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Obsessive-Compulsive Disorder (OCD)
Obsessive Compulsive Disorder involves intrusive, distressing thoughts, urges or images called obsessions. These thoughts/urges/images often can't be relieved unless a specific action, known as a compulsion, is performed. Compulsions are behaviors or mental acts that one engages in to temporarily ease the distress caused by the obsessions but usually lead to a cycle of repetitive behaviors. OCD can come in many shapes and forms, but the underlying mechanisms are the same.
Here are some examples of common OCD subtypes:
Body Dysmorphic Disorder (BDD) is a mental health condition characterized by a preoccupation with perceived flaws or defects in one's physical appearance, which are often minor or imagined. Individuals with BDD may engage in repetitive behaviors, such as excessive grooming, comparing, mirror-checking, or seeking reassurance, and may avoid social situations due to concerns about their appearance. The disorder can significantly impact daily functioning and often causes high levels of distress.
Checking OCD is a subtype of Obsessive Compulsive Disorder characterized by recurring doubts and fears, leading to compulsive behaviors such as checking and rechecking things excessively. Individuals with Checking OCD might feel compelled to repeatedly verify tasks like locking doors, turning off appliances, or ensuring personal belongings are in place. This cycle of doubt and ritual can disrupt daily routines and create high levels of distress
Contamination OCD is a type of Obsessive Compulsive Disorder where individuals experience persistent fears of being contaminated by germs, dirt, or harmful substances (Note: The core fear is not always related to fears of getting sick, it can be related to a feeling of disgust or a sensory feeling of being dirty/sticky/oily etc.). These fears often lead to excessive washing, cleaning, or avoidance behaviors in an attempt to reduce anxiety. This form of OCD can significantly impact daily life and mental well-being.
Individuals with this type of OCD experience obsessive thoughts related to the nature of existence, the meaning of life and the afterlife, and philosophical questions. They may ruminate excessively about their purpose, the universe, and mortality, often leading to heightened anxiety and distress.
People with this subtype of OCD have intrusive thoughts that they have done something in the past that they cannot remember accurately, especially if the action may have been inappropriate in some way. These thoughts often involve fears of having committed a harmful or morally wrong act, even though there's no evidence to support the existence of such memories.
Harm OCD, also known as Harm Obsessions or Harm-Related Obsessive-Compulsive Disorder, is a subtype of Obsessive-Compulsive Disorder (OCD) where individuals experience distressing and intrusive thoughts, images, or urges related to causing harm to themselves or others. There are two main subtypes of Harm OCD:
Aggressive/Intentional Harm OCD: This subtype involves obsessions and intrusive thoughts centered around causing harm to others. Individuals with this subtype might experience distressing thoughts or images of physically hurting loved ones, strangers, or even animals. They often fear that they might act on these thoughts, even though they have no intention of doing so.
Accidental Harm OCD: This subtype involves obsessions and intrusive thoughts related to causing harm to oneself. Individuals with this subtype may experience distressing thoughts or images of self-inflicted harm or suicide. They may fear that they will lose control and act on these thoughts, even if they genuinely do not want to harm themselves.
In "Just Right" OCD, individuals experience discomfort and distress when things don't feel "just right," causing significant anxiety; they may repeatedly engage in rituals or adjustments until they achieve a sense of perfection or completeness, even though the criteria for achieving this feeling may be subjective.
Magical Thinking OCD involves irrational beliefs that thoughts or actions can influence unrelated events. Individuals may perform rituals like counting, repeating phrases, or arranging objects to counteract perceived connections.
Pedophilia OCD involves distressing and unwanted intrusive sexual thoughts related to children, despite having no desire to act on these thoughts and not feeling attracted to children in any way. Individuals with this subtype of OCD often experience extreme anxiety, guilt, self-doubt, and shame.
Perinatal OCD, also known as postpartum OCD, emerges during pregnancy or after childbirth. Individuals with this condition experience distressing thoughts related to their baby's safety, often leading to compulsive behaviors. This type of Obsessive Compulsive Disorder can significantly impact the daily lives of new parents.
Racist OCD is a subtype of Obsessive Compulsive Disorder characterized by distressing, unwanted thoughts related to race and racism. These thoughts, incongruent with personal values, might include racial slurs or prejudicial thoughts. Individuals may use mental rituals to manage anxiety and seeking reassurance.
This type of OCD involves obsessive preoccupation with events from the past, particularly negative events or mistakes. Individuals may continually review and scrutinize past experiences, seeking reassurance or trying to prevent the negative consequences associated with those events.
Relationship OCD, often referred to as ROCD, involves distressing doubts and intrusive thoughts about one's romantic relationship. Individuals with this condition may constantly question their feelings or the compatibility of their partner, or whether their partner is attractive enough for them. These thoughts can lead to repetitive behaviors such as seeking reassurance or mentally analyzing the relationship, and comparing to others.
Religious OCD, also known as Scrupulosity, is marked by intense preoccupation with religious thoughts and an overwhelming fear of not meeting religious standards perfectly. Individuals with Scrupulosity often experience persistent worries about whether they have fulfilled or violated religious obligations that are not in line with their sociocultural context. This constant mental struggle can lead to significant distress and interfere with daily life, especially with religious practices. While there is no evidence that religiosity causes OCD, religious individuals who suffer from OCD often experience scrupulosity symptoms.
Sensorimotor OCD involves persistent and distressing obsessions related to bodily sensations and movements. Individuals with this condition experience intense preoccupation with normal bodily processes, such as breathing, swallowing, or blinking, and often become hyper-aware of these sensations. People with Sensorimotor OCD may fear that they will constantly be aware of their bodily functions without ever experiencing relief
Sexual OCD involves distressing intrusive thoughts, urges, or images related to sexual themes, or related to engaging in sexual or violent acts. Individuals may engage in rituals to alleviate anxiety, despite recognizing the thoughts as unwanted and not in line with their true desires.
Sexual Orientation OCD, also known as SO-OCD or Homosexual OCD, is characterized by intrusive doubts and fears regarding one's sexual orientation. Individuals with this condition experience distressing thoughts that conflict with their perceived sexual identity. These thoughts can lead to compulsive behaviors such as seeking reassurance, checking, or analyzing past experiences.
Staring OCD involves a person becoming preoccupied with the idea of staring at someone inappropriately, and it often involves actual staring, though this experience is distressing and does not provide any sort of gratification to the OCD sufferer. They may worry that they will be caught and get in trouble or create an awkward situation, and often wish that the need to stare will go away, but find that the more they wish they could stop staring, the more intense the experience becomes, and the more they feel the urge to stare.
Suicidal OCD, a subtype of Obsessive Compulsive Disorder, encompasses distressing intrusive thoughts about self-harm or suicide. Individuals experience unwanted mental images or fears of harming themselves, despite not desiring to act on these thoughts. This condition can lead to severe anxiety and emotional turmoil.
Symmetry and Ordering OCD involves an intense need for things to be symmetrical or arranged in specific orders, which is sometimes (but not always) related to “magical thinking” (for example, thinking that a loved one might be harmed if their picture frame is not straight). Individuals may perform repetitive organizing or counting rituals to ease discomfort or anxiety, impacting daily life.
Tourettic OCD involves tics, compulsions, and premonitory urges that are overlapping and tightly intertwined. The specific behaviors seen in TOCD are typically complex tic-like behaviors although with a compulsive and partially anxious nature reminiscent of “just right“ OCD. TOCD is not classified within the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) as an independent diagnostic entity, but evidence suggests that TOCD is an intermediate neuropsychiatric disorder distinct from either TS or OCD alone and as such represents a unique phenomenology (Katz et al., 2022).
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