Ever found yourself scoffing at someone, ‘Oh, you’re so OCD’ whenever they rearrange a vase of flowers or tidy up their desk? Well here’s some news for you! Firstly, OCD is not an adjective so one simply cannot be OCD. On the contrary, one might have OCD. But that said… the likelihood that one has it is low.
While the term OCD is often used to casually describe perfectionistic tendencies and an eye for detail, it really is much more than that. OCD stands for obsessive-compulsive disorder, and it is a mental health disorder in which a person experiences distress-causing obsessions and are compelled to perform compulsions to reduce this distress.
Obsessions
Obsessions are recurrent and persistent thoughts, ideas, images, or impulses that cause great distress. There are a variety of obsessions ranging from phobias to fixations to immoral thoughts. And they evoke an equally wide variety of distressing emotions like anxiety, disgust, and horror, just to name a few. When faced with this illogical but overwhelming sense of distress, people with OCD would ignore or suppress the obsessions, distract themselves with other activities, or exercise compulsions.
Compulsions
Compulsions are repetitive behaviors that a person with OCD is driven to perform to reduce the distress caused by an obsession. They may be directly related to the obsession or not at all, as shown in both genres of examples in the table below.
| Obsession | Compulsion | |
| Related examples | Fear of contamination by people or environment | Wash hands, shower, clean objects relentlessly |
| Fear of harming oneself or others accidentally due to negligence | Checking compulsions like checking if doors are locked or outlets are turned off relentlessly | |
| Extreme concern with order, symmetry, or precision | Order and arrange things in a certain way | |
| Fixation on certain superstitions | Doing things a certain number of times because the number is supposedly lucky | |
| Non-related examples | Unwanted intrusive and disturbing images, usually sexual in nature | Repeatedly counting to a certain number |
| Obsessive worry and concern about moral judgement | Doing routine activities repeatedly |
Treatment
The combination of seemingly uncontrollable obsessions and ritualistic compulsions in people with OCD may disrupt their daily routine, often lowering their quality of life. This, however, can be treated with a multi-pronged approach consisting of therapy, medicine, and even surgery.
1. Cognitive Behavioral Therapy/ Exposure and Response Prevention
Exposure and response prevention or ERP, is a type of cognitive behavioral psychotherapy. In ERP, a person is being gradually exposed to their obsession while learning and practicing how to resist the urge of their compulsive behaviors. By staying in the state of distress without anything bad happening to them, people come to accept that their obsessions are not real and that they can cope without relying on compulsions. While this method takes a great deal of time and effort, ERP has been largely effective in improving the quality of life in people with OCD.
2. Medication
A high dose of antidepressants, typically used to treat depression, can be prescribed to control the obsessions and compulsions of OCD as well. And of the wide range of antidepressants in the market, selective serotonin reuptake inhibitors (SSRIs) are most commonly chosen due to their fewer side effects. They prevent reabsorption of neurotransmitter serotonin, better known as the ‘happy hormone’, by nerve cells in the brain. This results in higher serotonin levels that continue stimulating the brain, improving your mood, emotion, and sleep.
3. Surgery
Neurosurgical procedures like deep brain stimulation have significant success in keeping OCD in check. It involves inserting electrodes into the brain to regulate abnormal impulses and chemical production. These electrodes are linked via extension wires to a neurostimulator inserted under the skin near the collar bone, which can be controlled via an external remote controller to modify the level of stimulation.
These are only some of the possible treatments for OCD out there, many of which are usually administered simultaneously for the best treatment outcome. Support from medical professionals, support groups, as well as family and friends can also play a significant role in providing relief to a person with OCD.
So the next time you let slip a comment on how someone is ‘OCD’, perhaps think about how a casual ‘synonym’ for perfectionism could be someone else’s life-disrupting disorder.
Demographic facts
- Around 2% of the world’s population is diagnosed with OCD.
- OCD symptoms usually manifests before 25 years of age, often in childhood and adolescence.
- More women have OCD than men, but males often develop symptoms earlier than females.
Written by Genevieve Teo
Edited by Lydia Yasmin
Illustrations by Lim Daphne
