Do I have OCD?

When someone mentions OCD, what comes to your mind? Is it the image of a person obsessed with cleanliness, who repeatedly washes his/her hands? Or, is it an image of someone who obsessively straightens and arranges anything and everything?

While these characters may fall under the OCD umbrella, the truth is OCD often manifests in lesser known ways. Let’s take Jane, for example. Jane is someone who often has negative thoughts popping up in her mind. Dark, scary thoughts like “I’m going to lose control and kill someone”, or images of her physically hurting a loved one. These thoughts, these images, scare her. She hates having them. Every time she has them, she is compelled to perform all kinds of mental gymnastics in a desperate bid to get rid of them.

Sometimes, she repeats the phrase “I’m not a murderer” in her mind over and over again. Sometimes, she prays. She also tries to block out the bad thoughts by doing mental calculations. Often, it takes her many hours a day of doing these mentally exhausting exercises just to feel less anxious. Her daily struggle is not only emotionally draining but also affects how she interacts with others. Her work is suffering too.

What Jane has is a form of OCD.

So, what is OCD?

Like its name suggests, Obsessive Compulsive Disorder is all about obsessions and compulsions. What are obsessions? These are thoughts, images, urges and fears that come into one’s mind, unbidden, unwanted, and causing distress to the person.

What about compulsions? Well, these are the things one does to ease the distress that comes with the obsessions. These are often a variety of activities one performs to neutralise the obsessions in order to get rid of the distress.

Here’s a diagram for clarity:

Many people who have OCD don’t even know that they have it. This is because OCD takes on many forms, some of which may seem bizarre or incredible to others.

Let’s look at another example, June*. June takes a long time to walk from her house to the bus stop. She also takes a long time to walk from school to home. In fact, June takes a long time to walk anywhere, period.

Sometimes, she pauses mid step and takes a few steps back. She then walks forward again before taking yet another few steps back. This could go on for a while, before she walks on.

Why? Well, sometimes, June has thoughts. Thoughts that take the mental form of a swooshing boomerang. She would imagine her thoughts flying out from her mind, with strings trailing behind, swooping off to and twirling around a tree or a streetlight. She would then feel uncomfortably stuck, the strings of her thoughts seemingly tying her back. She would feel a lot of distress if she were to walk on, with the strings tugging at her. So, she would pause in her steps, mentally unwind her thoughts from the tree (compulsions), which often takes a few tries, and then, she can finally move on.

As you can see, OCD may present itself in multiple ways.

So, how do you know if you have OCD?

Put simply, you can check to see if you have any obsessions, that is, thoughts, images, urges, fears, that come unwanted and uncontrollably to mind. Here’s a list of common fears/obsessions:

• Fear of getting contaminated by germs, dirt, body fluids, etc.
• Worries about losing control of oneself and harming others, blurting out vulgarities, etc.
• Worries that one will be responsible for terrible things happening, or harming others
• Need for everything to be exact and even, or symmetrical
• Unwanted sexual obsessions, e.g. about children, homosexuality (when one is straight but worries about being homosexual), incest, aggressiveness etc.
• Fear of offending god or worries about whether one is moral enough

Note that these are not exhaustive, and obsessions may come in many forms.

Then, check if there’s anything that one has to do repeatedly, to try to neutralise or get rid of, neutralise or undo these obsessions. This can come in many forms: repeated hand-washing, telling yourself “it’s just a thought” repeatedly, erasing the thought in your head, switching the lights on and off repeatedly, etc.

The key thing to look out for is whether you have to do the behaviour/mental act repeatedly, to feel better.

Some common compulsions are:

• Washing and cleaning
• Checking that you did not or will not harm others, that nothing terrible happened, that you did not make a mistake, etc.
• Repeating routine activities (e.g. stepping in and out the doorway), repeating activities in multiples (e.g. switching lights on and off 3 times to feel right), repeating body movements (e.g. tapping some parts of the body)
• Mental compulsions, e.g. mentally reviewing events, praying to prevent harm, counting while doing a task, neutralising (e.g. erasing a thought mentally, thinking of a good word to replace a bad word) etc.

If you have obsessions and compulsions, then consider the following. How much are these obsessions and compulsions affecting your mental wellbeing and your life?

If they are causing significant distress to you, and/or significant problems in your social life, work, school, or any daily activities you need to do, then you may have OCD.

However, do note that proper assessments should be done by professionals to determine if you truly have OCD.

I think I have OCD. What should I do?

Do not worry, there is hope! While having OCD in your life can be debilitating and distressing, effective treatment is available. With the right help, many people with OCD have been able to break free of the chains of OCD, and live freer, more fulfilling lives.

Cognitive Behavioural Therapy (CBT), specifically, Exposure and Response-Prevention (ERP) therapy, is seen as the gold standard in treatment and is often highly effective when it comes to treating OCD. Sometimes, pharmacotherapy is recommended too, in combination with psychotherapy.

If you think that you, or a loved one has OCD, please seek professional assessments and therapy, and begin the journey to recovery from OCD.