Obsessive-compulsive disorder (OCD) is a long-lasting condition where a person loses control of their thoughts. OCD is when someone has uncontrollable, recurring thoughts and behaviors that they feel the urge to repeat over and over. For example, a person with OCD can’t leave the house until they’ve gone about their ritual; otherwise, they believe something bad will happen to them. It can get so bad a person is consumed by their thoughts and have a tight grip on their lives.
Having a routine in your life and adhering to a schedule is healthy. When you wake up, you might make your bed first thing, have a shower, go for breakfast and drink a cup of coffee before you start your day. Creating a neat environment for yourself at home or work is a good thing. However, when you begin encountering anxiety when something isn’t done, or you have to fight urges to repeat these tasks, you might be dealing with something more than having a neat personality.
At one point, obsessive-compulsive disorder was considered one of the most disabling illnesses because of its ability to ruin your quality of life and cause people to lose their income. The condition affects one in 40 adults in the United States, but finding recent statistics to back up these figures is challenging due to a lack of recent studies. This means the number of people struggling with the condition could be higher.
There are several variations of OCD, and those who are diagnosed could experience different symptoms. For that reason, it’s important to understand an OCD diagnosis and find out if you’re experiencing one of its many variations. Below we’ll discuss in-depth what OCD is, its commonality, causes, and how it’s treated. If you’re worried you might be suffering from OCD and feel powerless over your symptoms, it’s important to continue reading.
What is Obsessive-Compulsive Disorder (OCD)?
Obsessive-compulsive disorder (OCD) is a chronic anxiety disorder where a person experiences uncontrollable, recurring, or unreasonable thoughts followed by a behavioral response. Obsessions are repeated urges, thoughts, or mental images that ultimately lead to anxiety. Compulsions are repetitive behaviors that someone with OCD feels the urge to complete as a response to their obsessive thoughts.
According to Menije Boduryan-Turner, Psy.D., a psychologist based in California, there are four categories of OCD behaviors, also known as compulsions.
- Acting compulsively in ways that include handwashing, checking, moving objects, locking, staring, praying, or seeking symmetry
- Constantly looking for reassurance from friends or loved ones, Google, or talk to Siri.
- Avoiding potential triggers that include objects, social interactions, or purposefully walking around things like cracks in the ground
- Mental compulsions, including counting, repeating words, rumination, mental checking, thought suppression, visualization, neutralizing (replacing negative thoughts with positive thoughts, and mental reviewing (going over past actions)
The cycle of OCD will persist through operant conditions, compared to compulsions which are behavioral responses to reduce feelings of anxiety. The effectiveness in which these compulsions are relieved negatively reinforces these behaviors as a response to obsessions. For example, the relief a person feels once they seek reassurance from a friend or loved one is enough to keep the cycle going.
An OCD diagnosis significantly affects a person’s life because of anxiety, intrusive thoughts, and uncertainty. OCD obsessions can be triggered at any moment and are extremely invasive. Those with the disorder find it challenging to leave the house because they’re embarrassed by their ritualistic behavior in a public setting.
Prevalence of OCD
An estimated 2.3 percent of the U.S. population suffers from this condition, roughly translating to one in 40 adults and one in 100 children. As mentioned above, OCD could be more prevalent throughout the country, but due to the old studies, that figure is unknown. However, according to a Harvard study, the prevalence of the condition in a 12-month span was higher in females at 1.8 percent than men at 0.5 percent.
An estimated two-thirds of those with OCD had significant symptoms before they turned 25, and families with a history of the disorder have a 25 percent chance of another family member developing symptoms. Half of those with OCD have severe impairment. One-third of adults with OCD had moderate symptoms, and 15 percent of adults have mild impairment.
The average age of onset is around 19.5 years old, and males make up the majority of early-onset cases. Nearly 25 percent of males have onsets before they turn ten, while females are diagnosed with the condition after age ten. Those who are diagnosed early will encounter more severe symptoms, as well as higher rates of bipolar disorder and ADHD.
What Are the Causes of OCD?
A combination of environmental, genetic, and neurobiological risk factors might cause the disorder. OCD symptoms are linked with communication areas in the brain, and abnormalities in neurotransmitter systems, such as dopamine, serotonin, and glutamate, are also involved. A key characteristic of OCD is that a person does not have serotonin readily available in parts of the brain, which are vital for communication to take place.
Receiving an accurate OCD diagnosis may take up to nine years. Even worse, it can take another 17 years for sufficient care. Unfortunately, only ten percent of those with adequate care will recover from OCD, while 50 percent will see an improvement in their symptoms.
Although all forms of OCD have some symptoms in common, the way in which they’re presented in daily life will differ from one person to another, leading you to wonder if there are different types of OCD.
Are There Different Types of OCD?
Despite all forms of OCD presenting similar symptoms, the way in which they’re presented from person to person indicates the different types of OCD that exist. The content of someone’s obsessions isn’t important, but it’s what feels important in that moment.
An individual’s subtype is the particular way their OCD affects them. What is their mind focusing on? What thoughts are resulting from their focus? Despite subtypes remaining stable over time, new symptoms can appear while old symptoms fade.
OCD is considered heterogeneous by clinicians because it’s so different from one person to another. However, there are some common cluster symptoms that researchers have noticed from one case to another.
- Contamination obsessions: These are considered harm obsessions in conjunction with checking compulsions, which are fear-of-harm thoughts, taboo thoughts.
- Symmetry obsessions: There is a lot of discussion with regards to what these symptom clusters could be, which might explain why you may not notice familiar ones here. There is debate about whether these are other subtypes. These are considered a group of compulsions and obsessions that are common in those with OCD.
It’s hard for clinicians to discuss subtypes of OCD because there isn’t enough research to back them up. Since they’re not perfect categories, it’s not worth spending time trying to figure out a subtype you fit into. However, for many with the disorder, the recognition of their own experience on a list of subtypes is comforting at the beginning of the treatment process.
Imagine feeling as though you have symptoms that you can’t find online and others can’t relate to, and suddenly you find a list of symptoms that match yours. When you recognize this subtype you’re reading about; you don’t feel alone anymore. It allows your hopelessness to melt away because you know others face similar struggles, and there might be a way to treat it.
There are some common OCD subtypes that may put you at ease to learn if you’ve been looking for symptoms.
What Are Common OCD Subtypes?
Learning about these symptoms can help you speak with your doctor and find a course of action to treat them. While OCD is a broad condition, you may wonder what are some of the most common OCD subtypes. Let’s take a look below.
Harm OCD is a subtype of the disorder that causes people to be deeply disturbed by violent thoughts. Although these are thoughts most people have experienced and can shrug off, those with the condition are completely overwhelmed by them. For example, it could lead to obsessions that include:
- Thinking about jumping in front of a train
- Stabbing a significant other with a sharp object
- Thoughts of running someone over while you’re driving your car
- Thoughts of killing someone and not remembering
It can also cause compulsions that include:
- Refusing to be near trains
- Hiding all sharp objects
- Continuously visiting an area to see if you ran someone over
- Calling the person you thought about killing to see if they’re safe
A less common subtype of OCD known as SO-OCD, or sexual orientation OCD, involves an obsession with your sexuality. It’s sometimes referred to as homosexual OCD or HOCD, which is misleading. It can occur to someone of any sexuality, about any type of sexuality. You don’t need to be attracted to the same sex for it to happen. It can lead to obsessions that include the following:
- If you were attracted to someone of the same sex, you might feel that you’re gay.
- You might feel that other people think you’re attracted to the same sex.
- You wonder if you were into the person you dated of the opposite sex or if you were more into someone of the same sex.
SO-OCD may lead to compulsions that include the following:
- Looking at pictures of the same sex to see if you’re attracted to them
- Asking people repeatedly if they think you’re straight
- Avoiding people of the same sex to avoid confusion
Pedophilia OCD is prone to stigma because of how people feel about pedophiles. However, as you’ll find with all types of OCD, these are obsessions, not desires. Many people are distressed by these thoughts because they don’t reflect what they want. It’s terrifying in their minds because of the consensus about pedophiles within our society. It can lead to obsessions that include the following:
- What if I have sexual thoughts about the child I’m babysitting?
- I had a sexual thought when I was around my sister’s kid. Does it mean I’m attracted to them?
- Did I molest a kid and not remember doing it?
POCD can lead to the following compulsions:
- Scouring the internet for stories about pedophiles to find evidence and prove you’re not one
- Staying away from kids because you fear you’re a pedophile
- Beating yourself up for having these thoughts in your head
Relationship OCD is a subtype of the condition that leaves a person unable to tolerate the uncertainty of an intimate relationship. It causes them to obsess about their relationship, and the countless possibilities life might throw their way. It can lead to the following obsessions:
- Is the person I’m dating right for me?
- Is it possible someone out there is better for me?
- Are we meant to be?
- What if we’re not meant to be together, but we end up getting stuck together?
Relationship OCD will lead to the following compulsions:
- Finding relationship quizzes online and taking them
- Looking up others on social media to see if their relationships are going better than yours
- Continually going over situations in your head and asking if you really had fun during certain situations
Just Right OCD
Just Right OCD varies a bit from the other subtypes because it’s challenging to identify a specific fear or set of worries. It’s more likely to be a strong feeling that something is wrong when things are a certain way. It’s one of the more discussed types of OCD you’ll find in TV shows, jokes, or movies. Just Right OCD can lead to obsessions that include:
- Something doesn’t feel right at all.
- I need to start over to make this perfect.
- Something isn’t right.
It may lead you to experience compulsions including:
- Performing actions over and over, for example, closing doors.
- Reordering, rearranging, and organizing things repeatedly
- Changing wording several times in notes or emails
Contamination OCD is likely the most stereotyped form of the condition. Those with this subtype are afraid of getting sick or infecting a loved one if they come in contact with bacteria. A person with contamination OCD will wash their hands several times a day, sterilize things obsessively, and change clothes throughout the day in fear of germs. It can lead to other obsessions, including:
- Feeling as though you caught a sexually transmitted disease (STD) each time after you have intercourse, even if it’s protected.
- You may feel as though you gave your brother’s baby a severe illness by holding them.
- The entire place is full of bacteria.
It can also lead to the following compulsions:
- Constant hand washing and sanitizing everything around you
- Always cleaning different things around the house
- Avoiding being around kids, at the doctor’s office, or in public
Pure-O, or pure obsessional OCD, is one of the subtypes that some experts don’t believe exists. The idea is that someone with Pure-O OCD has obsessions without any visible compulsions. However, since they still have compulsions, they aren’t purely obsessional. Whether or not studies provide backup, many people identify with this subtype because they don’t have more obvious compulsions as mentioned in the subtypes above. These obsessions can be about sexuality, sex, religion, personal health, harm, romance, or anything previously discussed. It can lead to the following obsessions:
- What if I’m actually a bad person?
- Is life even worth it anymore?
- What if I were to go and push this guy off a bridge?
- If I don’t clean up my mess well enough, someone can slip, fall, and get seriously hurt because of me.
Pure-O OCD can lead to the following compulsions:
- You only make time for people who tell you that you’re a good person.
- Always thinking about the meaning of life
- Seeking signs in your head to reassure you that you’d never push someone off a bridge
- Repeatedly trying to remember a situation that you haven’t done to see if you missed a detail
Other OCD Subtypes
To name a few, religious OCD is a subtype characterized by obsessions and compulsions around violating a moral, ethical, or religious belief. Someone’s OCD could center around their fear to sin, lie, pray incorrectly, or offend someone. They could also be afraid to accidentally steal or cheat.
Another example is hit and run OCD, which is less frequently discussed. It’s characterized by a fear of running a person over while driving. Individuals with this subtype find their obsessions cause them to avoid driving due to fear, or they have to trace their route to make sure the bump road wasn’t a person.
OCD can take hold of your past as well. Real events OCD is characterized by obsessions and compulsions about someone’s past actions. An individual struggling with real events OCD will have obsessive thoughts about something that was said to a friend or family member many years ago and be concerned about whether they were offended.
OCD subtypes follow the same cycle of obsessions and compulsions of conventional OCD. However, for some, it’s not worth working too hard to figure out their subtype, while others find comfort knowing they are going through something similar to someone else.
Treating OCD Subtypes
Despite the subtype, the process of treating OCD is all the same. Exposure and response prevention (ERP) therapy is considered the gold standard when it comes to treating OCD. This type of therapy involves targeting the source of the individual’s obsessions by directly exposing them to it. In many cases, individuals find that ERP reduces their anxiety to the point where they don’t experience intense fears relating to their thoughts regularly.
Exposure and response prevention therapy is an active form of treatment. It requires the individual to engage by participating in exposures, transparency, and a willingness to be uncomfortable, even if it’s shameful or taboo. You’ll meet with your therapist frequently at first. As the condition improves, the frequency of visits will decline. ERP is an extremely successful form of therapy. An estimated 80 percent who go through it will see positive results within 12 to 25 sessions.
Obsessive-compulsive disorder can have devastating consequences in a person’s life who foregoes treatment. Without help, your symptoms can continue getting worse as you allow them to fester within your brain. With the evolution of therapy and modern remedies, there’s no reason for you to suffer another day when help is available.
If OCD has been destroying your life and you want to start on the path toward recovery, pick up the phone and reach out to a medical professional today. They can help guide you toward a path of recovery and normalcy again.