“Oh my gosh! You’re so OCD.”
“Did you see how particular she is about the pictures being straight? Maybe she has OCD.”
Our pop culture lexicon throws around the phrase, “OCD” as if it’s simply an exaggerated way of expressing that someone is very particular. However, the reality is that clinical OCD is much more than just a penchant for particularity. Living with OCD can be both debilitating and frustrating.
What Does “OCD” Stand For?
OCD stands for Obsessive-Compulsive Disorder. While it was previously listed in the DSM (Diagnostic and Statistic Manual of Mental Disorders) as a subheading of anxiety disorders, it now has its own category.
The criterion for OCD goes beyond simply having anxiety about a certain topic or being particular about how things are done. The defining characteristics of OCD include these components:
“Recurrent and persistent thoughts, urges or images that are experienced, at some time during the disturbance, as intrusive, unwanted, and that in most individuals cause marked anxiety or distress.” (DSM-V)
“The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some thought or action (i.e., by performing a compulsion).” (DSM-V)
Individuals who suffer from OCD usually find themselves in a vicious cycle. They experience a thought that causes anxiety and are driven to repeat behaviors or compulsions to reduce the anxiety. To be classified as OCD, there must be both intrusive anxiety thoughts and compulsive behavior that is time-consuming and creates a significant disruption in a person’s life.For example, an example could be someone who has anxiety around germs. They begin to wash their hands very carefully every time they walk in the door. Despite this, the anxious thought, “what if I missed washing something off?” continues to haunt them. The individual might try to relax, only to have anxiety intrude again with this thought, which can only be ameliorated by washing their hands again.
This example is simplistic, as OCD can take many other forms than the stereotypical example of washing one’s hands repeatedly. However, with this example, it’s easy to see how the compulsive handwashing behavior could escalate to a point where it became time-consuming and interfered with significant components of one’s daily life.
When suffering from a compulsive need to perform a behavior, an individual’s anxiety levels can become almost unbearable until they can complete the behavior. Then the cycle begins again. You can see how this becomes much more disruptive than a penchant for tidiness.
Co-morbid Mental Health Symptoms
You might be curious about how to differentiate it from other mental health issues that seem similar. The fact is that many anxiety and trauma-related issues can have a similar intrusive thought–compulsive behavior loop.
Eating disorders, anxiety disorders, PTSD, and body-focused repetitive behaviors, such as hair-pulling and skin picking, can all share similar characteristics, but a diagnosis of OCD is usually given after determining that the compulsive behavior does not fall under one of those other umbrellas.
What causes OCD?
Researchers don’t know exactly what causes OCD. There is likely a genetic component that makes people more susceptible since we know that about 25% of those with OCD have a close relative that also has it. The complex interaction of neurotransmitters (brain chemicals like dopamine, serotonin, and adrenaline) also plays a part in how OCD develops; some people have a predisposition to these neurotransmitters becoming imbalanced.
As with many mental health concerns, especially stressful incidents can increase the likelihood that someone suffers symptoms, though researchers say that stress does not cause OCD on its own. Some children can also have an onset of OCD-like symptoms after certain kinds of bacterial infections.
How do you treat OCD?
Cognitive Behavioral Therapy (CBT) is the recommended form of treatment for OCD. If you imagine the intrusive thoughts and compulsive behavior of OCD as a feedback loop, a counselor using CBT can help the client to disrupt this loop in a safe environment.
A thorough case history of the obsessions and compulsions that someone is currently experiencing can then allow the counselor to design a series of exercises to build the capacity to withstand the compulsive urges. This effectively interferes with the negative feedback loop and helps to weaken the hold of the compulsive urges on the individual.
At the same time, the counselor can help the client discover rational ways of interacting with intrusive thoughts and evaluating their truth. Instead of accepting their intrusive thoughts as absolute truth, the client can learn to challenge them and replace them with more accurate information.
What does the Bible say about OCD?
While the Bible may not specifically mention OCD, it does have a lot to say about the value God places on us as His creation. The psalmist David declares, after saying that there is no thought hidden from God, and nowhere we can go from His presence:
For you formed my inward parts; you knitted me together in my mother’s womb. I praise you, for I am fearfully and wonderfully made. Wonderful are your works; my soul knows it very well. – Psalm 139:13-14
If God has declared that His creation is intentionally made, and made to be good, then that means, that God does not condemn you for struggling with something like OCD. As part of a sinful world, humans suffer from brokenness in their brains and bodies. An individual’s unique brain chemistry interacting with their stressors and life history does not make them less of a Christian or less valuable to God.
The apostle Paul famously struggled with his “thorn in the flesh.” We don’t know exactly what that thorn was, but the important lesson here is that Paul’s affliction was a means for him to become more reliant upon God, and a window for his human weakness and frailty to illustrate God’s power more fully. Paul tells us:
God decides whether to heal, or not, and counseling can be a means to aid that healing. Christian counseling can be especially great for something like OCD where there is a firm basis for truth – the Bible – to help counter some of the intrusive and repetitive thoughts. It encourages us to use our minds to bring our bodies and behaviors into a closer alignment with what God says is true.
Three times I pleaded with the Lord about this, that it should leave me. But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore, I will boast all the more gladly of my weaknesses, so that the power of Christ may rest upon me. – 2 Corinthians 12:8-10
God promises that He “gave us a spirit not of fear but of power and love and self-control” (2 Timothy 1:7) If you choose to seek treatment for OCD be comforted by the knowledge that God is with you and can grant you the clarity of mind and the self-control necessary to master the compulsions you feel.
There is no shame in struggling with something like OCD, but in the ongoing process of being made increasingly like Jesus, we are offered the opportunity to continue to heal the parts of us that are suffering. If you are interested in learning more about OCD treatment, we’d love to talk to you and see if we can help.
Cognitive behavior therapy and ERP. Beyond OCD. (2018, April 2). Retrieved December 6, 2021, from https://beyondocd.org/information-for-individuals/cognitive-behavior-therapy.
What causes OCD?, Beyond OCD, (2018, April 2). Retrieved December 6, 2021, from https://beyondocd.org/ocd-facts/what-causes-ocd
“Stressed”, Courtesy of Daniel Reche, Pexels.com, CC0 License; “Disequilibrium”, Courtesy of Elina Araja, Pexels.com, CC0 License; “Shadow of the Hand”, Corutesy of Maisa Borges, Pexels.com, CC0 License; “Pleading”, Courtesy of cottonbro, Pexels.com, CC0 License
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