Obsessive compulsive disorder (OCD) – causes, symptoms & pathology


Double-checking things is a pretty common
human behavior, like—did I shut the garage-door? Better double-check. How about locking the
front door? Double-check. Gas-stove and oven off? Double-check. We all do it. But what
if you feel compelled to triple-check it, or even quadruple check it, or quintuple check
it even, then it might be considered an obsession. Now, what if you have to do a certain ritual
with the gas-stove and oven before leaving the home each time, like: make sure the gas-stove
is off, wipe down the gas stove to clean it, double-check that the burners are off, make
sure the oven is off, wipe down the oven to clean it, and then open the oven door to make
sure no heat is coming out, and then leave the house. Then that might be a compulsion. Obsessive compulsive disorder, or OCD, is
a specific type of anxiety disorder characterized by these obsessions or compulsions. Obsessions
are recurrent and intrusive thoughts that are typically unwanted and tough to get out
of your brain. These unwanted thoughts like “my house is unsafe”, cause anxiety, and
usually they they lead to compulsions, which are actions that might be performed to try
and reduce the anxiety associated with obsessions. As you might imagine, these thoughts and rituals
can have a serious impact on someone’s daily life. OCD affects around 3% of the population,
and affects both men and women equally and usually starts in childhood or in the teen
years. Celebrities like David Beckham and Howie Mandel are known to be affected by OCD,
and a more severe example is that of Howard Hughes, business tycoon and entrepreneur,
among other things, who was affected by relatively incapacitating OCD later in his life. Although obsessive-compulsive includes both
obsessions and compulsions, one doesn’t need both obsessions and compulsions for a
diagnosis, some individuals might have just obsessions, or just compulsions, but the majority
of patients have both, often where the compulsion is performed to alleviate an obsession. A
very common compulsion is cleaning, which often stems from an obsession with germs or
contamination. Another common compulsion is checking, usually because they have obsessions
that something’s unsafe, so they’ll check to make sure that something’s definitely
locked by unlocking and re-locking, sometimes several times. More generally, repeating is
a compulsion on its own, where an action or phrase is repeated several times, and usually
this is done because if it’s not, they think something bad will happen. Sometimes patients
might feel compelled to order and arrange things, because when they’re out of order,
it causes anxiety and discomfort. Finally, mental rituals are also obsessions, these
are often done to try and neutralize intrusive or—what they think are—bad thoughts. So
they might try and call up specific words or phrases they think are good thoughts to
try and replace the bad thoughts. Now the diagnostic and statistical manual
for mental disorders, the fifth edition, or the DSM – V gives specific diagnostic criteria
to meet for a diagnosis of OCD. First and foremost, they need to have the presence of
obsessions, compulsions, or both. The obsessions and/or compulsions need to also be time-consuming,
often such that it produces distress with their social and work life, for example, taking
two hour per day folding and unfolding clothes and then being late for work. It’s also
important that the obsessions and compulsions are not due to the physiological effects of
a substance or another medical condition. Finally, the apparent anxiety isn’t better
explained by another mental disorder, like for example, an obsession with personal appearance
like in dysmorphic disorder. Like most mental disorders, there isn’t
a known cause of OCD, though it’s thought to be a combination of genetic and environmental
factors. Sometimes OCD seems to run in families, and an important clue is that identical twins
are more often affected than non-identical twins. It’s now thought that abnormalities
in serotonin neurotransmission in the brain plays a key role, though the exact mechanism
is unknown. Treatment usually involves psychotherapy,
medications, or both. Among psychotherapy options, cognitive behavior therapy has been
effective, specifically a technique called exposure and response therapy, where patients
are first exposed to the anxiety and compulsion-provoking situation; ultimately showing that the anxiety
actually lessons when the compulsion is not carried out. Because the cause has been linked
to serotonin, selective serotonin uptake inhibitors, or SSRIs, have been shown to be an effective
drug treatment, though they often come with symptoms and side effects that may need to
be further treated with medications or psychotherapy. With the right treatment, patients often return
to normal daily life and activities.

63 comments

  1. this video brought me so much joy. i was smiling all through it because something i've felt with for such a long time, is being described in a way ive always wanted to but could never let it leave my mouth. one of my obsessions is that nothing i say makes sense, and so as a result of that to help reduce my anxiety from that i repeat myself over and over, trying to make the right words come out until i feel satisfied. i'll be sure to link this vid when someone asks me about my ocd.

  2. If anyone wants some advice, apparently a lack of exposure to sun light can cause low serotonin levels. This video says that a serotonin imbalance is linked with ocd. My ocd is at its worse right now, and I’m spending more time inside than any other point in my life. Only go outside for a couple minutes every day.

  3. I think I have ocd. I always have to go back and check things even if they’re stupid. For example if I don’t go back 10 seconds in a video, I can’t get it out of my head and then I go back. If I don’t double check the stove even if I haven’t turned it on, I get an overwhelming fear that something bad will happen
    if I don’t check. I can’t shake the thoughts and it really messes with my life. I don’t have problems with washing my hands or being very clean, and ocd doesn’t affect me as much at school as it does at home. so I really don’t know. Can someone help me out?

  4. I have thoughts of if this happens then something bad will happen .

    So like I will think if the next car that comes around is green I will lose my job. Then sometimes it can be a green car and sometimes not is just scary because when it is green you try and rationally think of why that wasn’t a car or something like that and then worry about your job for a long time till you realise that its been 3 months and theres no evidence to support that your gunna lose your job. It’s absolute torture. This OCD is called magical thinking.

  5. The "repeat" mechanism was presented way too simplified. You don't just endlessly repeat stuff and then suddenly stop for no reason. There's always some system or idea behind the repeats. It's either a "good" number, like, for example, you define 5 as a "good" number, because when you were five you got that instrument that you still love and play, or you met your loved one 5 years ago. You choose the number and you define it. There's no logic behind it, it just has to be reasonable for yourself in some way. So, if 5 is a good number, you will repeat 5 times. There are other methods too, though. Sometimes you will have to repeat indefinitely until it feels like you "did it right". Again, the definition is made by you. It can be anything and also more than one thing. For example, you have to repeat until you manage to finish the action exactly after an exhale and before you start to inhale again. If you "don't succeed" on a try, you have to repeat until you "get it right". A mix of methods is also possible. Like, you have to repeat for 5 times, but also make sure to finish number 5 with a "good" action. If you fail, you have to repeat the 5 and try to "get it right" again. That is why and how it gets time consuming. If you fail, then the fear kicks in. And it's agonizing. So much so, that it can keep you at a task for a very long time.

    My OCD was so bad at one point, I almost choked myself on several occasions, because I tried to control my breathing insanely. I had other OCD issues too, but that one was the most exhausting. I managed to get better and I keep track of my personal development and as soon as I recognize a negative development I get back to my ERP and fight it. I don't always succeed at everything. But most of the time I do. I haven't choked myself in 4 years now. I'm still struggling, but I'm fighting every day and the fact that I got better helps me to keep going. It gets tougher around winter. The other day I found that I had started rituals again while watching commercials of meds against flu. I have this weird idea that if I don't I'll miraculously get sick when watching them. So I started to very consciously watch them again, making very sure I don't perform any rituals. I keep doing that for a few days and the urge to perform is basically gone. One important trick is to realize when rituals try to sneak in again. You have to detect and fight them, or they will slowly take over. I have experienced it. Doing one annoying thing isn't all that bad, after all. If it makes you feel better, why not? Then another thing comes up and it's just one thing, so you can do that little thing too. Then one more thing comes up and before you realize it, all you do is try to prevent disaster from happening with the weirdest methods. Just the act of "going to bed" from the living room to the actual bed could take up to about 45 minutes for me – not to mention the terrifying fear that I experienced among the way. (Yes, it can take that long, or even longer, remember you don't just have to do it, but you have to do it "right" – or repeat.) Today I do it very simply, just like everybody else. During times that are stressful the compulsions can sometimes come forth more forcefully and get to me, but it's nowhere near as bad as it used to be. So, if anyone who suffers actually reads this: Don't give up! It's worth the fight. It's worth the fear and the sweats and the tears, because at the other end there's a better life.

  6. i always clean,clean and clean more and i get tired my body didnt want to do it but my brain tell to do so hm sometimes ppl around me get annoy towards me bcos of being too much clean like i not barely touch the table at cafe when eating , not allow my friend to touch my bed, my things and sometime im stress because they cannot understand when i said they cannot touch something but they ignored me it cause a mental depression for me why ocd is exist?

  7. Omg idk if I have ocd but I do repeat things a lot and I do arrange my things just so it’s perfect. Sometimes I do have anxiety attacks over homework when I don’t know what to do. I’m also very young too. I’m only 11. Do I have ocd?

  8. I just hate extra dots on a sheet that are not necessary and waste time on it I turn fan switches to a select speed Because I feel right and not one but every fan in the house I check things 3 times not everything but some. My sister had OCD as well and I am not obsessed with thoughts of a kind. I don't know if I have OCD OR NOT

  9. I was wondering how the basal ganglia works in stress. I think I read somewhere that during the stress response the basal ganglia instructs ritual activity to relieve the stress. I've been struggling recently and smoking has now creeped back in. I'm guessing smoking is still a part of the firmware in my basal ganglia. I also think I have OCD, but need to check…

  10. I've never been diagnosed with ocd because I've never said anything about what I do and I also hide it very well. I do all the things that this video is showing soo I guess I have ocd😂

  11. i have the tendency to avoid doing certain actions because i believe it's bad luck. like for example, i can't sleep under my blankets because then i will forget my homework, get a bad grade, and i will get grounded. another example is that there's a certian song i will listen to and i believe it will somehow cause a fight to happen between me and my mom. i went to a therapist and they told me it sounds like ocd, but i don't know. it's not like i'm cleaning, or checking, or repeating an action, i just can't do anything without worrying if whether or not these things will give me good or bad luck.

  12. at night when i shut off my computer, and get the wlan adapter out, i have to always check atleast 10 times if it really is shut off or more and that really robs my sleep

  13. OCD is not always about checking either. I don’t check anything…but I do have intrusive thoughts and need to “dismiss” the bad thoughts by replacing them with “good ones.” Sometimes in order to dismiss a thought a compulsive behaviour comes along….but it has never had anything to do with checking!

  14. Lmao am I the only one who has to go back 5 seconds to re-read subtitles a couple of times in movies/shows

  15. idk if i have ocd ,but my head tells me for example if i do not wash my hands 2 times im a bad person or shit like that and if i cant do it i say a Word like fake or something like that in my mind ,it really bothers me a LOT

    (sorry for my bad grammar…)

  16. Okey so i realized that i have common in this video i feel uncomfortable when things are not right like..i was checking the doors repeatedly,thoughts abt non-sense that will be resulting ended up not sleeping in short scaring myself.. : D

  17. When i am touching somebody i really need to touch a part that i looked at (like an elbow or armpit).is that ocd ?

    (I know it sounds weird,sorry)

  18. I had ocd since i was a kid… And now stoped… Since it was killing my life… First tried with drugs from shrink.. But read about it..always was knowing wtf is wrong with me… But since i found out what it is and how is freaking me out… Then i just stoped thinking my self fuk that…. You will not destroy my life And just ignore this part… And dont give a fuck

  19. When I am out of my home I Don't have any kind of OCD I dont care anything but when I am at home specially at night I feel unsafe I have to check my door whether is it lock or not but in day I walk to outside keeping my door open.

  20. My numbers are 3, 7, and 37: because 3 comes before 7, 73 for example isn't right. I'm also okay with 9, because 3×3=9. Not 49 (7×7) though, because 4 "isn't right". When i look at the time i add up all the numbers, and if it equals 9 or a multiple of 3 i'm alright. If it doesn't show a 3 or a 7 i have to count to 37 to make it right.

    I haven't been diagnosed with ocd, but i've had compulsions since i was little (praying a LOT because i was afraid something bad would happen to my loved ones). I just recently started looking into it, and some compulsions came back after a very long time.
    I think i have mild ocd, because it doesn't give me a lot of anxiety (i always just do my compulsions so i don't have to worry about them) but it's hard. It's mostly checking behind doors, under beds… I also have compulsive skin picking.
    Nobody knows. I need help but i don't know where to find it.

    I also think i have adhd, but i have the fear i'm just lazy.

  21. I never got diagnosed cause I never went to anybody to check me out but I have it since I'm a kid.
    The more stressed I am the worse it gets let's say I'm working a stressful job. I have at least an hour daily of rituals. Saying things while I'm touching a certain spot every day or even doing a complete ritual when I go lock things up that consists of every step calculated things I have to say things I'm touching a certain way while saying something looking this direction and so on.

    Life's been crazy with this and depression so I reduced the stress so much that I'm handling it I think that's the only way besides medication.
    You have no idea how bad it is if you mess up a part of the ritual or if you get interrupted it's like you set a chain reaction off that will kill you and your family or something along those lines

  22. I don't think I have OCD. I just know that I wash my hands and dishes so much and consistently have to wash them to the point that my hands are peeling and I have this terrible eczema breakout. But I'm pretty normal with everything else.

  23. When I feel like I want to draw something and I draw it and it turns out bad , I cant relax till I make it perfect I keep drawing it till its perfect or at least my brain says its perfect

  24. Thanks for such a great effort and information sir, I m sure it will help many others, I know how does it feels especially when a child suffers from ocd and he doesn't even know what actually is happening to him, I was attacked by ocd when I was 10 but now I have learnt to overcome it and helping million others With this Channel.Once one knows compassion towards oneself and honour the god within, anyone can overcome OCD. I have invented so many methods and techniques like NFLBG method and universe meditation which are really helpful for OCD patients , if anyone is suffering from OCD is mostly welcome on my channel.With lots of love (Calm soul India)

  25. I have OCD and people some times just don’t understand how annoying it is. For example I have to take 3 steps from my sink to the toilet or else something bad is going to happen.

  26. I have a wierd thing that my mom says is related to to my OCD. I bite my skin a lot, especially on my arms and hands. Is that related to my OCD, or is it something else???

  27. One of my wierd compulsions is doing the same thing on my left and right side. Ex.: If I tap a pencil for three times on one side, I have to do the same on my other side. If I do 5 on the second side, I have to tap two more times on the first side. I hate it so much!!

  28. I NEED A SELECTIVE SEROTONIN RE-UPTAKE INHIBITORS TO MINIMIZE THIS SHIT OCD WASTING MY TIME IN MY EVERYDAY LIFE.

  29. OCD is terrible and I hate being like this. I cant leave the house without worrying my stove is on or my cat's gonna die or something. I litterly have trouble at school worrying about my backpack or my classes. It's taking over my life and it sucks really bad and I cant get the help I need…

  30. It is a lack of thinking mental controle and balance….correct the thinking to healthy ..out of unhealthy……controle ur thinking backtrack….instead of letting your choice in thinking controle you…the other way round be self monitoring ..aware of your thoughts and patterns ….living with these people is very uncomfortable…each time they flare up they go deeper into this addictive behaviour…a lot of time wasting feeding compulsions that make them sicker and sicker…find the cause or trigger of when it started…

  31. I have strong urges to touch and scratch random things (specifically tiny crevices), I count things (specifically letters in sentences and words), and I add unnecessary punctuation when I count an odd number of letters, and I also have strong urges to pull on my hair until it hurts, but all it does is relieves a bit of stress for like 2 seconds. The counting has been happening for about 2 years, and the touching and hair-pulling has been happening for the past 6 months. Do I have OCD? It’s been getting a lot worse lately.

  32. I’m not very sure if I have ocd. I suffer from emetaphobia and that makes me feel worried that I’ll be sick. And sometimes.. like I need to wear a certain type of underwear… I know it’s weird but most underwear I don’t wear because I’m worried they’ll bring bad luck from past things that have happend . For example: I never ever wear pink or blue underwear in fear that I will get bad luck. I also excessively wash my hands and have to get 3 paper towels at school, wipe my hands then open the door with the paper towel then hold door open with my foot and Chuck paper towel in the bin, and if I miss the bin I can’t leave otherwise I have bad luck. When I come back from the bathroom at school I open the door with my arm so I don’t get any germs on me. This is all very irrational but idk

  33. I don’t feel the other. Stuff except the repeating and checking and feeling like something bad will happen to me if I don’t do it

  34. iam a victim of ocd it made my life a hell whn I was a student right from school to collg, all classmates gone away from me they called me a maniac & mental,I remember bfr getting inside examination hall I used to touch t book & clip board almst hundred times without doing that cannot enter t hall also when studying i cannot study for almost long hours repeating was my compulsions…that time I cannot identify this is ocd,then I myself visited t doctor and did psychotherapy after my +2 bcs my mummy had no knowledge that this is mental disorder and i should be taken to hospital,now iam 41 years still remember those black days which made my life a miserable…..t biggest impact is on friendship I didn't have any best friends evryone ran away from me still now iam remberi with lot of grief and sadness my dirty past….

  35. everyone in the comments
    Im SoOoOooo OcD Er MaH guRd

    – OCD affects less than 1% of the population, im pretty sure one small compulsion or behaviour does not warrant a diagnosis.

  36. I’ve lost my brother to this illness. He even tried to do suicide. He can’t do anything anymore. He can’t stand, walk, touch or even look. It has taking over his life now… don’t make fun of OCD.

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