OCD - Psychologus

Oben could not stop thinking about what just happened. The day was going fine, he had had a good bout of meetings with his clients. Everything was going great in fact. But his heart dropped when he went back into his office.

Oben had a neat array of fountain pens, always on the right side of his desk. They were color-coded. And each pen was aligned neatly, the capped nib facing his revolving chair. But when he came back into his office, he noticed that one of the pens was missing.

It was his midnight blue pen, one that he had just gotten this summer.

His mind started racing as he began to think about all the places that he might have dropped his pen.

It couldn’t be that far from my office – I never take these pens off my desk unless I have to! He thought.

So, he began searching. Oben began by shifting the table to see underneath it. But then, exasperated, he began emptying the drawers. The notebooks that he threw out made heavy thuds against the floor and the furniture. People from outside his office started noticing until a colleague, Roma, who he was dating opened the door.

“Oben, is everything alright?” But then she stopped.

Oben was frantically now skimming through the shelf behind his chair, clearing all the papers and files out onto the floor.

“It was just here! I don’t believe how it could be anywhere else!”

This was not the first time that Roma and several other colleagues had seen Oben ‘lose his mind’ over very small things. He had had a similar breakdown when he noticed that a paper weight was missing.

And Roma had only borrowed it. Well, she should have told him beforehand, but she thought, that’s nothing to freak out over, right?

Hearing the commotion, a colleague of Oben’s summoned the HR. Safe to say, Oben was not liked. But it took more than 10 minutes for the HR team to convince him to join them in the conference room.

Oben felt exasperated. But he also knew he was in trouble. He had promised them that he would be taking regular sessions with his shrink. But, this time he could not control himself.

Because of the damage that was caused to the shelf and the desk and the ‘disruptiveness’ of Oben’s actions, he was given a 2 week suspension from work. This was not the first time Oben had had such a mental breakdown.

But the HR representative’s message this time was clear:

‘Get your act together, or do not join the office again.”

But Oben felt hopeless, powerless.

2 weeks later, Oben returned. He had had made an active effort to not lose it anymore. Roma met him at the door and greeted him with a donut. While Roma and Oben had had conversations within this time, he told her that he was busy working on himself.

‘So, what’s up? How do you feel?’ Roma inquired.

‘Everything’s fine, Roma. Absolutely fine!’ Oben cheerily replied, as he began arranging his pens neatly on the right side of his desk.

Obsessive-Compulsive Disorder (OCD) is a common mental illness that affects 1-3% of the world’s population. It is marked by unwanted thoughts, or obsessions, doing the same things over and over again, or compulsions. These symptoms make patients’ lives very difficult because they take up a lot of time, make them very upset, and make it hard for them to do things.

According to sources, cognitive-behavioral theories have long said that obsessions often make people feel more anxious or uncomfortable and that compulsions are actions that people do because of their obsessions. There is some proof, though, that compulsive behavior is what starts it all and obsessions happen after the fact to explain these behaviors. This idea needs more research, though. Most people who have OCD are very aware that their obsessive symptoms are too much and wish they could control them better.

OCD may be caused by genetic, neural, behavioral, cognitive, and environmental factors. It appears as though OCD runs in families, which suggests a possible genetic link. Scientists are still looking into this. Brain imaging tests have also shown that people with OCD have brains that work in unique ways. Children with OCD may show signs after getting an illness, such as group A streptococcal diseases like strep throat, Lyme disease, or the H1N1 flu virus. This set of OCD symptoms in kids may be called pediatric acute-onset neuropsychiatric syndrome (PANS) by doctors. If a kid has PANS, their symptoms come on quickly and get worse over a few days.

Learning-based theories say that people with OCD learn to avoid things or situations that make them afraid by doing routines that make the perceived risk smaller. The first fear might start during a time of high stress, like after a stressful event or a big loss. When someone links a scary thing or situation with their OCD, they start to avoid that thing or situation in a way that defines their disorder. One more idea is that people get OCD when they get their thoughts wrong. Most people have unwanted or bothersome thoughts from time to time, but for people with OCD, these thoughts become more important or extreme.

Studies also report that it is still not clear if traumatic events and stressful life events can cause OCD on their own or if they can act as a trigger for people who are already more likely to have it. Some things that can happen in the environment that might make OCD worse are problems during pregnancy or birth changes in reproduction that come with getting older, social and economic issues, hurt badly, or a very bad illness. Also, people with OCD may have post-traumatic stress disorder (PTSD). OCD is a mental illness typified by compulsive behaviors and obsessions. These obsessions and compulsions can take up a lot of time and make it hard to go about daily life and be with other people. Therefore, it is important to identify the signs and get the required treatment. The following are the diagnostic criteria and diagnostic features of OCD, as highlighted by DSM 5 TR:

Diagnostic Criteria

A. Existence of Obsessions, compulsions, or a combination of both
(1) and (2) describe what an obsession is:
1. Thinking, wanting, or seeing things over and over again that you find annoying and don’t want to be there; these thoughts, urges, or pictures usually cause a lot of worry or distress in people.
2. The person tries to avoid or push away these thoughts, urges, or pictures, or they try to cancel them out with a different thought or action (i.e. by doing a compulsion).
(1) and (2) explain what compulsions are:
1. Doing the same things over and over, like washing hands, putting things in order, or checking, or doing the same thoughts over and over, like praying, counting, or softly repeating words, because they feel like they have to or because of rules that must be followed exactly.
2. The actions or thoughts are meant to stop or lessen worry or discomfort, or to avoid a feared event or situation. However, these actions or thoughts are either not really related to what they are meant to stop or lessen, or they are clearly too much.
Note: Young children might not be able to explain why they are doing or thinking these things.

B. The compulsions or obsessions take up a lot of time—more than an hour a day, for example—or they significantly impede social, occupational, or other crucial areas of functioning, or they cause clinically substantial discomfort.

C. The obsessive-compulsive symptoms are not caused by the body reacting to a substance (like an illegal drug or a medicine) or another health problem.

D. The problem cannot be explained by signs of another mental illness, like worrying too much, like in generalized anxiety disorder, or being too focused on how you look, like in body dysmorphic disorder (for example, hoarding disorder involves throwing away or parting with things; trichotillomania (hair-pulling disorder) includes pulling at the skin; stereotypes (like in stereotypic movement disorder); regulated eating (like in eating disorders); obsession with drugs or gambling (like in substance-related and addictive disorders); obsession with having an illness (like in illness anxiety disorder); sexual urges or fantasies (like in paraphilic disorders); impulses (like in disruptive, impulse-control, and conduct disorders); culpable thoughts (for major depressive disorder); thought insertion or delusional preoccupations (for schizophrenia spectrum and other psychotic disorders); or recurring trends of action (for autism spectrum disorder).

Diagnostic Features

OCD induces thoughts and compulsions (Criterion A).
Obsessives repeat ideas, images, or sensations like “contamination” or “violent or horrific scenes” “to stab someone”.
Obsessions are unpleasant and generate tension and suffering in most individuals.
The individual attempts to forget or repress these urges or replace them with a new idea or behavior.
Compulsion sufferers repeat actions like checking, washing, mentally counting, or speaking words to themselves. They do these things because they are obsessive or have to obey regulations.
OCD sufferers often experience obsessions and compulsions.
Obsessions and compulsions frequently involve concern about getting filthy when you wash your hands or being wounded when you inspect something repeatedly.
Some believe they undertake compulsions to relieve tension from their habits or prevent becoming sick.
To prevent injury to a loved one, organizing things equally is not a good method to connect to the dreaded scenario.
However, daily lengthy showers are excessive. Compulsion sufferers don’t do them for enjoyment, but they may feel better.
Obsessions and compulsions vary by individual.
Some themes or aspects are prevalent. Cleaning, symmetry, forbidden thoughts, and harm are examples.
Some people have problems getting rid of things and wind up collecting them due to habits and compulsions like fear of hurting others.
These compulsions are distinct from the hoarding disorder’s core accumulation behaviors, which will be discussed later in this chapter.
These motifs are seen in many nations, persist in individuals with the disease, and may be connected to brain regions.
People typically have many indications.
Criterion B requires an addiction or habit to take up more than an hour a day or produce clinically substantial anxiety or impairment to be declared OCD.
These needs distinguish the disease from unpleasant thoughts or behaviors like double-checking the door latch. OCD sufferers have many and varied obsessions and compulsions.
Some have mild to moderate symptoms and obsess or compel one to three hours a day, while others have practically continual intrusive thoughts or compulsions that make it hard to perform anything.