What is Obsessive-Compulsive Disorder?

Before we begin I must restate that I am not a doctor. I am not a specialist or professional. The content provided on this website is self-researched. I did my best to gather all information possible but I am sure there are missing details. Seek out professional help if you believe you are suffering from OCD and please call your doctor or 911 immediately if you believe you are having a medical emergency.

Obsessive-Compulsive Disorder, OCD for short, is a disorder of the brain where certain thoughts become obsessions and usually cause reactive compulsions. These undesired and repeated thoughts become very intrusive in daily life. They may include disturbed imagery, magical thinking, repetitive tics, or thoughts of doom. These thoughts may cause certain compulsions to be acted out as a result, such as washing hands repeatedly, checking things over and over and never truly being satisfied, or apologizing to a higher power for having a bad thought.

The thoughts can quickly become distressing and attempting to ignore the compulsion can be extremely discomforting or lead to full blown panic. The thoughts don't go away and cause elevated worry. OCD will force someone to obsess over the smallest details and the what-ifs of the situation.

Everbody has random, sometimes obscene, thoughts but OCD will force these thoughts into the spotlight and the show can go on for hours. The disorder can be characterized as a preoccupation with mental control - that is, the afflicted will continually battle for comfortable control over their thoughts to such a degree that the effort ends up backfiring. Not only is this constant battle mentally straining, but the need for control makes every random thought a potential dangerous intruder.

OCD causes individuals to expell enormous amounts of mental energy in their day to day lives combatting the anxiety that obsessive thoughts create. They may be constantly worried about something and are only awarded short periods of relief when their immediate attention is required elsewhere, but just as quickly, once the attention is lost, the looming obsessions come back in full force. Ignoring the thoughts can be incredibly difficult since thoughts can't simply be shut off. For exmaple, OCD will force someone with a contamination-specific obsession into utter mental chaos if for some reason they are unable to wash their hands. That thought will grow and gnaw at them every moment until they finally see the soap bubbling around the skin. And that agony isn't because they touched garbage or some other obviously dirty surface, but it can be because they had a momentary random thought about the possibility of a dangerous chemical flowing through the air and landing on their fingers, even if they are in the solitude of their home, an enclosed vehicle, or a classroom. The thought itself becomes real enough for it to cause enormous amounts of worry. The condition can be thought of more simply as taking something trivial and blowing it up into gargantuan proportions.

OCD affects over 1-2% of the US Adult population in any given year, according to This Statistic and This Statistic 2. That is about 2 million people. But these two sources are reflecting a study done between 2001 and 2003. I'm sure as the internet matured and awareness of OCD has spread, many of those who did not even know they lived with it now probably do and have sought professional help. The number is probably slighty higher in the current year. The statistics also don't account for children who are also suffering with OCD.

OCD is not cute. Never was, never will be. The OCD that is portrayed in popular culture is an illusion. People need to understand the war that rages on within a mind suffering with OCD.

The severity of the condition ranges from person to person. It can go from unnoticeble or undiagnosable to extremely debiliting and powerfuly life altering.

There is no complete agreement on its fundamental cause but its effect is well documented and there are treatments available. However, with any illness, treatment is very specific to each individual and no pill or method is universally successful.

The more and more someone gives in to an obsession and acts out the subsequent compulsion, the deeper they fall into the trap. But even saying it in that specific way is a lie because it implies that the mistake is entirely self-sustained, which is not completely true. Because of studies such as this one: Why it is difficult to recover from ocd, there is great evidence for the fact that a sufferer with OCD has a brain that functions differently because of abnormal wiring. A quote from the article

"The research follows another recent study published in Biological Psychiatry, which discovered a lack of communication between specific brain areas in patients with OCD. In particular, it found disrupted connectivity between neural pathways that connect the front of the brain with the basal ganglia, which are critical for flexible thinking and goal-directed behaviours that we know are impaired in OCD patients and are likely to contribute to the difficulty of overcoming the drive to perform needless compulsions."

gives us just one example of brain-disruption within the sufferer.

Another article from Psychology Today lists a great amount of detail of scientific study on the subject of OCD and the agreed upon consesus about certain wiring of the brain that leads to the disorder. It is a meaty article, but here is just one quote

"Dysfunction of the cortico-striato-thalamo-cortical (CSTC) circuitry has been a well-agreed upon area of dysfunction in the neuroanatomical model of OCD by neuroscientists (Milad & Rauch, 2012; Goncalves et al., 2017; Li & Mody, 2016). This area houses a number of feedback loops which project from the prefrontal cortex to the striatum, to the thalamus via the globus pallidus, and back to the cortex. Therefore, it is not surprising that higher order cognition such as impulse control related to physical movements and decision making are impaired in OCD."

Neuroscientific Lingo aside, the circuitry of a specific part of the brain leads to impaired impulse control and decision making. This is factual observation of physical anomalies in an impacted brain and cannot simply be mended with friendly advice such as "Just don't do it" or "Just don't think about it". Physical impairment, or something that is externally visible is inherently believable as it is objectively verified through visual confirmation, but impairment in the brain, especially something as elusive and just recently actively studied as OCD, is not visible to the naked eye. It isn't an obvious affliction and because it isn't inherently deadly, it isn't considered impactful to the common observer. If people knew, as with many other disorders and diseases of the brain, of the interruption OCD causes in the life of a sufferer, the daily struggle to play out those compulsions or suffer the panic attack, to obsess over thoughts for hours until they feel lost or depersonalized, they would see it in a completely different light. OCD is not cancer, surely, but it is an affliction that can be life altering. It may not kill the sufferer, but it will cause them daily grief.

And although this is reality for some, there is always light at the end of the tunnel. Research is actively being done by a host of international scientists: International OCD Foundation. Yale School of Medicine and John Hopkins, to name a few, are institutes that also are actively researching the disorder. There are new discoveries made regularly: OCD Research Discoveries and treatments are becoming more specialized: Specialized Cognitive Behavioral Therapy

OCD is no game. It isn't a random funny teenage experience. It can be a life-long struggle for millions of people World-Wide. A random person on the train, a friend, a family member, can be experiencing an agonizing internal struggle that you were never aware of. They may be silently panicking, obsessing over an inconsequentially random thought, or wishing that they checked one more time to be positive that they turned off the stove when leaving the house. It is this silent suffering that makes it hard to recognize. It may be frustrating to deal with somebody who has OCD because their actions or reactions may be interrupting, but remember that what they are doing is not out of their own desire but out of their need to quell the building anxiety and stress that is bubbling within their heads. Understanding the disorder is key to being helpful.