Obsessive Compulsive Disorder (OCD) involves feelings, thoughts and behaviors. For the vast majority of people with OCD, the feeling of anxiety stands out as prominent.
OCD sometimes runs in families, but no one knows for sure why some people have it while others don’t. Researchers have found that several parts of the brain are involved in fear and anxiety. By learning more about fear and anxiety in the brain, scientists may be able to create better treatments. Researchers are also looking for ways in which stress and environmental factors may play a role.
For example, a man with OCD might have an obsessive thought that a doorknob is contaminated and the thought of touching the doorknob causes him great anxiety. He takes a spray bottle of disinfectant and sprays the doorknob, which decreases his anxiety. Then he reaches for a Kleenex to give him a barrier from any possible remaining germs. He feels relieved. And that momentary relief feels pretty good; well, that is until the next doorknob appears.
The pattern repeats: an obsessive thought, an overestimation of danger or risk, increased anxiety, a compulsive action, and then feelings of relief provided by the compulsive action.
OCD also involves thoughts. For some people with OCD, their obsessions and compulsions are more in their heads than in their guts. Consider a woman who feels compelled to count everything she sees—ceiling tiles, stairs, books on a shelf, you name it; she counts it. But she actually reports feeling not particularly anxious at all. It’s just that she feels things aren’t “right” if she doesn’t count everything imaginable. Her feelings are more about distress over things being out of order rather than anxiety.
OCD can also show up primarily in behaviors. For example, a man might feel a driven need to go through doorways in a particular manner. Until he gets it “right,” he can’t let himself continue on his way. He can’t come up with any particular thoughts about why he needs to go through doors in this way; he just feels he must. And that feeling of having things be “just so” isn’t exactly the same thing as anxiety.
As these examples illustrate, OCD manifests itself in many widely differing forms. The prominent feature(s) may involve anxiety, thoughts, behaviors, urges, or distress. Although OCD is currently considered a type of Anxiety Disorder, many professionals believe it deserves its own separate diagnostic category. In part, that’s because much of the urges and distress brought on by OCD just don’t look like classical anxiety.
The take home message is that this is a fascinating, yet quite complex disorder, and can be debilitating. If you think you may have OCD, consider seeking professional consultation. This is one problem that you don’t want to self-diagnose. The good news is that treatment for OCD, particularly Cognitive Behavioral Therapy (CBT) works very well.