We have all listened to a song on the radio and then the lyrics seem to get stuck in your head. The song keeps on playing over and over again. You feel slightly annoyed and then get distracted and the lyrics simply go away.
Imagine if instead of a song it was a terrible thought or image which got trapped in your mind. The harder you tried to get rid of this thought or image the more you kept thinking about it. Then the thought created anxiety and distress. Which only made it more concrete in your mind. You start thinking that if there is anxiety the thought or image must be true. This thought or image now feels intense, true, and most of all frightening. Many people with Obsessive Compulsive disorder (OCD) feel this agony endlessly.
OCD is a mental disorder which is characterized by 4 main components:
First, obsessions which are thoughts, images, or impulses that are intrusive and cause significant distress. This distress can feel like fear, doubt, disgust, or that something needs to be done “just right”. These thoughts are relentless and happen over and over again. It often makes the individual feel out of control. These obsessions often develop into themes. Common themes are: unwanted sexual thoughts, contamination, harm, losing control, perfectionism, and scrupulosity or religious obsessions. The obsessions are not excessive worries about real-life issues and usually are not related to a current real-life situation.
Second, compulsions which are repetitive behaviors or mental acts the individual performs as a response to the obsession. Compulsions are meant to take individuals away from the risk and distress. The largest issue is compulsions only provide momentary relief. Common compulsions are: mentally reviewing situations, seeking reassurance, checking, washing, counting, and praying.
Third, these obsessions and compulsions cause substantial distress. This can look different for each individual, but usually they are very time consuming. They impede on the normal activities such as working, going to school, having fun with friends, or developing meaningful relationships. Sufferers from OCD often have problems with self-esteem, due to feeling like they are not living the life they really want to be living. They avoid activities, objects, people, and places as an effort to stay away from the risk of having more obsessions which can make them feel isolated and alone.
Forth, the person at some point recognizes these obsessions and compulsions are unnecessary or irrational. It is hard to recognize this when an individual is experiencing the anxiety or distress associated with the obsessions or compulsions. It might be at a point when the distress has minimized and the individual has a moment of clarity. People might make comments like, “This is so stupid” or “I know it is not real but…”. OCD creates a vicious cycle of obsessions, distress, compulsions, temporary relief which confirms the fear, only to start the cycle over again. It can be agonizing but individuals should have hope because there is effective treatment. The greatest and most operative treatment is Exposure and Response Prevention.