Obsessive-compulsive disorder (OCD) is a psychiatric condition that causes people to have distressing and repetitive thoughts (obsessions) that often lead to an action they feel the need to perform (compulsions). They may need to do these compulsions once or repeatedly until they feel more at ease. Obsessions and compulsions can vary from person to person, but doctors usually characterize these into specific groups. People often experience symptoms from several different categories, which can evolve over time. Here are some of the most common.
Possibly the most recognizable form of OCD, this type involves obsessions about things being in precisely the right place or symmetrical. For example, someone may feel the need to have all wall hangings level, make all labels on cans in the pantry face outward, or keep everything on their desk completely neat. If the person doesn’t perform the compulsions to make everything just right, they might experience distress or even thoughts that the lack of organization will cause some unrelated harm to them or their loved ones.
Contamination OCD revolves around two general ideas. The first is the thought that people can spread non-viral illnesses through touch or proximity. The second is that everyday things, thoughts, and words can “contaminate” a person, making them feel unclean. People with this type often feel the need to wash their hands repeatedly and clean items frequently to avoid spreading the perceived contamination. They may fear making themselves or someone else ill from being careless, or they might feel disgusted and uncomfortable around “unclean” items, which can lead to avoidance of certain objects, people, or places.
3. Intrusive Thoughts
People who experience intrusive thoughts have distressing and often abhorrent ideas pop into their heads seemingly at random. These obsessions can involve hurting a loved one, causing harm to a stranger, or even the idea that simply thinking about something can make it more likely to occur. To quiet these obsessions, a person might have to perform an action, such as saying something aloud or repeating something mentally. While people who experience intrusive obsessions may have violent or harmful thoughts, they neither agree with them nor do they act upon them. In fact, these ideas are so contradictory to how they feel that people often become distressed that their mind even created the thought in the first place.
This type has similarities with intrusive thought-based OCD, but there are some key differences. The ideas that get stuck in the head of someone with rumination-based OCD aren’t repulsive or distressing. Instead, they might be philosophical, religious, or metaphysical conundrums (essentially questions that have no proven answers). People who experience ruminations will be stuck on this topic for a while and might ignore responsibilities while they try to figure out an answer. Since these questions often have no definitive solution, people might feel unsatisfied or empty after thinking about this topic for so long.
Checking is an obsession in which a person is concerned about causing damage or harm by being careless. Their compulsions might include checking doors to make sure they’re locked, stoves to make sure the burners are off, or their wallet to make sure their credit cards, IDs, and cash are all still there. They might have to check something multiple times or even stare at it for a period before they can feel more at ease.
If any of these obsessions or compulsions sound familiar to you, or even the general concept sounds right (without the thoughts and actions lining up directly), schedule an appointment with your Baylor St. Luke’s Medical Group primary care physician. If you think your child may be exhibiting OCD symptoms, speak with their pediatrician. They can refer you to a psychiatrist and help you on the way to diagnosis and treatment.
OCD UK | Types of OCD
International OCD Foundation | OCD and Contamination