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Contrary to what you might see on social media, obsessive-compulsive disorder (OCD) doesn’t mean a person likes to be neat and tidy. There are several types of OCD, but the hallmark of the condition is intrusive thoughts — known as obsessions — that create extreme anxiety. Then, to relieve their discomfort, a person with OCD performs a certain act known as a compulsion. Here’s what OCD looks like for different people.
An estimated 1% of the population has obsessive-compulsive disorder. This isn’t an exhaustive list, but the following types of OCD are extremely common:
In contamination OCD, the intrusive thought is that the person may have touched something dirty and could catch a disease. The compulsion is usually frequent hand washing or cleaning. The person may also avoid touching certain objects such as doorknobs, bathroom stall doors or faucet handles.
A subtype of contamination OCD is the fear of mental contamination, in which a person avoids thoughts or phrases that make them feel like a bad person. They may also avoid talking to people whose behavior they don’t like for fear of accidentally becoming like them.
Not always relegated to the realm of OCD, emetophobia is the intense fear of vomiting. It becomes OCD when a person starts performing compulsions to abate the intrusive thought, “What if I throw up?”
Compulsions include not finishing all the food on their plate, only eating at certain times or rereading expiration dates on food packaging. People may avoid restaurants where they previously felt nauseous or heard of someone becoming nauseous. They may also count calories to make sure they don’t go over a specific, self-determined limit at which they fear they will vomit.
Drivers with hit-and-run OCD fear they may have run someone over. A bump in the road triggers the intrusive thought that they hit someone, and then the compulsion is to drive back and check the road. People with this type of OCD will often be late to work or miss appointments because they start driving in a loop, checking the same spots over and over to ensure they didn’t hurt anybody.
“Does my partner love me? Am I actually attracted to my partner? What if I cheated on my partner, but can’t remember it?”
The hallmark of this type of OCD is an intrusive thought that seems to threaten a person’s relationship. The compulsion may be asking for reassurance, checking to see if they’re attracted to someone else, ruminating or doing research to “prove” they love their partner.
One trait that characterizes many OCD sufferers is a great concern for other people’s well-being, safety or happiness. This makes intrusive thoughts of harming someone very distressing, yet very common for the exact same reason — uncomfortable thoughts become more intrusive over time as the person begins to fear them.
People with harm OCD often have thoughts of punching, pushing or stabbing someone they love. New parents may be terrified of dropping their baby or otherwise hurting them somehow. Then, they may compulsively try to remember harming someone, ask others to ensure they didn’t do anything wrong or frequently check on their loved ones.
Closely related to — or perhaps a subtype — of harm OCD is pedophilia OCD, where a person is intensely worried that they may be a pedophile. This type of OCD often afflicts new parents. The intrusive thought is that they might be attracted to a child, and unlike with pedophilia, the thought causes extreme anxiety and disgust. Compulsions often involve not looking at children, asking for reassurance, doing research or trying to gauge their attraction to adults.
“Did I accidentally break a rule? Did I tell a lie?”
People with scrupulosity OCD obsess over following the rules and being a good person. Many people with this type of obsessive-compulsive disorder are intensely religious. If they accidentally commit a transgression or even believe they did, then they may worry they’re a bad person or fear going to Hell.
Compulsions often include excessively confessing their sins, performing cleansing rituals or writing prayers to make sure they’re done correctly. They may repeatedly seek reassurance from religious leaders. Several written reports from the 1600s, which may be the oldest known accounts of OCD, describe these exact behaviors.
Obsessive-compulsive disorder is not about organizing things for the sake of aesthetics. The three letters in OCD describe the condition perfectly: Obsessions trigger anxiety, anxiety triggers compulsions and compulsions trigger a disorder.
This cycle usually repeats itself until a person gets the right medication and undergoes therapy. Although OCD often lingers despite these interventions, people with the disorder usually feel much better after taking these steps and can get their normal life back.
