Individuals with obsessive-compulsive disorder oftentimes feel the need to repeatedly check things or perform certain rituals or routines repeatedly. These upsetting and intrusive thoughts are called obsessions. Those with OCD attempt to control them by performing certain rituals known as compulsions. One of the more well-known symptoms is when an individual has an obsessive fear of dirt and washes their hands repeatedly even though they are clearly clean. Some of those with OCD are obsessed with repeatedly checking things, such as making sure that the door is locked when they leave the house, or ensuring that the stove is off by repeatedly checking it out.
Those with OCD realize that such behavior is not rational, but they feel powerless to stop. These rituals are oftentimes very time-consuming and distressing. Approximately 15 percent of those with OCD attempt suicide, and two thirds of those with the disorder suffer from major depression. OCD can run in the family and appears to have a genetic component, but its cause is mostly unknown. OCD frequently begins in childhood or the teen years. It is usually treated with psychotherapy and medication, oftentimes SSRIs. OCD is generally treated with psychotherapy, medication, or both.
Some OCD lacks overt compulsions. Instead, individuals refer to unwanted thoughts or questions whch the individual repeatedly attempts to push away. This is known as pure-obsessional OCD. First, the individual has an unwanted thought. Next, they engage in mental activity to attempt to escape the thought. For example, a mother with pure OCD may experience the intrusive thought of smothering her infant even though she has no desire to do so. Periods during which the activity is at a high is known as rumination. Those with OCD may engage in rumination for several hours a day.
Individuals with OCD struggle every day with a combination of shame and an overwhelming desire to avoid risk. They continually fear that something horrible will happen and perform, oftentimes elaborate, compulsions, in order to neutralize these fears. For example, they may have intrusive thoughts, known as obsessions, of pushing someone into traffic as they pass them on the sidewalk, or they might have intrusive and disturbing thoughts during sex which makes the activity impossible to enjoy.
Unfortunately, an estimated 60 percent of those with OCD never get help for their disorder. OCD is associated with disruptions in relationships, loneliness, celibacy, and divorce and relationship conflict. It is also associated with over 8 billion dollars lost in the United States alone, once treatment, lost days at work, and lost productivity in work, are taken into account.
Those in the Middle Ages may have been candidates for exorcism, since OCD was associated with blasphemous thoughts. Those being treated in the early 20th century may have undergone Freudian psychoanalysis on the ground that the patient allegedly had an unconscious desire for their mother. The informal use of the word “anal” to refer to someone who is unusualy preoccupied with cleanliness or overly rigid and controlling comes from the Freudian idea that strict toilet training causes children to become neurotic in this way.