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Symptoms and Definition of Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder (OCD) is a condition where an individual will experience obsessions, compulsions, or both.

Obsessions

Obsessions are defined as unwanted thoughts, images or impulses that repeatedly enter into a person's mind in an intrusive way and cause the person to feel very anxious or distressed. Examples of obsessions include:

  • Thinking about things that feel utterly shameful and unacceptable, like having sexual contact with a family member;
  • Having disturbing images come to mind, such as vivid and gruesome scenes of hurting oneself or others;
  • Having impulses to do things that one feels are wrong, like insulting one's friends;
  • Feeling very worried about coming into contact with something dirty or contaminated.

Individuals will find these obsessions to be very disturbing and may worry that having these thoughts, images or impulses means that they might act on them by actually doing the things that are represented in their obsessions. (However, having OCD does not make one lose control of one's actions.)

As a result, the person will try as much as possible to push these obsessions out of their mind, sometimes by making themselves think about other things or by doing a specific act, which can include compulsions.

The individual will recognize that their obsessions are a product of their own mind, but these will still feel intrusive and unwanted. Obsessions are never simply excessive worries about real-life problems

Compulsions

Compulsions are ritualistic, repetitive actions that a person feels driven to perform, either as a way to cancel-out or atone for an obsession, or as a way to obey a certain invented rule that they feel they must follow rigidly. These actions are done as a way to prevent some dreaded situation from occurring, though there will be no realistic connection between these actions and the things they are meant to prevent, or else the connection is blown out of proportion. Examples of compulsions include:

  • Washing one's hands several times in a row, or even showering excessively, to make sure that one is completely clean;
  • Going back to check multiple times that the door is locked or the stove is turned off;
  • Needing to do specific actions a certain number of times or in a particular order;
  • Needing to place or arrange items in very specific positions.

Insight and Awareness

Individuals with OCD recognize, at least at some point during the course of their disorder, that their obsessions and compulsions are excessive and do not make logical sense. The obsessions and compulsions will tend to feel ego-dystonic, which means that they are experienced as being foreign to the person's true attitudes and beliefs, and as intrusive and unwanted. Still, the person will be unable to ignore their obsessions or resist performing their compulsions, and these will represent a source of significant distress and interfere with the person's ability to function at school or work or to participate as usual in their regular activities and relationships.

If an individual for the most part does not see their obsessions or compulsions as being excessive and unreasonable, then they are said to have OCD with poor insight.

 

Overview

Diagnosis