Almost everyone has experienced worries, doubts or fears at one time or another. It’s natural to worry about things such as your health, the well-being of your family or a special someone, classes and exams, or what the future will bring. It’s not even abnormal if you’ve had an occasional intrusive or “bad” thought, such as a mean or even aggressive thought about someone who has upset you. That’s not OCD.
OCD is diagnosed when obsessions and compulsions:
- Consume excessive amounts of time (an hour or more each day; for some individuals, OCD consumes many hours a day)
- Cause significant distress
- Interfere with daily functioning at work or school, or with social activities, family relationships and normal routines.
OCD is characterized by obsessive thoughts, impulses, or images and compulsions (overt or mental rituals) that are difficult to suppress. Obsession and compulsions take a considerable amount of time and energy away from living your life, enjoying your family and friends or even doing your school work.
When OCD symptoms are present, you need to talk to a knowledgeable mental health professional for evaluation and treatment. Your college or university most likely has a student health center and/or counseling center, so that may be a good place to start.
What are OCD Symptoms?
One of the best ways to understand OCD is to learn how obsessions and compulsions are linked. In some cases, compulsions are shaped by the nature of the obsessions. Compulsive washing, for example, is commonly performed in response to obsessive fears of contamination. Similarly, a fear of the house burning down may lead to excessive checking of the stove, oven and iron.
In other cases, obsessions and compulsions are paired in a way that defies explanation; the compulsive behavior is completely unrelated to the obsession. For example, a student may feel compelled to tap his desk in class to prevent harm from coming to his family while he is away at school.
It’s important to note that some people with OCD perform rituals not in response to a distinct obsession or fear but rather in response to certain sensory phenomena. Visual, auditory or tactile sensations may trigger a need for something to look, sound, or feel “just right.” Upon seeing a tile floor, for example, a person may experience a need to trace over each of the tiles mentally in a symmetrical fashion.
In other cases, external triggers are absent, but the individual has an inner feeling and/or perception of discomfort that causes him or her to repeat a behavior until the feeling is relieved; the behavior needs to be repeated until it feels “just right” or “complete.” In still other situations, repeating behavior is preceded neither by obsessions nor sensations, but rather by a need or urge.
A few common examples of OCD are shown below; more about symptoms can be found here.
| Obsession | Compulsion | |
|---|---|---|
| Obsessive fears of contamination, dirt, germs | Compulsive hand washing, bathing, showering, constantly cleaning a dorm room or apartment, doing laundry many times a week, avoiding touching things others have touched (doorknobs, bathroom fixtures, desks, computer keyboards); avoiding touching other people, avoiding public places such as washrooms, stadiums, classrooms, the library because they are “dirty” | |
| Fears of harm or danger; fear of harm, illness or death coming to oneself or others; fear of causing harm to others (such as causing a fire or accident); fear of acting violently or aggressively toward another person
Note: Individuals with OCD who have violent/aggressive thoughts neither have a history of violence nor act upon these urges or ideas |
Compulsive checking that doors or windows are locked, electronic gadgets or computers are turned off; constantly calling, texting or emailing someone you care about to see if he or she is OK; constantly asking others for reassurance that everything is OK; unreasonable avoidance of ordinary activities, places, animals, or people for fear of causing harm | |
|
Saving useless items – scraps of paper, food wrappers or containers, pop cans, broken items; being unable to part with things that are not needed any more; holding on to items for fear that they might be needed some time in the future, such as textbooks, old class notes, food, school papers, clothing; accumulating items or objects because they are contaminated and therefore cannot be touched; buying every item in a store that one has touched (and therefore “contaminated”) to prevent others from becoming contaminated; buying multiples of the same item (buying 3 of everything because it’s a person’s magic number) | |
| Fears of violating religious or moral rules (called “Scrupulosity”) | Compulsive praying (sometimes to get the wording or the sequence “perfect”); constantly seeking reassurance that you haven’t sinned or God isn’t going to damn you to hell; in some religions, going to confession multiple times a day or praying long hours; repeatedly needing to confess perceived “sins” or “bad behavior; avoiding religious objects/places that may trigger obsessions | |
| Fears/feelings/urges related to symmetry or order | Compulsive need to arrange and rearrange — either physically or mentally such as constantly “evening up” every hanger in the closet or items on a desk or night stand so they’re perfectly aligned; thinking or saying phrases or words in a particular order for an extended period of time; mentally plotting the arrangement of objects on a grid or streets on a map; arranging and rearranging items by color or size; avoiding a particular room because of symmetry triggers (gymnasium floor triggers a need to trace all of the circles on floor with the eyes) | |
| Fears/feelings/urges related to having something “just right,” “just so” or “perfect” | Compulsively seeking reassurance from friends, teachers, others, that what has been completed is “right” or “perfect;” inability to finish assignments because they have to be “just right” or “perfect;” extreme slowness with activities, school work, chores because everything has to be done “just so” or “right” or in a certain order or pattern; trying to “know everything” about a subject, even when the information is trivial or isn’t needed for your class work or exams; avoiding starting an assignment because it will have to be done “perfectly” | |
| Fears/feelings/urges related to sexual content | Seeking reassurance regarding one’s sexual orientation (e.g., seeking reassurance that one is not gay or lesbian, when he or she is actually heterosexual; seeking reassurance that one is not a heterosexual when he or she is gay or lesbian); avoiding magazines, books, DVDs, etc., for fear of seeing something that will trigger sexual obsessions | |
| Fears/feelings/urges related to numbers, e.g., “good” numbers, “bad” numbers, “magic” numbers | Touching objects a certain number of times; reading words or pages a given number of times (numbers may have a magical significance — are able to keep harm from occurring) |