What is Obsessive Compulsive Disorder?
Imagine being plagued by obsessive thoughts or images, such as your boyfriend or you getting in a bloody car accident. Imagine compulsively getting up every night, every hour or more, to check on your kids because you want to make sure they haven’t been kidnapped.
Dr. Mia Gregor, clinical psychologist at The Center for Personal Development in Chicago, Illinois says “Individuals with OCD have obsessions and compulsions that cause significant distress and impairment in their daily functioning. This means that they have recurring thoughts (or obsessions) that are exaggerated or unrealistic. For example, fears of contamination or fears that they will cause some sort of disaster.”
These obsessions lead to anxiety, which leads to a need to relieve the anxiety. Gregor adds, “The obsessions are often extremely disturbing to the individuals and so they feel compelled to perform some sort of ritual (or compulsion) to decrease the anxiety created by their obsessions. For example, washing their hands 500 times a day or checking the stove 100 times a day.” However, performing these rituals provides only temporary relief. But not performing them greatly increases their anxiety.
According to the National Institutes of Mental Health, OCD affects about 2.2 million American adults, and the problem can be accompanied by other mental disorders such as eating disorders, other anxiety disorders, or depression. OCD strikes men and women in roughly equal numbers and usually appears in childhood, adolescence, or early adulthood but can occur later in life, too. One-third of adults with OCD develop symptoms as children, and research indicates that OCD might even run in families.
What is Obsessive Compulsive Personality Disorder?
If you have taken even a basic psychology class, you are likely familiar with both OCD and Obsessive Compulsive Personality Disorder (OCPD). Though these mental disorders may sound and seem similar, they do have distinct differences.
Gregor says “A majority of people with OCD are aware that their obsessions and compulsions are unrealistic and exaggerated, but they are just unable to stop the cycle. However, unlike OCD, people with OCPD do not have intrusive obsessive thoughts and ritualized compulsive behaviors. They have more of a preoccupation with perfectionism, rules, and orderliness.”
People with OCPD are typically rigid, withhold their emotions, and have extremely high standards. Gregor explains, “In relationships with others they tend to operate by the motto ‘It’s my way or the highway’ and may become angry if they cannot control their environment.”
People with OCPD believe there is only one way to do things and only they are capable of handling it. “In occupational settings, they may look like a ‘workaholic,’ taking on all work assignments and not delegating them to others,” says Gregor. “However, it is their perfectionism and their need for control that keeps them from allowing others to complete the tasks.”
Gregor adds, “It is important to know that OCPD is considered a chronic, maladaptive pattern of thinking that most likely developed in childhood. This is a style of life rather than an episodic condition like OCD.” Further, OCPD may not present as disabling as OCD but it can still lead to secondary problems such as job loss and relationship problems, which can contribute to feelings of depression and/or anxiety.
If you have or have had OCD, don’t stay up at night worried you are going to develop OCPD. Gregor says, “Because you have been diagnosed with OCD or OCPD does not mean that you will also be diagnosed with the other. Seventy-five percent of individuals diagnosed with OCD do not have OCPD and 80 percent of individuals diagnosed with OCPD do not have OCD.”
What is it like to have OCD?
According to Gregor, an example of a OCD is a man spending all night, many nights, arranging items throughout the house and cleaning, to the point that he does not get to sleep until 4am and then still has to get to work at 7am. Though he gets little sleep, he gets relief, albeit temporary, from his anxiety.
If this man had OCPD, he may insist that his wife go to bed before he does every night so that he can “tidy the house” and know that it will be exactly the same when he arises the next morning. This is more about control than relieving anxiety.
“Another example of OCD is a 33-year old, stay at home new mother that spends all of her time cleaning her new-born baby’s room (to the point that her hands develop sores from the cleaning chemicals and, worse, she disrupts the child’s nap and feeding times) for fear that her child may become contaminated with germs,” says Gregor.
Why does someone develop OCD?
Though there are many routine things people do on a daily basis, like eat, shower, brush teeth, exercise, watch TV, walk the dog, tidy the house, work, and sleep, these activities are not considered OCD behaviors unless they are causing distress and negatively affect a person’s ability to function.
For example, if you are obsessed with keeping your house tidy to the point you can’t find time to eat, sleep, work or spend time with your family, you should consider seeking professional help. However, if you are expecting company and spend a day or two cleaning the house just for the occasion, you probably don’t have OCD.
Unfortunately, the exact causes of OCD are unknown, though Gregor says genes are thought to play a role. “We know that family members of someone diagnosed with OCD often are diagnosed with OCD themselves or another anxiety disorder. However, genes alone do not explain OCD. It is more likely that genes set the groundwork and learning, environment, and stress contribute to the disorder.”
Gregor adds, “The course of OCD is chronic and may wax and wane in response to stress. However, it can be an extremely disabling condition and may lead to other problems (such as job loss, relationship problems, and health problems) and other psychological problems (such as depression or other anxiety disorders).”
What are the treatments for OCD and OCPD?
According to Gregor, there is a wealth of data that supports pharmacological treatments (usually SSRIs), cognitive behavioral therapies, and behavioral therapies in the treatment of OCD. Exposure and Response Prevention (a behavioral therapy) is considered to be the treatment of choice for mild-moderate cases of OCD.
“Unfortunately, there is little research on the treatment of OCPD. Many individuals diagnosed with OCPD will not enter into therapy on their own,” says Gregor. “It is more usual that they enter into therapy at the request of another person or because their interpersonal relationships are suffering.”
She adds, “Also, they may enter into therapy due to problems that are secondary to OCPD, including depression or anxiety problems and health problems. There has been some evidence of success with cognitive therapy that targets the irrationality of the person’s thoughts.” More research is needed.
Get help
There are many resources for people with OCD and OCPD (mental health professionals as well as print and online information). Check your local listings for a mental health professional or organization in your area.
Gregor concludes, “My recommendation for people who think that they may have OCD or OCPD would be to seek professional assistance through a consultation with a psychiatrist or psychologist. Remember that OCD is progressive and chronic, so ignoring it will not make it go away.”
May is Mental Health Month, visit The National Institute on Mental Health for more information on OCD and other mental disorders.
And be sure to check out the SheKnows.com Health and Wellness Channel for more articles on mental health and wellness.
