OCD: Causes and Types of Obsessive-Compulsive Disorder

OCD is not about a love of order. It is a disorder in which intrusive thoughts and repetitive actions get out of control and interfere with life. Let's look at where it comes from and why it is so easy to get confused about the names.

What OCD is: obsessions and compulsions

Obsessive-compulsive disorder is a mental disorder with repetitive thoughts (obsessions) and behaviors (compulsions). A person cannot control or stop them, and they interfere with their life. Obsessions are intrusive thoughts, urges, or images that cause anxiety. Compulsions are actions that a person repeats to reduce this anxiety or stop the thoughts. It is a mistake to think that OCD is simply being neat: more often a person gets stuck on an action that they feel compelled to repeat. Over time, obsessions and compulsions can change.

Causes of OCD

The exact cause is unknown. Genetics, biology and brain chemistry, as well as the environment, may play a role. Risk factors include a family history: people with a close relative (parent, brother or sister, child) with OCD have a higher risk, especially if the relative's disorder began in childhood or adolescence. Differences in the structure and function of certain brain areas, childhood trauma, including abuse, and temperament traits — shyness, frequent low mood, anxiety and depressiveness in childhood — are also mentioned. In some cases, OCD or its symptoms in children occur after a streptococcal infection.

Types of obsessive-compulsive disorder

Obsessive disorder with a predominance of intrusive thoughts and compulsive disorder with a predominance of compulsive actions are distinguished separately. In terms of content, obsessions vary:

• fear of germs or contamination;
• fear of forgetting, losing, or being unable to find a needed item;
• fear of losing control over one's behavior;
• worries about harming oneself or others;
• unwanted thoughts about sex or religion, aggressive thoughts.

Compulsions also differ: excessive handwashing and cleaning, repeated checking (whether the door is closed, whether the stove is turned off), counting, arranging things in a strict order. Some people with OCD have Tourette syndrome or another tic disorder.

Aggressive obsessions: what they are

Aggressive obsessions are intrusive thoughts about harming oneself or others. In the list of obsessions, such thoughts are listed separately, alongside the fear of losing control over one's behavior.

How the diagnosis is made and when to see a specialist

The first step is to tell a doctor about the symptoms. They will perform an examination and ask about health history to rule out other causes. If there are no physical explanations, they may conduct an OCD test or refer you to a psychiatrist. OCD can sometimes be difficult to recognize: its symptoms resemble other anxiety disorders, and they can co-occur. A disorder is usually discussed when a person cannot control their thoughts or behavior, even while understanding they are excessive, spends at least an hour a day on them, does not enjoy the actions (they provide only brief relief), and has noticeable problems in daily life. OCD most often begins at ages 10–30, and the first consultation with a psychiatrist often occurs only between ages 25 and 35.

OCD by itself is not a reason to call an ambulance. Call 103 or 112 if there is a threat to life.

This material is for reference and does not replace a doctor's consultation: it is better to understand your condition together with a specialist.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer