Obsessive-compulsive disorder much more than just a compulsion

Are you the kind of person who locks the door to your room twice before going off to class? Or maybe you are the kind of person who organizes your closet by color. 

To you, these habits may seem part of your daily life, but to those who don’t partake in the same rituals, they may seem unusual. In fact, when your friends wait for you to lock your door twice or move that yellow sweater, they just may exclaim, “That’s so OCD.” 

This simple phrase has turned millions of people into instant psychologists with their split-second diagnosis of obsessive-compulsive disorder. I confess having used this phrase on some of my friends who have odd habits. 

Even some of our more famous gentry claim to have this disorder. 

Just Google “celebrities with OCD,” and you will find that people like Cameron Diaz and Howie Mandel have their own compulsions. For example, Cameron Diaz has to open doorknobs using her elbows due to her fear of germs, and Howie Mandel fist bumps his fans instead of high-fives or handshakes because he also has a fear of germs.

This is not to discredit or debase these or any celebrities that have OCD; it is just that the public’s focus is on the physical manifestations of this disorder when there is much more beneath the surface. 

Obsessive-compulsive disorder is a two-sided disorder. 

While most people focus on the aforementioned compulsions that usually manifest themselves in visible ways, they regularly disregard the obsessions. 

According to the Mayo Clinic, OCD is an anxiety disorder characterized by unreasonable thoughts and fears — the obsessions — and these unreasonable thoughts and fears lead you to repetitive behaviors — the compulsions.  

For people like Olivia Loving of “The Atlantic” the obsessions are much darker. 

When Loving was a child her obsessions manifested in thoughts and fears that were beyond just “unreasonable” for a child at her age. She recalls thoughts of child molestation and fearing that she could hurt the people she loved. 

Once having these thoughts, she would immediately “punish” herself by imitating a church ritual through kissing or pressing her tongue against the ground. 

This disorder is not some desire for organization and cleanliness gone horribly awry, but rather a serious malady of the mind that poisons the victim’s thoughts. 

We must fix the public’s biased view of OCD that only focuses on the compulsions. The media is responsible for perpetuating this biased view of OCD because it constantly de-emphasizes the seriousness of OCD. 

For example, the MTV series “True Life” dedicated an episode to individuals with OCD, where the entirety of the episode was focused on highlighting the individuals’ most unusual and bizarre thoughts and behaviors, rather than addressing OCD as a disorder. 

The media is more focused on the idea of “selling the story” by highlighting the compulsions, while minimizing the educational aspects of OCD such as the obsessions that lead to the compulsions.

In some instances, as Loving’s narrative explains, patients who mention their OCD can sometimes be unjustly prescribed as dangerous.

In fact, co-founder of the International Obsessive-Compulsive Disorder Foundation, Fred Penzel, Ph.D., recalls a patient’s child being taken away from her after hospital personnel overheard her expressing fear that she may hurt her child. It wasn’t necessarily that this patient was undoubtedly going to harm her child, but rather that it was an illogical fear of hers arising from her OCD. 

Essentially, rather than the hospital personnel considering her OCD as the cause of her fear, it was assumed that she truly wanted and intended to harm her child.

According to Penzel, these obsessive thoughts are typically nonsense, and that should be acknowledged. 

The way to differentiate between OCD and dangerous impulses is that patients with OCD have an inner dialogue — where they constantly question their obsessions — that normally talks them out of the action. While the truly dangerous people have no inner dialogue or second thoughts, explains Penzel. 

Either way, simplifying OCD based on what we see from celebrities and television shows won’t spread awareness; it will spread misinterpretations. And, as an unintended result, it will attach a negative stigma to those living with OCD.

It’s not just a matter of acknowledging that OCD is a real condition, but working to realize who and what we’re hurting while saying, “That’s so OCD.” 

Max is a freshman in LAS. He can be reached at mpfishe2@dailyillini.com.

Samantha Brown, 27, was eventually diagnosed with unusual form of OCD

  • Samantha Brown, 27, was eventually diagnosed with unusual form of OCD
  • Had she lost another half a stone, she may have suffered organ failure
  • Says her weight loss was rooted in her desire for some control in her life
  • Research has shown OCD increases the risk of suffering an eating disorder

Anna Hodgekiss

04:49 EST, 12 November 2013


09:30 EST, 12 November 2013

An artist saw her weight drop to just 5st 7lb because she was terrified that all food was going to poison her.

Samantha Brown, 27, was eventually diagnosed with an unusual form of obsessive compulsive disorder.

Her chronic anxiety, an effect of an obsessive compulsion to control her food intake, caused her weight to shrink dangerously low, to the horror of her family and friends.

Recovered: Samantha Brown's weight plummeted to to 5st 7lb because she thought basic foods were poisoning her. She was later diagnosed with a rare form of obsessive compulsive disorder and now weighs a healthy 9st 7lb

Recovered: Samantha Brown’s weight plummeted to to 5st 7lb because she thought basic foods were poisoning her. She was later diagnosed with a rare form of obsessive compulsive disorder and now weighs a healthy 9st 7lb having undergone therapy

Miss Brown was working as a freelance fashion stylist when her OCD began to manifest itself.

She said: ‘I was incredibly stressed, doing a job that I hated. The recession had hit and the work was drying up.

‘I was working so hard to make something of my freelance career, which involved a lot of rejection. I felt as if I had no control.

‘I began dictating to myself what I could and couldn’t eat. As my behaviour developed, it became an OCD, where I thought practically everything was poison.

‘It was all rooted in my desire for control.’

Decline: Samantha pictured while she was rapidly losing weight. Her chronic anxiety, an effect of an obsessive compulsion to control her food intake, caused her to only eat Coco Pops, salt and vinegar crisps and thin-crust pizza

Samantha rapidly losing weight

Decline: Samantha pictured while she was rapidly losing weight. Her chronic anxiety, an effect of an obsessive compulsion to control her food intake, meant she only ate Coco Pops, salt and vinegar crisps and pizza

While OCD is treated as an entirely
separate condition to eating disorders such anorexia and bulimia, it is
known that patients with OCD tend to experience eating disorders more

Miss Brown, of Leicester, suspects her paranoia that food was harming her was made worse by the fact that she also suffers from ME, which causes chronic fatigue.

Shrinking: Samantha says her eating habits were rooted in her desire for control

Shrinking: Samantha says her eating habits were rooted in her desire for control

Miss Brown said: ‘I didn’t want to be thin. I wasn’t avoiding eating to stay skinny.

‘Instead, I was convinced that unless I restricted myself to the foods I had decided were OK, I would poison myself.

‘I drew up an “allowed” list and a “forbidden” list. Before long, the “allowed” list had just three things – Coco Pops, salt and vinegar crisps, and thin-crust pizza.

‘Eventually, all I could manage was Coco Pops. My mum became really concerned. She would try to tempt me with new foods like macaroni cheese, but all I could do was sob into the plate, pleading with her and warning her that it would kill me.’

At her lowest ebb in the spring of 2012, Miss Brown, who is 5ft 8in, weighed just 5st 7lb. The physical and emotional exertion was so great that she contemplated suicide.

She said: ‘I thought I was being an enormous burden on my parents, and I didn’t know whether I would ever get better. I couldn’t see any way out.’

An appointment with her GP finally put her anxieties in context and, after an intensive course of cognitive behavioural therapy, she finally began to put on weight.

She said: ‘I stood on the scales and the doctor said, “if you lose another half a stone, your organs are going to fail”. It was a wake-up call.

‘When the doctor diagnosed me with OCD I was surprised because I thought I would be described as having a simple eating disorder. 

‘It never occurred to me that my
behaviour – my systematic approval and disapproval of foods – was

‘But once I heard that I had OCD, it all started to make

‘He said it was rare for OCD to have
the effect it had on me, but not unknown. He had seen two other women in
a similar situation over the course of his career.’

Now Miss Brown, who exhibits art all over London, weighs a healthy 9st 7lb and maintains a balanced, varied diet.

She said: ‘I want to help other people who are struggling with OCD issues, if only by raising awareness about the different forms the condition can take.’


Well-known symptom: Sufferers of Obsessive Compulsive Disorder carry out repetitive and ritualistic actions, such as washing hands

Well-known symptom: Sufferers of Obsessive Compulsive Disorder carry out repetitive and ritualistic actions, such as washing hands

Obsessive Compulsive Disorder is an anxiety-based condition, characterised by the sufferer having uncontrolled intrusive thoughts that dictate their actions, moods and fears.

The disorder is often depicted incorrectly in films and on television, where the sufferer has endearing or ‘amusing’ ritualistic behaviour. This depiction underplays the debilitating and often alienating nature of the condition.

It affects children, adolescents and adults. The majority of sufferers display symptoms from an early age.

The most well-known symptom of OCD includes the continuous and obsessive washing of hands, sometimes until the skin is irritated and feels raw.

Other common symptoms include: repetitive rituals such as closing doors in a specific way, or repeatedly checking locks or appliances; hoarding; preoccupation with violent, religious or sexual thoughts; and aversion to particular numbers, words or objects.

OCD sufferers can appear paranoid and even psychotic, and they can suffer emotional stress from the resulting breakdown in relationships at work and in their private lives. Worse still, many sufferers are aware that their actions appear irrational, leading to further anxiety. Suicide rates in sufferers is high, and more than 50 per cent of sufferers experience suicidal tendencies.

Despite its irrational nature, OCD has been associated with above-average intelligence – both share personality traits such as high attention to detail, meticulous planning and a higher than normal sense of responsibility.

People suffering from OCD can have related disorders, such as bipolar disorder, anorexia nervosa, Tourette syndrome, Aspergers syndrome, Attention Deficit Hyperactivity Disorder (ADHD), and dermatillomania (skin picking) and trichotillomania (hair pulling).

Famous sufferers include: Dr Samuel Johnson, retrospectively diagnosed because of his ritualistic behaviour of counting stairs and crossing doorway thresholds in a specific way; actress Cameron Diaz, who says she is irrationally terrified by the transmission of germs – especially from doorknobs; singer Justin Timberlake, who admits that certain foods must be present in his fridge at all times; Leonardo DiCaprio, who used his childhood OCD as inspiration when he played fellow sufferer Howard Hughes in The Aviator; and footballer David Beckham, who has said he must count his clothes and arrange books and magazines in straight lines.      

Comments (182)

Share what you think

The comments below have been moderated in advance.

Jughead Jones,

Truro, United Kingdom,

5 hours ago

Nice set of cans !


York, United Kingdom,

5 hours ago

Poor thing. To some people actually WANT this to happen to themselves. Awful.



5 hours ago

She is hot now. Top figure,


Scotland, United Kingdom,

5 hours ago

How strange that OCD is not a problem is countries that are poor? You also never hear about nut allergies or lactose intolerance where found it scarce?



5 hours ago

That before photo.. OOOF!

Dave Ninetynine,

Darlington – UK,

5 hours ago

Stand by for the “coco-pops, crisps and pizza” diets in all the women’s magazines.


New Mexico USA, United States,

5 hours ago

I eat crisps and pizza and I’m nowhere near as small as 5st 7lbs — maybe I should add cocopuffs to my diet!
Just kidding, OCD is a terrible affliction and I wouldn’t ever ridicue someone who suffers from it.


Cheltenham, England,

5 hours ago

She had such a voluptuous figure before what a shame


Cheltenham, England,

5 hours ago

Sounds legit

Mackem Lass,


5 hours ago

I think I must have this OCD….because I cannot stand people smoking in my vicinity. I used to think it was just because I didn’t want my hair and clothes to stink of smoke but I think now the rational explanation is OCD.

The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline.

Who is this week’s top commenter?
Find out now

Exercising Anxiety Away

(dailyRx News) Have you ever felt a “runner’s high,” that relaxing, happy feeling after a bout of exercise? Research shows that it could be an effective treatment for some types of anxiety.

Researchers reviewed previous studies and trials on anxiety symptoms and exercise programs for healthy people, people with chronic illnesses, and people who had been diagnosed with an anxiety disorder.

They found that exercise often helps to reduce symptoms of anxiety and can sometimes be used as a part of anxiety disorder treatment.

Exercise treatment showed the most consistent results for healthy people, people with chronic illnesses, and people with panic disorder. The researchers emphasized that more studies are needed to look at the relationship between exercise programs and specific anxiety disorders like obsessive-compulsive disorder.

Matthew Herring, PhD, Jacob Lindheimer, MA, and Patrick O’Connor, PhD, conducted the review to see how exercise affects anxiety.

Anxiety is a state of worry that triggers certain physical responses in the body. Most people experience anxiety, and some people experience it more frequently and intensely than others.

People with anxiety disorders can deal with excessive, severe anxiety. Anxiety disorders encompass phobias (intense fears), social anxiety disorder, generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder.

According to the article, about 40 million Americans suffer from an anxiety disorder every year.

The authors of this review looked at several studies dealing with anxiety, anxiety disorders, and physical activity to note how exercise affected anxiety symptoms.

Previous studies have shown that people with less intense anxiety get more exercise than those with more intense anxiety. However, the authors of the article noted that this relationship could go both ways. People with severe anxiety may feel less of a desire to exercise, or people who exercise may experience less extreme symptoms.

The researchers looked at several previous studies and analyses to see how exercise affects people with anxiety but without an anxiety disorder.

They found that trials show a reduction in anxiety after both strength and aerobic exercise in healthy people without serious physical or mental illness. Additionally, a review of eight studies has shown that yoga is a promising treatment for anxiety.

People who have chronic illness but no anxiety disorder often experience anxiety. The researchers looked at previous trials on exercise programs for people with chronic illnesses like cancer, inflammatory diseases, and COPD.

People with chronic diseases who experienced anxiety also benefited from exercise programs. Some studies showed that exercise programs that were short, but included longer sessions, were most effective.

The researchers noted that previous studies found mixed results for exercise programs used to treat people with anxiety disorders.

Patients with panic disorder seemed to benefit particularly from exercise training, according to a clinical trial that tested 12 weeks of aerobic exercise against 12 weeks of group therapy. Both of the treatments led to improved symptoms.

Patients with other anxiety disorders like social anxiety disorder, generalized anxiety disorder, and obsessive-compulsive disorder showed some improvements in previous studies, sometimes in addition to other treatments like therapy or medicine.

The researchers suggested that physical activity may reduce anxiety symptoms by improving patients’ self-esteem, teaching persistence in difficult circumstances, and the chemicals that the brain releases during exercise.

The authors of the review concluded that exercise training can help improve anxiety symptoms for both healthy people and people with chronic illnesses. It may also help people with anxiety disorders, sometimes in addition to other types of treatment.

The researchers emphasized the need for more studies examining the effects of exercise on specific anxiety disorders.

The article was published in the American Journal of Lifestyle Medicine on November 6.

The authors did not disclose funding sources or conflicts of interest.

Kids Without Fear.com | panic attacks, obsessive thoughts

Kids Without Fear.com


tell a friend


Cognitive Behavioral Therapy for Anxiety

If you or your child suffers from panic attacks, obsessive thoughts, unrelenting worries or incapacitating phobias, you or your child may have an anxiety disorder – which does not mean that you have to live with anxiety and fear. Treatment can help, and for many anxiety problems, therapy is a good place to start. Certain types of therapy, such as cognitive behavioral therapy and exposure therapy, are particularly beneficial. These therapies can teach you how to control your anxiety levels, stop worrisome thoughts and conquer your fears.

When it comes to treating anxiety disorders, research shows that therapy is usually the most effective option. That’s because anxiety therapy, unlike anxiety medication, treats more than just the symptoms. Therapy can help you uncover the underlying causes of your worries and fears; learn how to relax; look at situations in new, less frightening ways and develop better coping and problem-solving skills.

As anxiety disorders differ considerably, therapy should be tailored to specific symptoms and concerns. If you have obsessive-compulsive disorder, your treatment will be different from someone who’s getting help for anxiety attacks. The length of therapy will also depend on the type and severity of the disorder. However, many anxiety therapies are relatively short-term. According to the American Psychological Association, many people improve significantly within 8 to 10 sessions.

The leading approaches to treating anxiety today are cognitive behavioral therapy and exposure therapy.

Cognitive behavioral therapy (CBT) is the most widely-used therapy for anxiety disorders. Research has shown it to be effective in the treatment of panic disorder, phobias, social anxiety disorder, and generalized anxiety disorder, among many other conditions. Cognitive therapy examines how negative thoughts, or cognitions, contribute to anxiety while behavior therapy focuses on how you behave and react in situations that trigger anxiety.

The basic premise of CBT is that our thoughts, not external events, affect the way we feel. In other words, it’s not the situation you’re in that determines how you feel, but your perception of the situation.

Imagine you’ve just been invited to a big party. Consider three different ways of thinking about the invitation, and how those thoughts would affect your emotions.



As you can see, the same event can lead to completely different emotions in different people – it all depends on individual expectations, attitudes, and beliefs. For people with anxiety disorders, negative ways of thinking fuel the negative emotions of anxiety and fear. The goal of cognitive behavioral therapy is to identify and correct these negative thoughts and beliefs. The idea is that if you change the way you think, you can change the way you feel.

Thought Challenging

Thought challenging – also known as cognitive restructuring – is a process in which you challenge the negative thinking patterns that contribute to your anxiety, replacing them with more positive, realistic thoughts. This involves three steps:

1. Identifying your negative thoughts. With anxiety disorders, situations are perceived as more dangerous than they really are. To someone with a germ phobia, for example, shaking another person’s hand can seem life threatening. Although you may easily see this is an irrational fear, identifying your own irrational, scary thoughts can be very difficult. One strategy is to ask yourself what you were thinking when you started feeling anxious. Your therapist will help you with this step.

2. Challenging your negative thoughts. In the second step, your therapist will teach you how to evaluate your anxiety-provoking thoughts. This involves questioning the evidence for your frightening thoughts, analyzing unhelpful beliefs and testing out the reality of negative predictions. Strategies for challenging negative thoughts include conducting experiments, weighing the pros and cons of worrying or avoiding the thing you fear, and determining the realistic chances that what you’re anxious about will actually happen.

3. Replacing negative thoughts with realistic thoughts. Once you’ve identified the irrational predictions and negative distortions in your anxious thoughts, you can replace them with new thoughts that are more accurate and positive. Your therapist may also help you come up with realistic, calming statements you can say to yourself when you’re facing or anticipating a situation that normally sends your anxiety levels soaring.


tell a friend

About the Author:


You might also be interested in:



If you don’t see your comment after publishing it, refresh the page.

No comments yet (Click to Comment)

SocialTwist Tell-a-Friend

Health Check: PANDAS | pandas, childhood disorder

A little known childhood disorder dramatically attacks a child physically and emotionally, and it’s not on many doctors’ radar screens so often it goes mis- or undiagnosed.

Jeanne Muto-Kyle said her son, T.J., changed drastically in February 2010.

“I couldn’t leave the house. I was seeing things. I went a whole day without speaking,” T.J. said.

Muto-Kyle said her son went through three years of doctors and testing.

“I was afraid for myself,” T.J. said. “I thought I was literally insane.”

“One day at school and all of a sudden I was going like this a lot in school. I didn’t know why,” Austin Teixeira said, demonstrating a tic.

“He stopped eating. He had sensory issues. He developed really strong tics, blinking of his eyes,” Moira Teixeira, Austin’s mother, said. “Out of nowhere.”

It took many months for 10-year-old Austin and 14-year-old T.J. to get accurate diagnoses. They have PANDAS.

“It’s Pediatric Autoimmune Neuropsychological Disorder Associated with Streptococcus. But, you know, you wake up one day and the child that you’ve known is someone else,” Moira Teixeira said.

Common childhood ailments can trigger this complex disorder, like strep throat and pneumonia. And PANDAS strikes without warning. The symptoms can be many or few.

T.J. had anxiety, tics and severe obsessive-compulsive disorder.

“He was fearful of everything,” Muto-Kyle said.

That is why parents of children with PANDAS in Southern New England come together each month in person and almost daily on Facebook.

The disorder takes a toll on the entire family, and getting together provides a source of comfort.

“We can laugh about it. You know it’s kind of like, ‘I’ll trade you some rage for some OCD.’ Because it’s like I’ve had enough rage now for the last couple months,” Moira Teixeira said. “Austin went four weeks this summer afraid to eat.”

The stories are similar to varying degrees, and all of them are challenging. T.J. was treated with antibiotics and prednisone.

“Within a month it was night and day,” his mother said.

He’s back to school full time.

As for Austin?

“For the past like month or two I’ve felt great,” he said.

The problem with PANDAS is it really never goes away. There are flare-ups that can be triggered by being around someone with pneumonia or strep throat.

National experts in PANDAS are gathering in Providence this weekend to talk about the latest research and treatments.

Cannabidiol (CBD) May Help Treat Obsessive-Compulsive Disorder

Brazilian Researchers Investigated OCD Cannabidiol

As we know, medical marijuana has long been used to help treat various types of anxiety. Cannabidiol (CBD), in particular, has received a great deal of attention for it’s anti-anxiety potential and a number of high-CBD products are making their way into the market with increased regularity.

That being said, no two forms of anxiety are alike. One suffering from social anxiety has a vastly different experience than that of a PTSD patient. The same is true of those suffering from obsessive-compulsive disorder.

Their experience is unique – OCD patients have obsessive thoughts and worries that trigger anxiety. The only way to compensate for this anxiety is to act out their compulsions. We all, at some point, question whether we left our front door open; most of us are able to go on with the day, forgetting all about it until later. With OCD patients, however, anxiety levels often skyrocket if unable to complete their compulsions (check the front door in the example above).

Cannabidiol (CBD) Could Help Patients Manage OCD Symptoms

Presently, obsessive-compulsive patients are often treated with selective serotonin re-uptake inhibitors (SSRIs), like the antidepressant Prozac, in addition to psychotherapy. With that said, a team of researchers published a study in the journal Fundamental Clinical Pharmacology earlier this month that investigated cannabidiol (CBD) and its ability to help treat rats with OCD.

The research team, which represented the Department of Pharmacology at the University of Sao Paolo, was led by Dr. Francisco Guimarães. First, they administered Meta-chloro-phenyl-piperazine (mCPP) – a psychoactive drug that is often found in ecstasy pills. It is known to induce panic attacks in those prone to having them and has been determined make symptoms of OCD worse. Further, the study adds that mCPP is been known to inhibit the anti-compulsive effects of SSRIs.

“Even a low dose of CBD decreased the marble-burying behavior without a change in the rats overall activity level.”

Once mCPP was administered, the researchers conducted a “marble-burying test” with the rats in order to evaluate OCD activity. Low doses of the drug, according to the study, was found to increase marble-burying tendencies in rats, while large dosages seemed to decrease them. There was, however, no difference in noticeable anxiety behaviors.

The researchers then administered two levels (30mg/kg or 15mg/kg) of cannabidiol (CBD) and evaluated the obsessive-compulsive activity in each rat. Interestingly, even a low dose of CBD decreased the marble-burying behavior without a change in the rats’ overall activity level.

According to the study, its results reinforce the possible anti-compulsive effect of cannabidiol (CBD). More research will be necessary before CBD is used to treat obsessive-compulsive disorder in a clinical setting, but findings such as these suggest that cannabis may be a valuable tool in OCD treatment.

The invisible obsessions ruining lives: Say ‘Obsessive Compulsive Disorder …

  • Physical acts are the most common forms of compulsion
  • But 10-15% of OCD sufferers carry out their rituals entirely in their minds
  • This form of the disorder is harder to treat and can go unnoticed for years
  • Almost half the UK population think they have mild OCD
  • The true incidence is between 1-3% of the population

Grace Mccann

17:58 EST, 4 November 2013


18:02 EST, 4 November 2013

Mental compulsions: David Bass is plagued by thoughts that he has said something offensive

Mental compulsions: David Bass is plagued by thoughts that he has said something offensive

The words ‘obsessive compulsive disorder’ usually conjure up a picture of someone constantly washing their hands, or checking they have locked the door or turned off the stove.

OCD, which affects one person in 100, causes obsessive, unwanted thoughts and images, which trigger compulsive, ritualistic behaviour.

Physical acts such as washing and checking are the most common compulsions, but 10 to 15 per cent of sufferers carry out their rituals purely internally, in their minds.

David Bass is one of them.

‘My OCD’s all going on in my head,’ says David, 25, who is from Bedfordshire and worked as a TV presenter before becoming ill.

David is plagued by thoughts that he has said something offensive – when talking to women, he panics needlessly that he has made sexually inappropriate remarks; when speaking to a black friend, he worries he has said something that could be construed as racist.

As a result, he scans over everything he has just said.

‘I feel compelled to replay everything I’ve said in my mind,’ says David.  ‘Ironically, this means I zone out and may end up seeming rude anyway.’

This form of the disorder is harder to treat – and because it’s less recognised and there is no visible behaviour, can go unnoticed for years. Sufferers may not even realise they have it.

Studies show there are many misconceptions surrounding OCD. Research published last month suggested that almost half the UK population believe they have mild obsessive compulsive disorder, when the true incidence is much lower – between 1 and 3 per cent of the population (ie, nearly a million people).

Experts note that people frequently say they are ‘a little bit OCD’, meaning they like routine or need to double-check they have locked the front door – but this is to misunderstand what can be a devastating mental illness.

‘Performing such rituals is not pleasurable,’ says a spokesman for the National Institute of Mental Health. ‘At best it provides temporary relief from the anxiety created by obsessive thoughts.’

The form of OCD that David suffers from has been described as ‘purely obsessional OCD’ or ‘pure O’ because there is no visible compulsive behaviour (the ‘C’) – but this is another misconception.

‘There’s a myth that OCD can exist without the “C”,’ says Professor David Mataix-Cols, a specialist in the disorder at the Institute of Psychiatry in London.

‘A patient may suggest that they have only the obsessive part of the disorder, but we find they are doing lots of the compulsive behaviour inside their heads – for example, praying silently in an effort to calm their anxiety.’

The stereotype: Hand-washing is one of the more common compulsions, but 10 to 15 per cent of those suffering from OCD carry out their rituals internally

The stereotype: Hand-washing is one of the more common compulsions, but 10 to 15 per cent of those suffering from OCD carry out their rituals internally

For these patients, such rituals perform the same function that handwashing does for others, adds Dr David Veale, a consultant psychiatrist and OCD expert at the South London and Maudsley NHS Trust.

He explains that they try to get rid of the obsessive thoughts by distracting themselves or ‘neutralising’ the thoughts by performing mental rituals to try to calm their anxiety.

‘But these ways of coping ultimately don’t work – or make things worse,’ says Dr Veale.

Doctors can’t explain why some people suffer only psychological symptoms, but Dr Veale says that such patients are often highly intelligent: ‘They are likely to be analytical types, trying to solve things in their heads.’

David Bass struggles with an exhausting range of mental compulsions. At the moment, he is suffering with an obsession that he may somehow end up  in prison.

‘I keep worrying that I’ve knocked someone over when driving,’ he says. ‘I repeat, “You haven’t, you haven’t, you haven’t” in my head to try to reassure myself.’

He often attempts to suppress the disturbing thoughts that trigger his anxieties. ‘I’ve done this a lot in church, where I’ve been plagued by the fear that I would shout out something blasphemous, such as “Jesus is a demon”,’ he says.

‘It’s an unbearable thought so I try not to think it.’

Unfortunately, this fuels the problem. It’s a phenomenon known as the white bear effect, after studies in which healthy people were asked not to think of white bears, and found they could not help thinking of exactly that.

Indeed, David is so overwhelmed by the thought of blaspheming in church that he no longer feels able to worship.

We are all occasionally struck by unwanted thoughts. But while most of us can think of something else and move on, OCD sufferers become consumed by them.

What causes the disorder is unknown but stress, genetics and childhood difficulties may all play a part.

David, who has suffered with the condition from the age of 12, suspects that it runs in his family. His mother and maternal grandmother have both displayed compulsive behaviour.

‘My mum once went on holiday and had to drive 50 miles back to check she hadn’t left the gas on,’ he recalls.

‘I keep worrying that I’ve knocked
someone over when driving. I repeat, “You haven’t, you
haven’t, you haven’t” in my head to try to reassure myself.’

The disorder is generally very treatable. The standard treatments are drug therapy with antidepressants known as selective serotonin reuptake inhibitors, and cognitive behavioural therapy (CBT), a psychological method for helping people change their thinking and behaviour.

But OCD with purely mental compulsions can be harder to overcome, says Dr Veale.

This is because the standard CBT technique – gradually exposing patients to what they fear, and teaching them how to respond – is harder to apply.

David overcame an obsession with hygiene when he was a teenager using this approach.

‘I was particularly scared of dog muck,’ says David, who became so unwell that he would feel  compelled to open doors with his feet and wash his hands until they bled.

As part of his therapy, he had to hold a shoe and not wash his hands afterwards. ‘It sounds strange but it worked,’ he says. He was well between the ages of 14 and 16. But then the illness returned, this time with purely mental compulsions.

OCD symptoms often change in this way, according to Dr Veale.

Unfortunately, David is struggling to apply exposure therapy to his ‘What if I’ve said or done something awful?’ thoughts. Exposing oneself to something tangible, such as dirt, is easier.

David is taking the antidepressant sertraline and being encouraged by his therapist to face his fears by, for example, telling himself that he has actually knocked over a cyclist, and picturing the scene in as much detail as possible.

He must then resist the urge to neutralise the frightening thought or image with his mental rituals of saying to himself ‘you haven’t, you haven’t’.

‘Being properly frightened, and learning that you can calm down on your own without ritualising is essential,’ says Professor Mataix-Cols.

Dr Veale says it’s also important to help patients understand the context in which the obsessions are occurring. ‘It’s usually at a time of great stress or linked to some emotional memory,’ he says.

Perhaps the most important therapy for patients like David, whose anguish has often left him unable to leave the house, is to try to lead as normal a life as possible.

‘It’s crucial to get out there and do the things that are important to you,’ says Dr Veale.

n For more information, see ocdaction.org.uk and ocduk.org


obsessive compulsive disorder

Comments (1)

Share what you think

The comments below have been moderated in advance.


London, United Kingdom,

1 hour ago

This is me!! Glad to see I am already doing what the doctors say I should do. I allow the thoughts to come and try not to react because that makes it worse. You have to focus on what is good in your life.

The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline.

obsessive compulsive disorderWho is this week’s top commenter?
Find out now

Obsessions, Compulsions and Fear: Film Director R. Shanea Williams Gives a … | obsession, compulsion

  • Email a friend

New York, NY (PRWEB) November 03, 2013

If OCD was an American city, it would be the second most populated city in the country. Health officials believe there are 4 million adults and children in the U.S. living with Obsessive Compulsive Disorder. Now a new short film, Contamination, is putting a face on the often-misunderstood anxiety disorder.

“I had an idea about this character for a long time, a woman who was struggling with severe germaphobia which resulted in her having OCD,” said the film’s director, R. Shanea Williams. “Soon the voice for this character became louder and louder and I created a story around her. I felt it’d work as a short film due to it being a contained environment.”

Actress Cherise Boothe plays the lead actress, Jade. The Obie Award winner, who was featured in the film 42 and the Pulitzer Prize-winning play Ruined, explained why she felt compelled to participate in the project. “Jade’s life circumstances have her battling with a condition by which she feels completely overwhelmed and controlled. Her condition was one I knew little about and wondered how someone gets to the place where we find her in the film,” said Boothe. “The journey of getting inside Jade’s character, experiencing the world from her perspective, was an intriguing, challenging and daunting endeavor, three great draws for any artist.”

Williams said she wanted to give a voice to people we do not often see struggling with OCD. “If people are going to learn something from this film, it is that mental health issues are universal and affect people of all races, ages, and backgrounds.”

Contamination will make the rounds at several film festivals next year.


About the director:

R. Shanea Williams is a native of Richmond, Virginia and currently lives in Queens, New York. She graduated from the University of Virginia in 2003 with a BA in English and received her MFA in dramatic writing (with a concentration in screenwriting) from New York University in 2008. Williams was a quarterfinalist in the 2007 Slamdance Screenwriting Competition, and in 2011, she was a top 5 screenplay finalist in the Urbanworld Film Festival Screenwriting Competition. Contamination is her second short film.

Email a friend



Gain knowledge during OCD Awareness Week

This year, OCD Awareness Week runs Oct. 14 through Oct. 20. Obsessive-compulsive disorder (OCD) is a treatable, neurobiological anxiety disorder with very distinct signs and symptoms. A person suffering with OCD has persistent thoughts and fears (obsessions) associated with repetitive behaviors (compulsions), which typically result in a short-lived relief of anxiety.

The obsessions and compulsions can be extremely time-consuming, causing significant emotional distress, and may greatly interfere with day-to-day functioning and interpersonal relationships. Individuals with OCD may go to great lengths to hide their obsessions and compulsions due to embarrassment and shame.

It is estimated that one in every 40 adults, and one in every 100 children suffer with OCD.

Support groups are an important tool for individuals with OCD, their family members and friends. Making a connection with others who are impacted by OCD provides a sense of community, and lets you know you are not alone in this struggle. You can gain valuable insight, practical ideas and support from other OCD sufferers in your area.

I am recovered from severe OCD and have been co-managing a page on Facebook, “Obsessive Compulsive Disorder / OCD Awareness” (17,000-plus “Likes”) for nine months. I also have my own page (“OCD Anxiety Awareness ‘Recovery Coach’”). You may connect with us for information, support or our online group.

I am in the process of starting an in-person group in Napa. Please contact me if you have interest.

Mee Rhorer / Napa

What Is OCD? | ocd, obsessive compulsive disorder

ocd, obsessive compulsive disorder


Frequent, repetitive handwashing may be a sign of obsessive-compulsive disorder, or OCD.
Credit: caimacanul / Shutterstock.com

Obsessive compulsive disorder, or OCD, is a mental disorder characterized by recurrent, persistent thoughts (obsessions) and ritualistic behaviors (compulsions) that interfere with a person’s daily life and relationships, according to the “Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition” (DSM-5).

People with OCD often realize their compulsive behavior is irrational, but they feel powerless to stop, since that only increases their level of anxiety.

The International OCD Foundation estimates that about 1 in 100 adults in the United States — and 1 in 200 children — has OCD. The condition often appears first during childhood or the teen years, and it tends to occur in men and women in roughly equal numbers. [Hypersex to Hoarding: 7 New Psychological Disorders]

Symptoms of OCD

OCD has many manifestations, but commonly, the obsessions of a person who has OCD are in some way linked to his or her compulsions. A child who obsesses about germs or contamination, for example, might compulsively wash his hands. Other common obsessions and compulsions include the constant need to “check” things, like that the front door is locked or the oven is turned off; an obsession with counting or arranging things in a particular order; or compulsive hoarding.

While OCD symptoms show up differently in each individual, those who have the disorder have at least one thing in common: Their obsessive-compulsive tendencies get in the way of everyday life. This is what separates OCD from the day-to-day anxiety and habits that are deemed “normal.”

A small amount of obsessive thinking or compulsive behavior is not necessarily a symptom of OCD; these are normal responses to real stress that serve a valuable purpose. The ability to foresee — and then worry about — possible dangers allowed early humans to take precautionary measures and survive difficult situations. But those with OCD may worry and compulsively perform “precautionary” behaviors even after they have determined that no danger exists.

Causes of OCD

Researchers have many theories about the causes of OCD in humans, ranging from childhood trauma to bacterial infection to genetics — the condition often runs in families. But scientists agree that OCD coincides with abnormalities in certain brain processes.

When exposed to threatening or frustrating situations, most people with OCD experience hyperactivity in the parts of the brain regulating external stimuli, including the amygdala — the part of the brain where danger is evaluated and processed — and the orbital frontal cortex, which performs cognitive processing and decision-making functions.

Serotonin is a neurotransmitter (a chemical that relays messages within the brain) that may play a part in OCD. People with the condition who take medication that modifies serotonin levels have fewer symptoms of OCD (see Treatments, below).

Diagnosis of OCD

While not all perfectionist behaviors are symptomatic of OCD, the disorder can become so severe and time-consuming that it becomes dysfunctional, preventing a person from normal day-to-day activities.

Only a qualified physician or mental-health provider can make an accurate diagnosis of OCD. The condition is often present with other mental-health disorders, such as depression, eating disorders or other anxiety disorders.

Treatment for OCD

There are several methods of treating OCD; most involve some kind of medication, psychotherapy or a combination of both.

Cognitive-behavioral therapy (CBT) has been shown to be effective in treating OCD by teaching the individual with the disorder to try a different approach to those situations that trigger their obsessive-compulsive behavior. One type of CBT, known as exposure and response prevention, can help people with OCD by teaching them healthy ways to respond when exposed to a feared object (dirt or dust, for example).

Selective serotonin reuptake inhibitor (SSRI) antidepressants are the medications most commonly prescribed for treating OCD. Anti-anxiety medication may also be prescribed.

Both types of medications may take several weeks to begin to work, according to the National Institutes of Health. In addition to side effects such as headache, nausea and insomnia, antidepressants have been shown to cause suicidal thoughts and behaviors in some people. People taking antidepressants need to be monitored closely, especially when starting their treatment.

Follow Elizabeth Palermo on Twitter @techEpalermo, Facebook or Google+. Follow LiveScience @livescience. We’re also on Facebook Google+.

Genetic analysis reveals insights into the genetic architecture of OCD … | genetic, ocd

An international research consortium led by investigators at Massachusetts General Hospital (MGH) and the University of Chicago has answered several questions about the genetic background of obsessive-compulsive disorder (OCD) and Tourette syndrome (TS), providing the first direct confirmation that both are highly heritable and also revealing major differences between the underlying genetic makeup of the disorders. Their report is being published in the October issue of the open-access journal PLOS Genetics.

“Both TS and OCD appear to have a genetic architecture of many different – perhaps hundreds in each person – acting in concert to cause disease,” says Jeremiah Scharf, MD, PhD, of the Psychiatric and Neurodevelopmental Genetics Unit in the MGH Departments of Psychiatry and Neurology, senior corresponding author of the report. “By directly comparing and contrasting both disorders, we found that OCD heritability appears to be concentrated in particular chromosomes – particularly chromosome 15 – while TS heritability is spread across many different chromosomes.”

An anxiety disorder characterized by obsessions and compulsions that disrupt the lives of patients, OCD is the fourth most common psychiatric illness. TS is a chronic disorder characterized by motor and vocal tics that usually begins in childhood and is often accompanied by conditions like OCD or attention-deficit hyperactivity disorder. Both conditions have been considered to be heritable, since they are known to often recur in close relatives of affected individuals, but identifying specific genes that confer risk has been challenging.

Two reports published last year in the journal Molecular Psychiatry, with leadership from Scharf and several co-authors of the current study, described genome-wide association studies (GWAS) of thousands of affected individuals and controls. While those studies identified several gene variants that appeared to increase the risk of each disorder, none of the associations were strong enough to meet the strict standards of genome-wide significance. Since the GWAS approach is designed to identify relatively common gene variants and it has been proposed that OCD and TS might be influenced by a number of rare variants, the research team adopted a different method. Called genome-wide complex trait analysis (GCTA), the approach allows simultaneous comparision of genetic variation across the entire genome, rather than the GWAS method of testing sites one at a time, as well as estimating the proportion of disease heritability caused by rare and common variants.

“Trying to find a single causative gene for diseases with a complex is like looking for the proverbial needle in a haystack,” says Lea Davis, PhD, of the section of Genetic Medicine at the University of Chicago, co-corresponding author of the PLOS Genetics report. “With this approach, we aren’t looking for individual genes. By examining the properties of all genes that could contribute to TS or OCD at once, we’re actually testing the whole haystack and asking where we’re more likely to find the needles.”

Using GCTA, the researchers analyzed the same genetic datasets screened in the Molecular Psychiatry reports – almost 1,500 individuals affected with OCD compared with more than 5,500 controls, and nearly TS 1,500 patients compared with more than 5,200 controls. To minimize variations that might result from slight difference in experimental techniques, all genotyping was done by collaborators at the Broad Institute of Harvard and MIT, who generated the data at the same time using the same equipment. Davis was able to analyze the resulting data on a chromosome-by-chromosome basis, along with the frequency of the identified variants and the function of variants associated with each condition.

The results found that the degree of heritability for both disorders captured by GWAS variants is actually quite close to what previously was predicted based on studies of families impacted by the disorders. “This is a crucial point for genetic researchers, as there has been a lot of controversy in human genetics about what is called ‘missing heritability’,” explains Scharf. “For many diseases, definitive genome-wide significant variants account for only a minute fraction of overall heritability, raising questions about the validity of the approach. Our findings demonstrate that the vast majority of genetic susceptibility to TS and OCD can be discovered using GWAS methods. In fact, the degree of captured by GWAS variants is higher for TS and OCD than for any other complex trait studied to date.”

Nancy Cox, PhD, section chief of Genetic Medicine at the University of Chicago and co-senior author of the PLOS Genetics report, adds, “Despite the fact that we confirm there is shared genetic liability between these two disorders, we also show there are notable differences in the types of genetic variants that contribute to risk. TS appears to derive about 20 percent of genetic susceptibility from rare variants, while OCD appears to derive all of its susceptibility from variants that are quite common, which is something that has not been seen before.”

In terms of the potential impact of the risk-associated variants, about half the risk for both disorders appears to be accounted for by variants already known to influence the expression of genes in the brain. Further investigation of those findings could lead to identification of the affected genes and how the expression changes contribute to the development of TS and OCD. Additional studies in even larger patient populations, some of which are in the planning stages, could identify the biologic pathways disrupted in the disorder, potentially leading to new therapeutic approaches.

add to favorites
email to friend
save as pdf


Download mp3
 iTunes podcast
 Latest podcasts

SUBNETS aims for systems-based neurotechnology and understanding for the …

Despite the best efforts of the Departments of Defense and Veterans Affairs to protect the health of U.S. servicemembers and veterans, the effects of neuropsychological illness brought on by war, traumatic injuries and other experiences are not always easily treated. While current approaches can often help to alleviate the worst effects of these illnesses, they are imprecise and not universally effective. Demand for new therapies is high as mental disorders are the leading cause of hospital bed days and the second leading cause of medical encounters for active duty servicemembers. Among veterans, ten percent of those receiving treatment from the Veterans’ Health Administration are provided mental health care or substance abuse counseling.

DARPA created the Systems-Based Neurotechnology for Emerging Therapies (SUBNETS) program to pursue advances in neuroscience and neurotechnology that could lead to new clinical understanding of how neuropsychological illnesses manifest in the brain and to advanced therapies to reduce the burden and severity of illness in afflicted troops and veterans. The program will pursue a new investigative approach that establishes the characteristics of distributed neural systems and attempts to develop and apply therapies that incorporate near real-time recording, analysis and stimulation in next-generation devices inspired by current Deep Brain Stimulation (DBS).

DBS already exists as a therapy option for certain neurologic and neuropsychological illnesses in patients who are not responsive to other therapies. Approximately 100,000 people around the globe live with a DBS implant, a device that delivers electrical stimulation to reduce the motor impairment caused by Parkinson’s disease and dystonia. These devices are also being studied as therapy for depression, obsessive compulsive disorder, Tourette’s and epilepsy.

Despite recent advances, clinicians and researchers remain limited by the tools available to study, understand and treat systems of the brain. To achieve maximum benefit, clinicians are often forced to complete a slow, repetitive and imprecise cycle of observing behaviors and fine-tuning drug or behavioral therapy until the effects of a disease are reduced. The science has, to this point, been largely based on a century of identifying associations between features of complex behaviors and diffuse understanding of the brain.

SUBNETS aims for systems-based neurotechnology and understanding for the treatment of neuropsychological illnessesEnlarge

SUBNETS seeks to move beyond this limited understanding to create new interventions based on new insights that can be gained from the intersection of neuroscience, neurotechnology and clinical therapy. While there is no question that brain activity, anatomy and behavior are functionally linked, there is a growing body of evidence to suggest that many neural and behavioral processes are not localized to specific anatomical regions, but are emergent from systems that span several regions of the brain. SUBNETS will attempt to establish the capability to record and model how these systems function in both normal conditions, among volunteers4 seeking treatment for unrelated neurologic disorders, as well as among impaired clinical research participants.

DARPA is specifically interested in evaluating the underlying systems which contribute to the following conditions as described by the Diagnostic and Statistical Manual of Mental Disorders: Post-Traumatic Stress Disorder, Major Depression, Borderline Personality Disorder and General Anxiety Disorder. DARPA also seeks to evaluate the representation in the central nervous system of: Traumatic Brain Injury, Substance Abuse/Addiction and Fibromyalgia/Chronic Pain.

“If SUBNETS is successful, it will advance neuropsychiatry beyond the realm of dialogue-driven observations and resultant trial and error and into the realm of therapy driven by quantifiable characteristics of neural state,” said Justin Sanchez, DARPA program manager. “SUBNETS is a push toward innovative, informed and precise neurotechnological therapy to produce major improvements in quality of life for servicemembers and veterans who have very few options with existing therapies. These are patients for whom current medical understanding of diseases like chronic pain or fatigue, unmanageable depression or severe post-traumatic stress disorder can’t provide meaningful relief.”

As described in a broad agency announcement, the work will require development of novel medical hardware, complex modeling of human , clinical neurology and animal research. DARPA expects that successful teams will span across disciplines including psychiatry, neurosurgery, neural engineering, microelectronics, neuroscience, statistics and computational modeling.

“We’re talking about a whole systems approach to the brain, not a disease-by-disease examination of a single process or a subset of processes,” Sanchez said. “SUBNETS is going to be a cross-disciplinary, expansive team effort and the program will integrate and build upon historical DARPA research investments.”

Because programs like SUBNETS push the leading edge of science, they are sometimes society’s first encounter with the dilemmas associated with new technologies. DARPA pursues these technologies because of their promise, but the Agency understands that it is important to consider ethical, legal, societal and policy questions. For that reason, DARPA has convened an Ethical, Legal and Social Implications (ELSI) panel to inform and advise SUBNETS and other emerging neuroscience efforts. The panel’s membership represents the academic community, medical ethicists, and clinical and research scientists. ELSI panelists will provide guidance in addition to the standard oversight provided by DARPA and Department of Defense internal review boards that govern human and animal use and the Presidential Commission for the Study of Bioethical Issues that will oversee SUBNETS as part of the BRAIN Initiative.

More information: Armed Forces Health Surveillance Center, Summary of Mental Disorder Hospitalizations, Active and Reserve Components, U.S. Armed Forces, 2000-2012, Medical Surveillance Monthly Report, 2013 Jul; 20(7):4-11.

add to favorites
email to friend
save as pdf