Obsessive Compulsive Disorder is an illness that many people have, but none confesses to have. The disorder, described with the capital letters OCD, affects men, women, elders, teenagers and even children. It is, in short, an endemic ailment, as if it had been specially designed to live in our head.
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But there is still a sort of stigma or shame in those who suffer from it. All this is due to the prejudice and misconceptions which surround psychiatric disorders, as if they were a fault of the patients. Even OCD is included in the list of the disorders I suffered in my lifetime. That is why I decided to share my experience with you.
In this post, I’ll tell you a bit of my story, what I discovered about OCD, what I learnt, how I managed to keep it under control and conduct a normal and fulfilled life. If you are ready to overcome your OCD and stay better, continue reading.
Obsessive Compulsive Disorder: What is It and What Are the Symptoms?
OCD, commonly recognized as obsessive compulsive disorder, is a complex pattern of mental and behavioral disorders that move simultaneously under two ways:
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- Obsessions
- Compulsions.
Obsessions occur as intrusive and persistent thoughts that create disturbance in our daily activity.
There Are Three Types of Obsessions:
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- Thoughts (blasphemies, for instance)
- Images (disturbing porn scenes, for example)
- Impulses (such as the impulse to be aggressive and hurt others)
These obsessions may be triggered by events, ideas, thoughts, ideologies, religion and so on. When they occur, they fully take over our mind and life, as an immovable rock! In OCD, concentration and attention are only toward the obsessions. Patients can be irritable, depressed, dejected, but nothing will appear about the deep and intense suffering they are experiencing.
Compulsions are, instead, the actions that OCDs usually take to stop the intrusive thoughts or keep the irrational fear at bay.
Types of Compulsion:
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- wash hands billions of times per day, in order to avoid the obsession to get an infection
- avoid to touch potentially infected surfaces
- avoid to pick objects on the floor
- chase reassuring ideas to get rid of obsessive thoughts
- count your steps
- close the doors for the fear of a danger
- check the knob of the gas for the fear of a leak
- obsessive attention to details, order, and symmetry
Usually, the above-mentioned symptoms of compulsions are included in the four main types of obsessive-compulsive disorder:
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- Washer and Cleaner OCD
- Checking OCD
- Repetition and Counting OCD
- Order and Symmetry OCD.
Compulsion is an inner push, a sort of mental command that orders you to do something or take an action. With compulsion, you are forced to act. The action has, indeed, the function to relieve the anxiety caused by the obsession.
Obsession and Compulsion work in a combined way. Obsession, usually, can’t exist without compulsion. Sometimes, patients may have only intrusive thoughts, called “pure obsession”, but, even pure obsession is always accompanied by mental compulsion, such as reassuring ideas or thoughts to wipe away the intrusive ones. This last symptom is called “mental rumination”.
Obsession and compulsion have a heavy and disruptive impact on our existence, they deplete our immune system, depriving us from inner energy and joy of living. Then, magically, obsessions fade, little by little, and with them, even compulsions. This positive effect is only temporary, because, if not treated, OCD returns with the same disruptive power of always.
Why does all this happen? Why is OCD so horrible and persistent? Where does obsessive compulsive disorder come from? These are the same questions I asked myself when I was in the grip of OCD. The first time I had it, I was 8 years old.
Then, OCD disappeared and returned when I was 23 years old. That is the devilish demeanor of this disorder: it comes and goes, uncontrollably. To understand what I understood now that I am an adult woman, we need to come back to the origins of the matter.
The Roots of Obsessive-Compulsive Disorder
When I had this disorder, I looked for more information about it. I have always been an avid reader and to discover more about OCD, I read several psychology books. They were not focused only on obsessive-compulsive disorder, but on many underestimated aspects that could be involved in the occurrence of this disorder. One of these books captured my attention. It was the one by Belgian psychologist and psychoanalyst Pierre Daco, titled What is Psychology and written in 1979 in French and Italian. In the book, this European psychologist talked also about OCD, defined with the language of that time, “obsessive ideas”.
According to Pierre Daco, obsessive ideas were generated by the faults and unbalanced patterns of our modern lifestyle. In my view, this idea is fully applicable to the current time we are living in.
“We shouldn’t be so struck by the rise of obsessive disorders – the doctor explained in his book – just look around us, everywhere you see ambiguity, hypocrisy and people forced to hide their true self to be like the others want them to be. Falsity and manipulation are widespread and dominate the world, by now. People fear to openly express their true emotions. They don’t know themselves and restrain their full being. It is normal that human beings so much constrained and repressed suffer from a variety of mental disorders, especially obsessive ideas, and intrusive thoughts. These are the most evident expressions of their true self that struggles to come out and finally live! Obsessive disorder is the sad consequence of a long era of repression. We can consider our time as the age of Repression”.
Hence, following the reasoning of the psychologist, the primitive root of OCD is in the constant habit to repress emotions. This habit, in turn, is a deviant behavior that is typical of our modern age.
According to this theory, it is as if our mind has a sort of emotional deficiency and loses the capacity to produce balanced and healthy thoughts. It is pointless to remark that I fully agree with this point of view.
You must also know that OCD has different levels of intensity. It may occur with mild, medium, or strong sensations. The intensity depends on the type of OCD, age, and condition of patients. Psychologist Pierre Daco, in his book, explains that “when an obsessive thought invades our mind is because something in our brain or inner condition allows it to do that”.
Furthermore, many people believe that OCD worsens with age, but this aspect always depends on the onset of the disorder. The obsessive-compulsive crises are fluctuant in occurrence and intensity. If the patient has had OCD for many years and asked for treatment, OCD usually reduces. If the onset is late and untreated, the disorder may be the most debilitating disease that persons could endure in their lifetime. If your social, affective, professional life is severely impacted by your OCD, you can obtain disability benefits.
Coming back to the origins of OCD, during a public meeting, Italian psychologist Maria Tamburino said that “mental disorders are triggered when love and job are missing”. These words touched me very much, even because I have always lived in a Country, Italy, where a job is not a right (as written in the Constitution), but a privilege, often managed by criminal organizations.
The words of the Italian psychologist confirm the theory of the Belgian psychologist we can summarize like this: When Materialism becomes more important than Spirituality, meant as emotions, the result is only an impressive growth of mental illnesses.
The main psychological root of OCD may, hence, be, an emotional deficiency triggered by emotional repression and deviant behaviors built during years of social and economic development founded on the prevalence of production and profit over human feelings.
Even today, everywhere, you find lies, messages, ideologies made to manipulate minds and make only a profit! A world founded only on not existing values is a deviant world. Mind and World are interconnected and the deviance of one is the disorder of the other!
Yes, but why does someone develop depression, some anxiety and others obsessive compulsive disorder? The reply is that obsessive compulsive disorder may be also caused by other mental illnesses. There are, in fact, many causes which trigger it.
OCD Causes
The causes of OCD are mainly three:
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- psychological
- genetic
- physical
When the causes are psychological, OCD is considered a mental illness included in DSM 5.
Let’s see them carefully.
Psychological Causes
In most cases, psychologically caused OCD is not an isolated mental disorder, but the consequence, or rather, the symptom of other underlying psychiatric conditions. These conditions, in fact, occur in comorbidity with others. OCD may be the expression of an anxiety disorder, depression, panic disorder and bipolar disorder. Some of the symptoms, for example, such as checking the appearance in the mirror and hoarding tons of stuff and objects are being classified as separated disorders, namely dysmorphic body disorder and hoarding disorder. These two latest symptoms are classified as a form of OCD in which the compulsive component is stronger than the obsessive one.
When OCD is the result of another mental illness, it is only the iceberg tip used by our mind to hide the true problem. The reason that explains why some people develop OCD instead of depression depends essentially on the structure of their personality.
Persons who have perfectionism traits may be mostly susceptible to developing OCD. This disorder is, indeed, linked to an unrealistic vision of perfection. OCD patients are usually clever and sensitive. They aim to rigidly abide by social and ethical rules and to be honest, just, and blameless. The perfectionist traits are usually inducted by family environment and social pressures.
If you consider that we are pushed to be great and excellent since our childhood, OCD becomes the most probable disorder we’ll develop over our life. Even misunderstandings and misconceptions about religion and sexuality may trigger the most dreadful forms of OCD, such as the obsession about the unforgivable sin and the one on sexual perversion.
When OCD is associated with other mental illnesses, usually it is intermittent and alternates its symptoms with unexplainable anxiety, depression, mood swings and nowadays, even with some type of addiction. Patients with OCD are never aware about this alternance, because OCD has an early occurrence and starts when we are children or teenagers.
Only a psychiatrist can diagnose the exact cause of obsessive – compulsive disorder.
The most frequent diagnosis for psychological OCD is “OCD from mood disorder with a depressive component caused by problems to accept reality”. In short, this may be a diagnosis of depression or bipolar disorder. However, people are different and symptoms and occurrences of OCD may be different, too.
Psychological OCD needs to be promptly treated, because it can exacerbate the underlying psychiatric disorders. Unfortunately, many patients remain undiagnosed for the shame that still surrounds this sorrowful mental illness. The global prevalence of OCD patients is 2%.
The statistics regards diagnosed OCD cases, but I think the undiagnosed ones are much more. Only in Italy, for example, websites about OCD receive over 30 comments per post from people who say they suffer from obsessive-compulsive disorder.
If it remains untreated, OCD may take control of our personality and behavior, giving rise to the obsessive-compulsive personality disorder. This occurs just in patients with perfectionist traits. When they get older, OCD may lose its intensity because they become more aware about themselves, but the mild obsessive-compulsive symptoms leave a room to a behavior where patients behave obsessively and with controlling actions, being aware to do that.
OCD and behavior get, so way, merged into a unique trait of personality. However, OCD and OCPD are treated as two different disorders even when one might be the consequence of the other. OCD occurs with uncontrollable thoughts and actions, OCPD, instead, occurs with ideas and behaviors the patient believes to be able to control.
Genetic Causes
People who have had parents with OCD are likely to develop the same disorder. Obsessive compulsive disorder has genetic causes, also. Medical research, indeed, discovered that “One of the first reports in the English literature was based on fifty cases of ‘obsessional neurosis’ treated at the Maudsley Hospital in London. 37% of parents and 21% of siblings of cases were diagnosed with this disorder…”
Researchers are still investigating to discover if variations in the genes involved in the transportation of serotonin in the brain may cause OCD. The cause of this mental condition is still unknown, but genetic conditions may not be enough to trigger OCD. It is more probable that environmental and genetic conditions interact among them to cause OCD in people where genetic variations are detected.
Many illnesses have a genetic origin, such as breast cancer, Alzheimer’s disease, and schizophrenia. The latter causes obsessions and compulsions, also. However, the high number of people affected by OCD in the world makes us think that social, and environmental factors play an important role in the genesis and occurrence of obsessive-compulsive disorder.
Physical Causes
The cause of OCD may also be physical. Physical causes of OCD often relate to thyroid disorders, such as Hashimoto’s thyroiditis, and hypothyroidism. These conditions affect the neuronal mechanism of production of serotonin in our brain, causing depression. The latter, in turn, may cause obsessive-compulsive disorder.
In this case, hence, OCD might be a symptom of depression or a consequence of a brain impaired by an endocrine condition. There may be another possible physical OCD cause. It is halfway between a psychological and physical condition. I am talking about stress. The latter is a natural reaction of our body to help us cope with events or dangerous conditions. To face these stressful conditions, our endocrine system floods our body with a charge of hormones.
If our endocrine system is damaged by physical disorders, like in the case of thyroid diseases, we might have problems managing stress. I verified this condition by myself. When I crossed stressful events, I always had severe OCD symptoms.
The most terrible stress occurred on my wedding day. That day, I awoke with anxiety and obsessive ideas of guilt I have never had in my life. Unfortunately, that obsessive crisis ruined the most beautiful day of my life. I remember only a few things from my wedding day, because my mind was focused only on its obsession. Beware: not my obsession, but the result of a physical problem caused by an endocrine disorder.
I understood that only some years later, but this awareness allowed me to manage my OCD and conduct a nearly normal life. If you have thyroid diseases, you could be unable to manage stress and all this could result in obsessive-compulsive disorder. Obviously, it would be better to do a test that diagnoses the type of OCD you have in order to set the proper treatment.
Obsessive-Compulsive Disorder Test
The OCD test is a particular clinical examination to diagnose if you suffer from obsessive-compulsive disorder. It is performed as a written quiz with questions aiming to evaluate the types of symptoms you have. The test is carried out in a clinical environment with a psychologist and patient.
The answers of the test are strictly confidential to protect your privacy. Your doctor might also suggest you to do blood tests to verify if you have thyroid disorders. You might also be asked to do brain examinations such as PET scan and quantitative electroencephalogram (QEEG). These tests are today used to diagnose depression, anxiety, and OCD. The chart of the test shows a map with different colors used to detect brain diseases and mental disorders. Anormal colors in some areas of the brain may indicate an inflammation that triggers OCD.
This shocking finding has been made in 2017 by a clinical trial of the Center for Addiction and Mental Health in Toronto. The study discovered that OCD patients undergoing PET scans had high levels of inflammation in 6 brain areas involved in the onset of obsessive-compulsive disorder. The results of this study open the way for a new approach in the treatment of this neuropsychiatric disorder.
Scientists also suggest checking the quantity of serotonin in the blood and to do anti-TPO blood tests in order to verify the connection between serotonin deficiency, autoimmune disease, and OCD. Crossed findings increase the chances to turn OCD from a disruptive condition to a disease which can be easily cured.
OCD Treatment
The treatment of obsessive-compulsive disorder is usually psychological and psychiatric. A cognitive- behavioral psychotherapy showed to be effective. However, the proper treatment depends on the intensity, type, and cause of OCD. If the cause of the disorder is depression, patients may be prescribed antidepressants.
If they suffer from anxiety, they may take medications against anxiety. However, psychotropic drugs have the side effect of causing addiction and becoming ineffective over time. If OCD is triggered by autoimmune diseases, you should treat these diseases to overcome your OCD.
To reduce OCD, you should also try to confide your sensations to a person you trust, such as a friend, your soulmate, a priest. It is proven that confiding our personal sufferings to those who love us helps relieve OCD.
Over the years, for instance, I learnt to overcome my OCD by myself and manage it successfully. I learnt, among other things, that we can check the intensity and occurrence of OCD by reducing stress. I rest when I feel too tired, or avoid doing too many tasks all at once.
Furthermore, I learnt to live a more authentic life, without fear of criticism and by accepting my human limits. As regards religious OCD, stopping believing In God does not work, because after a temporary relief, intrusive thoughts will appear under other guises. Hence, atheism is not the solution. Accepting limits and our human imperfection is the key to overcoming the disorder step by step, even with the help of your therapist.
Conclusion
OCD causes tremendous discomfort. I know it, because I have had it! But Obsessive-compulsive disorder is a disease and when you have it, you are not guilty or a bad person. You are a lovely person who deserves to be loved and understood. We are not perfect and, sometimes, intrusive thoughts and impulses are there, in our mind, only to push us to accept our imperfect humanity. If we accept that, we’ll be able to find the strength to defeat OCD once and for all!
By Rosalba Mancuso
References & Bibliography:
- Istituto A T Beck – Il Disturbo ossessivo-compulsivo: i sintomi, le cause e il trattamento
- Dr. Pierre Daco – Belgian Psychologist – Introduction Book What is Psychology – Italian edition
- Dr. Maria Tamburino – Italian Psychologist
- Dr. Enrico Parpaglione – Psychologist in Turin – Quando l’ossessione è pura
- Maria Luigia Hospital – Monticelli Terme – Parma – Italy –DISTURBO OSSESSIVO COMPULSIVO. SINTOMI, DIAGNOSI E TERAPIA DEL DOC
- Y Sasson, J Zohar, M Chopra, M Lustig, I Iancu, T Hendler –Epidemiology of obsessive-compulsive disorder: a world view – J Clin Psychiatry 1997;58 Suppl 12:7-10.
- Gerald Nestadt, Marco Grados, and J F Samuels – Genetics of OCD – Psychiatr Clin North Am. 2010 Mar; 33(1): 141–158.
- Medline Plus – Obsessive-compulsive disorder
- Adam Feldman – Dr. Stacy Sampson – Why stress happens and how to manage it
- Clinical Center Nous – Il QEEG – www.centronous.com/centro/il-qeeg/
- Sophia Attwells, HBSc1,2; Elaine Setiawan, PhD1; Alan A. Wilson, PhD1,3, et al – Inflammation in the Neurocircuitry of Obsessive-Compulsive Disorder – JAMA Psychiatry. 2017;74(8):833-840. doi:10.1001/jamapsychiatry.2017.1567
SHORT BIO
Rosalba Mancuso is a Sicily-based freelance journalist with 31 years of experience as a contributor to national newspapers and magazines. International medical reporter and professional member of the AHCJ, American Association of Health Care Journalists, she covers stories and news on mental health, autoimmunity and neurological diseases. Website: https://rosalbamancuso.com.
