Obsessive-compulsive disorder (ocd). obsessions and compulsions

Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by the presence of obsessions (recurring and persistent thoughts, impulses, or images that are experienced as intrusive and unwanted, causing significant anxiety or distress) and/or compulsions (repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession or according to rules that must be rigidly applied).

Obsessions. Intrusive Thoughts

Obsessions are thoughts, urges, or mental images that occur repeatedly, are persistent, and are experienced as unwanted and intrusive.

The person attempts to ignore or suppress these thoughts, or to neutralize them with some other thought or action (a compulsion).

The contents of obsessions are varied, but some common themes include:

• Contamination: Fear of germs, dirt, or disease.

• Pathological Doubt: Constant uncertainty about whether an action has been performed (e.g., locking the door, turning off the gas).

• Order and Symmetry: Needing things to be perfectly ordered, aligned, or symmetrical.

• Aggressive Impulses or Feared Sexuals: Intrusive thoughts or images of a violent or sexual nature that are ego-dystonic (incompatible with one's self-image). Religious or Moral Preoccupations (Scrupulosity).

Compulsions. Rituals to Relieve Anxiety

Compulsions are repetitive behaviors (such as hand-washing, tidying, checking) or mental acts (such as praying, counting, silently repeating words) that a person feels driven to perform in response to an obsession or according to rules that must be rigidly enforced.

The goal of compulsions is to prevent or reduce anxiety or discomfort, or to avoid some feared event or situation.

However, these behaviors or mental acts are either not realistically connected to the thing they are intended to neutralize or prevent, or they are clearly excessive.

For example, washing hands for hours on end to avoid contamination.

Although compulsions may provide temporary relief from anxiety, in the long term they maintain the obsessive-compulsive cycle, as they prevent the person from learning that their fears are unfounded or that they can tolerate the anxiety without performing the ritual.

Diagnostic Criteria and Impact

For the diagnosis of OCD,The obsessions and/or compulsions must be time-consuming (e.g., more than one hour a day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

They are not due to the effects of a substance or another medical condition, nor are they better explained by another mental disorder.

OCD can be very disabling and profoundly affect quality of life.

The treatment of choice is usually cognitive-behavioral therapy, specifically Exposure with Response Prevention (ERP), often in combination with medication.