According to research, obsessive-compulsive disorder is the fourth most common mental health problem after depression, substance abuse and social phobia. Although it is so common, we may face a lot of mixed information and mislabelling regarding the answer to the question "What is obsessive compulsive disorder?". In this article, we will examine obsessive compulsive disorder in order to better understand this mental health condition, which can have quite devastating effects on the lives of those who experience it.
We all have times when we are more sensitive or anxious about certain issues. Some of us may be more cautious, more detailed, more organized, while others may exhibit more perfectionist thought and behavior patterns. In such situations, we can sometimes hear sentences such as "You are obsessed with this subject!", "Are you obsessive?", "Don't behave obsessively!" from the people around us. Although these comments from our environment refer to the symptoms of obsessive-compulsive disorder, obsessive-compulsive disorder is much more than a simple fixation, a subject that occupies our mind periodically or a subject that we are more sensitive to than other subjects.
Obsessive-compulsive disorder is defined as a mental health problem dominated by obsessions and/or compulsions. Obsessions are unwanted, repetitive and persistent thoughts. Compulsions, on the other hand, are repetitive behaviors or mental actions that the person feels obliged to perform under strict rules in order to feel a sense of completion.
In order to better understand obsessive compulsive disorder, it may be useful to examine the concepts of "obsession" and "compulsion" separately.
Obsessions: Obsessions are defined as distressing doubts, images or impulses that enter our mind involuntarily and repeatedly. These obsessive thought patterns often develop in a way that goes against our personal values. This condition is called "egodystonic". People with obsessive-compulsive disorder often find these unwanted thoughts irrational, excessive or unrealistic and try to resist or suppress them.
Compulsions: Behavioral patterns or mental actions that a person with obsessive-compulsive disorder develops against obsessions and feels compelled to perform are called compulsions. Some of the compulsions can be observed externally, such as repeatedly checking whether the oven is switched off. On the other hand, there may be actions that are difficult to observe from the outside, such as repeating a certain sentence in the mind. Mostly, the purpose of compulsions is to eliminate the anxiety and distress caused by the obsession or to prevent a feared situation. For this reason, the person may feel distressed if they do not perform these behaviors. These behaviors may be exaggerated or unrealistic compared to the anxiety-provoking situation. Sometimes compulsions become so time-consuming that we can call them rituals.
As mentioned above, all of us may have obsession-like thoughts or compulsive behaviors from time to time. At this point, the difference between obsessive-compulsive disorder and having some concerns that occupy our minds is seen in the effect of these thoughts on our daily lives. Persistent, unwanted, rigid thought or behavior patterns of people with obsessive-compulsive disorder can cause disruptions in their everyday lives. They think that if they do not perform these behaviors, something bad might happen to them or their loved ones. Although the thoughts of people with and without obsessive-compulsive disorder are similar in content, the level of anxiety about having these thoughts is different. People with obsessive compulsive disorder may think that having these thoughts is dangerous, abnormal or immoral. Because they have unwanted thoughts, they may worry that they will act on them. They may also think that having the thought is equivalent to performing the feared action. This distortion of thought is called "thought-action fusion". For example, we can see the fusion of thought and action in the following statement: "I am worried about taking off my clothes in public, so I can do it at any time." In the face of the anxiety caused by such thoughts, the person may try to remove them from his/her mind or suppress them. They may try to make sure that they do not do these behaviors by developing compulsions, or they may start to avoid going out since it may cause these behaviors to occur.
Research shows that avoidance behavior is an important feature of obsessive-compulsive disorder. People may restrict their activities in order to prevent their obsessions from being triggered. This can cause problems in their daily life, family relationships, social life and work environment. Behaviours such as not using shared toilets, not touching sharp objects, making sure that one is not alone with a child can be some examples.
Common obsessions and compulsions in obsessive-compulsive disorder include concerns about cleanliness, fear of contact with germs, fear of harming oneself and/or others, seeking reassurance, struggling with disturbing sexual thoughts, religious concerns and the search for symmetry. These issues sometimes take up so much space in a person's life that they can lead to physical health problems. For example, if a person is worried about catching germs, they may start to neglect health checks or experience dermatological problems due to excessive washing.
Before completing this section in which we answer the question "What is obsessive-compulsive disorder?", another point we would like to underline is that having obsessive-compulsive disorder is not something to be ashamed of and that very positive results can be obtained with treatment. If you think that you are experiencing some of the situations we have mentioned, you can consult a specialist. Remember that it is possible to reduce the negative effects of obsessive-compulsive disorder on your life.
Another condition that characterizes obsessive-compulsive disorder is the occupation of the mind by unwanted, disturbing and even disgusting thoughts. These thoughts are usually subjects that are considered taboo by society. People who are exposed to unwanted intrusive thoughts become afraid that they will perform the actions or images that come to their minds. They may also think that these thoughts mean that they are a terrible person. For this reason, people with obsessive-compulsive disorder who have unwanted thoughts withdraw from seeking treatment. Because they are worried that having these thoughts will make them look like a deviant, a violent person or a criminal, they may not seek help and may be exposed to these disturbing thoughts for life. Our brains are capable of creating many thoughts in a matter of seconds, and not every thought carries a meaning or warning about us. No matter how frightening or disgusting a thought is, this does not mean that we want to act on that thought. Let's not forget that obsessive-compulsive disorder is not characterized as an impulse problem. Therefore, people with obsessive-compulsive disorder are not at risk of acting on these thoughts. On the other hand, these thoughts are so contrary to their personal values that even the possibility of them being true causes high anxiety in these people. In other words, the problem here is not an inability to control, but an excessive need to control.
Sexual themes frequently arise among unwanted thoughts and images in obsessive-compulsive disorder. Sexual obsessions include concerns about sexual offenses against family members, animals or children, cheating on a partner, having sexual urges about friends or sexual orientation. At this point, the above-mentioned "fusion of thought and action" comes into play again. People may feel guilty for having these thoughts or images in their minds as if they had taken action. However, unlike sexual desires and fantasies that provide pleasure, sexual obsessions cause intense fear, anxiety, shame, disgust and guilt. In spite of these negative feelings, the person is still afraid of the possibility that one day they might act. They may ask themselves questions such as "What does it say about me that such a horrible thought can occur to me?" or "Even though the very thought of taking action disgusts me, how can I be sure that one day I will not lose control and take action?".
Compulsive and avoidant behavior can often be associated with sexual obsessions. People who struggle with this type of obsession may avoid being alone with children, sometimes even with their own children, for fear of inappropriate behavior. They may avoid films, TV series and people to prevent unwanted thoughts. They may think about their memories over and over again to make sure they are not sexually misbehaving, check their genital area to make sure they are not aroused, or need to hear from others that they are not doing anything wrong.
Sexual obsessions can be difficult to talk about and difficult to get help for, but like all obsessions, they are thoughts and images that appear in our minds against our will. Research shows that they do not have any meaning for our identity, values or morals, and that people are much less likely to act on them because they are too afraid and disgusted to act on them.
It is as important to learn what the symptoms of obsessive compulsive disorder are as it is to recognise what obsessive compulsive disorder is. Obsessive-compulsive disorder is characterized mainly by two symptoms: obsessions and compulsions. To be clinically diagnosed, a person must have obsessions and/or compulsions and these must occupy at least 1 hour of the person's day. Most of the time a person has both symptoms, but there are also people who have only obsessions or only compulsions. In order to get to know the symptoms better, we have compiled all the symptoms and examples of symptoms that can be seen in obsessive-compulsive disorder below.
If you want to develop a more concrete understanding of the question "What is obsessive-compulsive disorder?" you can examine the following examples.
Examples of obsessions:
Examples of compulsions:
When people with obsessive compulsive disorder are compared with the general population, both groups have an equal risk of developing schizophrenia. In other words, obsessive-compulsive disorder does not increase the risk of schizophrenia. On the other hand, studies on schizophrenia inform us that people diagnosed with schizophrenia are more prone to exhibit obsessive-compulsive behaviors.
Although obsessive-compulsive disorder is a mental health problem that can have devastating effects for those who experience it, it is possible to take positive steps and achieve a healthy life with the existing treatments. Many people may hesitate to seek treatment for reasons such as stigma, misunderstanding, shame or guilt. But expert psychiatrists and psychologists recognise that disturbing thoughts are not related to our character and have treatment methods that can help us to achieve well-being. For this reason, if you suspect that you or someone close to you has the symptoms we have examined above, it may be helpful to seek help from a specialist. We have detailed the main treatment methods used in obsessive-compulsive disorder for you below.
Cognitive Behavioural Therapy: CBT is a type of therapy that aims to help us correct thought patterns that are not good for us and help us adopt more functional and healthy behaviors. With this therapy method, we can find more effective ways of coping with the difficulties we experience by recognising our negative thoughts that do not benefit us. CBT is one of the most frequently used methods in the treatment of obsessive-compulsive disorder and leads to very positive results in a reasonable amount of time.
Exposure and Response Prevention Therapy: When we first look at the name of this therapy method, it may sound scary, but exposure and response prevention therapy is a method whose positive effects have been repeatedly proven by research. In fact, this therapy method is within the field of cognitive behavioral therapy. The main goal of the therapy is for the individual to confront the concrete or abstract situations that cause him/her anxiety, starting with the least anxiety-provoking ones, without exhibiting any compulsive behavior. It is then assessed whether the experience is as bad or dangerous as thought. Starting from the least anxiety-provoking thought, it is aimed to move on to more anxiety-provoking thoughts according to the client's rhythm, needs and well-being.
Medication: Pharmacological treatment is also shown as an effective method that can support therapy in the treatment of obsessive-compulsive disorder or to be used in the treatment of individuals who cannot receive therapy. The point we need to underline here is that such medications must be prescribed and monitored by a licensed mental health specialist.
