that. “Checking” habits in those with OCD can be extremely specific, time-consuming and excessive beyond the point of usefulness.
- Myth 5 – People can only have one type of OCD: Obsessions can change significantly at different stages of life. Individuals may face new life experiences which could change the way their illness presents. Due to this, treatment and counselling must be flexible in order to be effective and to ensure the best outcomes.
Obsessions & Compulsions Defined
To properly understand OCD, it’s important to understand the two defining traits of the illness: obsession & compulsion.
At one point in our lives, we were all obsessed with something. It could be your favourite dish, the new latest hit, or that series on Netflix. These things consume a good chunk of our time, but we tend to enjoy them. Unfortunately, this isn’t the case with OCD. People struggling with obsessions tend to have “unwanted and repetitive thoughts, urges, or images that don’t go away.”4 These are fears which haunt people with anxiety, making it difficult to live their lives. This could be the fear of losing a loved one, hitting someone while driving, unwanted inappropriate sexual thoughts, blasphemous or religious thoughts, or avoiding certain numbers or colours – to name just a few.
It’s normal for everyone to experience a variety of intrusive thoughts, but what differentiates OCD is that the brain is unable to dismiss these thoughts for what they are. The brain of a person with OCD thinks these thoughts are valid and that it must do something to reduce guilt and discomfort or prevent certain things from happening.
As a result, many individuals will perform repetitive “rituals” or compulsions in an attempt to manage their anxiety. These can be any actions including hand washing, counting, tapping, or organizing things in a specific, particular manner.4 Sometimes, rituals may help mitigate some of the stress, however, over time the symptoms will usually persist. This forces the individual to repeat the process over and over again until the obsession goes away and for everything to feel “just right”.
Compulsions only offer short-term relief from anxiety, but over time, the mind falsely learns that they’re an “effective” way to deal with the anxiety. This only serves to reinforce the compulsions more deeply. For someone without much insight into their condition, performing these compulsions are the only way they know how to deal with the obsessions. With OCD being one of the most undertreated mental health conditions, people may struggle with their obsessions and compulsions for their whole lives.
Over time, compulsions often grow to be more complex and time-consuming, so much that they may disrupt a person’s day-to-day function and activities. A person with “checking” OCD (see below) may spend fifteen minutes ensuring the stove is off before they can leave their house in the morning. They may have to check that the door is locked a certain number of times before they feel at ease. They may then spend more time checking the air pressure in their tires before starting their car, worried that their tires will blow out while driving. While each compulsion individually may not significantly disrupt a person’s life, people with OCD often struggle with multiple obsessions and compulsions together which impacts their quality of life and ability to function.
Types of OCD
It’s important to understand that there are different types of OCD and that it’s a unique condition in that it presents differently amongst different individuals. Because of this, treatment and care must be individualized to specifically meet the person’s needs. A few examples of the different types of OCD can be seen below:5
- Checking: You’re afraid you’ll burn down the house. You know the stove is off, yet you have to check again. The anxiety still lingers, so you continue to check, over and over again, until everything feels “just right.”
- Counting: “If I walk through that door, I have to take 10 steps. If I forget, then I have to start over again. If I don’t, my obsessive thought of (e.g. family member getting hurt) will come true. If I miscount, then I have to start again.”
- Contamination: “I’m worried about getting my family sick. If I touch anything, I’ll get my hands dirty. I have to wash them over and over again. If they’re still not clean, I’ll have to keep washing them … over and over again.”
- “Just Right”: “Everything must be placed in a certain way. Books on the left, pens on the right. Nothing can be tilted. Everything must be straight. If it’s off, then I will fix it. Only then will it be just right”.
OCD can be a challenging condition to work with, but this doesn’t mean it can’t be treated or managed. Through learning and discussion, we can help everyone understand the condition better and improve awareness. Next week we’ll talk about how to manage OCD as well as common treatment methods. Stay tuned!
As always, we hope you took away something valuable from this piece. If you have any questions or concerns regarding this article or others, feel free to reach out to us on Instagram, Facebook, or at ask@orbishealth.ca with your feedback. We’d love to hear from you.
RESOURCES
- Obsessive Compulsive Disorder. (n.d.). Retrieved June 26, 2018, from https://cmha.bc.ca/documents/obsessive-compulsive-disorder-2/
- 4 Myths About OCD. (n.d.). Retrieved June 26, 2018, from https://www.psychologytoday.com/ca/blog/the-truisms-wellness/201605/4-myths-about-ocd
- Orenstein, B. W. (2011, October 13). 8 Common Myths About OCD. Retrieved June 26, 2018, from https://www.everydayhealth.com/anxiety/8-common-myths-about-ocd.aspx
- Obsessive Compulsive Disorder (OCD). (n.d.). Retrieved June 26, 2018, from https://cmha.ca/documents/obsessive-compulsive-disorder-ocd
- Types of OCD. (n.d.). Retrieved June 26, 2018, from http://ocdcanada.org/types-of-ocd/
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