The Science of OCD

Obsessive-Compulsive Disorder, commonly known as OCD, is an anxiety disorder characterised by recurrent and disturbing thoughts (called obsessions) and/or repetitive, ritualised behaviours that the person feels driven to perform (called compulsions).

A 2001 World Health Organization mental health report estimated that OCD was among the top 20 causes of illness-related disability worldwide for people aged 15 to 44 years. The report also suggested that OCD was the fourth most common mental illness after phobias, substance abuse and major depression.

The majority of people with OCD have both obsessions and compulsions, but a minority (about 20%) have obsessions alone or compulsions alone (about 10%). Obsessions are persistent thoughts or urges that a person experiences that are strange, intrusive and not wanted. Most people have unwelcome or intrusive thoughts at certain times, but for individuals with OCD the importance of those thoughts are exaggerated. An obsession isn’t simply worrying about something a lot — it is overwhelming and constant. A compulsion is a repetitive kind of behaviour — like counting or hand-washing — that a person feels like they must perform in order to prevent something bad from happening, or to stop an obsessive thought. Not all “rituals” or forms of repetitive behaviour are compulsions. Normal repetitive behaviours that feature in everyday life include bedtime routines, religious practices and learning a new skill.

As per WebMD, obsessions often have a theme with accompanying symptoms such as:

1. Fear of germs or dirt – You might be scared to touch things other people have touched, like doorknobs. Or you don’t want to hug or shake hands with others.
2. Extreme need for order – You feel stressed when objects are out of place. It’s really hard for you to leave home until you’ve arranged things in a certain way.
3. Fear of hurting yourself or someone else – When you’re thinking of something completely different, you have thoughts about hurting yourself or someone else.
4. Excessive doubt or fear of making a mistake – You need constant encouragement or reassurance from others that what you’re doing is right or OK.
5. Fear of embarrassment – You’re afraid you might yell out curse words in public or behave badly in social situations.
6. Fear of evil or hostile thoughts, including warped ideas about sex or religion – You imagine troubling sexual or disrespectful scenarios.

Like obsessions, compulsions also have common themes and symptoms:

1. Washing or cleaning – You wash your hands, shower, or take a bath over and over.
2. Checking – You check repeatedly to make sure kitchen appliances are turned off or the door is locked when you leave.
3. Counting – You say numbers in a certain pattern out loud or to yourself.
4. Order – You feel the need to eat certain foods in a specific order. You arrange all your clothes or kitchen pantry items in a specific way.
5. Routine – You say or do things a set number of times in a certain way before being able to leave the house.
6. 6. Collecting or hoarding – Your home is full of things you don’t use or need, and you can’t stop yourself from buying more.

While these are not the only types of OCD, obsessions and compulsions will generally fall into these categories.

Personal Journey with OCD

When working on my content calendar towards the end of last year I quickly identified that O will be for OCD. But as we got closer to the day, I started getting more and more nervous about it because I knew this post will showcase me in all my damaged glory. But I believe , there is power in vulnerability and if I am going to comfort and inspire via this blog then I have to be at ease with being vulnerable.

I have OCD. I mentioned this in passing when I shared in a previous post that my OCD flared up during the first few weeks of my booze and kush break in Q2 . I have OCD and I have had it for as long as I can remember. My earliest memory of struggling with OCD is when I was in Standard Seven/Eight in primary school. I was hunched over a classroom desk, pinching my nose to hold my breath as I thought something over and over again. I obviously do not remember the exact obsession I was struggling with but I was convinced that the only way it would stop was if I did not breathe as I thought it.

Nowadays the term OCD is commonly misused to refer to being annal about something, but a hallmark of OCD is that the person recognises that their thoughts or behaviours are senseless or excessive. While I have struggled with OCD in general for approximately 20 years now, over the past few years I have noticed that my compulsions can and do really get out of hand.

From the WebMD list shared earlier, I struggle with four out of the six themes (only washing/cleaning and collecting/hoarding do not give me any trouble). If I had to list the themes in order of what I struggle with from most to least it would be checking, counting, routine then order.

My biggest struggle with OCD has to do with numbers, whether that is numbers in general or how many times I check/count something. I realised I had a problem with numbers when I used to smoke; I was very particular about how many cigarettes I could have in my pack at a given time. A cigarette pack has 20 sticks and it was impossible for me to leave 19/17/13/11/9 cigarettes in a pack because to me those are weird numbers. So I would smoke more or less (depending on the number) than I needed so that I could leave 18/16/14/12/10/8 cigarettes instead. I also cannot have the TV volume at a number I feel is weird, which is why I identify with this post’s featured image. The TV volume has to be either an even number or one of my favourite numbers.

Of late I really struggle with checking and my most crippling routine is in the morning before I leave the house. I need to make sure that all the sockets and lights are switched off and that my doors are closed, which is a normal, everyday thing to do. But I will check everything over and over and over, sometimes spending close to two minutes making sure that my fridge door is shut. I start closing and switching things off from the bedroom as I head out the front door but I end up restarting the routine many times over to ensure I do not miss a thing. I know that by the time I am checking the balcony door for almost the eighth time it is decisively locked but I simply cannot help myself from rechecking.

I also obsessively count the money in my wallet. I count the notes backwards and forwards and can do so around 10 times before I tell myself that enough is enough. My notes are also arranged from the highest denomination to the least, with the old notes placed to be used first. I know a number of people also like to give out their old notes first but I am rather excessive with it in that when I get money from the ATM I will scrutinise each and every note and then arrange them in order from the oldest to the newest.

Last month I was putting on my sleeping socks and noticed that I had worn the sock that usually goes on the left foot on the right foot instead. I had just gotten into bed when I noticed it and I tried my best to ignore it but my OCD would not let me so I removed the socks and wore them in the “correct” order.

These are just a few examples. Some of you will read this and think I am weird AF, which for the record is true but not because of my OCD. I am just a weird person in general. Lol. My mental illness does not make me any less human/worthy/awesome than my mentally fit counterparts. Which is why it is so important for me to be part of conversations that destigmatise mental health as I need everyone struggling with any form of mental illness to know that it is okay not to be okay. I want them to know that there is nothing to be ashamed about in asking for help. That in fact there is great strength in the vulnerability and honesty it takes to open up about stuff society usually frowns upon.

I have struggled with OCD for approximately 20 years now and when I was seeing a therapist in 2017 I mentioned it to her. She then posed a question to me that I will never forget. She asked if I really have OCD or is it my need for control. And I just really started to think about it from there. I like to be in control and I always attributed it to a combination of being a firstborn and a Leo, but when I started working on A Is For Anxiety I had an epiphany that part of my need for control stems from my childhood.

I grew up in a very violent household. I never knew which mood my father would come home in and always walked on eggshells as a good mood would change in the blink of an eye. Once I was old enough to understand how his volatile temperament impacted my childhood I began to avoid being in situations where the outcome is uncertain. Being in control of situations helps me feel as far removed as possible from that powerless little girl.

I mentioned earlier that over the past few years my compulsions started getting out of hand and if I were to pinpoint a specific time, it would have to be from 2012 when my mum was diagnosed with stage four breast cancer. I have since learnt that compulsions serve to alleviate anxiety which is probably why mine really flared up when my mum was diagnosed with a terminal illness. Yes I like to be in control but the fact that OCD is an anxiety disorder means I will need professional help to deal with it and it is one of the things I look forward to tackling once I am back in therapy this month.

Last but definitely not least, I need to make it clear that I am not an expert on OCD. So please if you identify with anything in this post I would urge you to seek professional clarification and not use my words to self-diagnose.

NB: The sentences in the first three paragraphs are “Frankensteined” from two articles one of my therapists sent me:

• Obsessive-Compulsive Disorder by John M. Grohol, Psy.D. Last updated: 19 Jun 2019
• What is obsessive-compulsive disorder? Last updated Thu 18 January 2018 By Hannah Nichols Reviewed by Timothy J. Legg, PhD, CRNP

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