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Chronos
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08 May 2010, 3:04 am

I'd like to take the opportunity to discuss something I come across a lot, which is the misunderstanding of the term OCD.

Many of you know that OCD stands for Obsessive Compulsive Disorder, but I've come to realize that many people aren't entirely clear on what OCD actually entails.

The "obsessive" in OCD does not refer to things such as obsessive interests. Nor does it refer to being obsessed with a person or overthinking a situation that's on your mind, and so on.

In OCD, "obsessive" refers to obsessions known as intrusive thoughts. These are thoughts which are usually of a disturbing nature which are involuntary and arise from the depths of the OCD sufferer's mind (they come from the basal ganglia to be exact). The sufferer usually finds these thoughts distressing and anxiety provoking, as they are usually counter to the intentions and personalities of that person. For example, common intrusive thoughts are violent images such as a loved one in a horrible situation, thoughts of a sexual nature, for example, thought which image someone you wouldn't want to think of in a sexual situation, magical thinking, such as the intense feeling that "something bad" will happen to a loved one if the sufferer does something (such as step on a crack, go through a certain doorway, touch something the wrong number of times, not perform a particular ritual the right way, etc), and the perception that something is "dirty".

These thoughts arise within the individual spontaneously, are usually very disturbing, and the sufferer knows they are illogical.

Compulsions refer to the drive to do, or act of performing some ritual to rid one of these thoughts. Common compulsions are checking, counting, and hand washing. Handwashing is a bit of a category of it's own. It is not really a form of germophobia as a person can be a handwasher without having a concept of germs. Handwashers actually suffer a phantom sensation which gives them the perception that their hand needs to be washed, and can also give the perception that something is dirty.

While some thoughts can be more unusual than others, and some rituals more complex than others, there is very limited variation in obsessions and compulsions among OCD sufferers.
There really isn't much of a spectrum compared to other disorders, and very specific circuitry is thought to be implicated in OCD.

People with OCD are not perfectionists or neat freaks. The only thing that must be done perfectly with OCD are the particular rituals, and in the context of OCD, "neat" and "clean" really have nothing to do at all with anything being neat or clean, but only with the perception that a particular thing isn't clean in some abstract, primitive sense, or isn't neat or just right in the sense that something "bad" might happen to a loved one if it isn't some arbitrarily perfect way.

It is not beyond a person with OCD to be a complete slob who only showers once a week and uses the same coffee cup every day without cleaning it. Yet this same person may still not be able to resist the compulsion to wash their hands 100 times a day, and may spend three hours every day picking pieces of hair and lint off their pillow with a magnifying glass.

It's not a matter of having to align everything on your desk just because it kind of irks you when they're not.

Most of the obsessions and compulsions people tend to talk about really aren't the kind seen with OCD.



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08 May 2010, 3:30 am

i was aware of difrence and am fed up of poeple using 'the fake kind' but you explained it very well


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08 May 2010, 3:35 am

Yeah. People often mistake the so-called obsessive compulsive personality disorder with OCD.

OCD is unwanted/intrusive thoughts + compulsions/rituals to alleviate anxiety of said thoughts, and to a disabling amount.

It has various levels of severity, from people unable to leave a bathroom to a person who whilst looks ok on the outside, is a mess inside due to the thoughts and need to do the rituals.

It can have subtle social deficits, and this is probably due to the preoccupation with the obsessions and attempting to hide the compulsions from others (funnily, the person with an ASD probably won't care about hiding the compulsions if they also have OCD).



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08 May 2010, 4:40 am

I know exactly what you're saying. I do a lot of these little compulsive things, and often times, I don't even realize it until I'm too late. For instance, I have a really bad habit of sitting on my legs and feet. It has gotten so bad, my knees are now physically messed up. For the longest time, we thought I was pigeon-toed because my feet do point inwards, but it's actually from the knees rather than the feet themselves (though I can turn my feet in the complete opposite direction so they may have something to do with it, too). But if I don't sit like this, it just drives me nuts. I can't really explain the feeling, but it's one I can't stand. So I usually just do it without even noticing I am until it's too late.

Another thing is that when I am under a lot of stress, my OCD tends to get much worse. I went to a community college about a year and a half ago and things did not go well for me. I was having problems with classmates in the class I was good at, and I couldn't do the work in the other class at all because it was too hard (it had a 60% drop-out rate so I wasn't alone). Anyway, I started developing a lot of these little good luck rituals whenever I had a hard assignment or a big test coming up. One was going around the entire campus and counting up all of the snacks in the vending machines. If they were certain numbers (like 38 snacks), that meant I'd do well. But if it was 43 snacks in any of them, that meant I'd do horrible. I was also to the point where I was counting every step I took. I knew from the stairwell to my class was 58 steps so I always tried to hit that number. It also bothered the heck out of me whenever the teacher did not wipe the board completely clean inbetween writing math problems. I know it bothered everyone else a lot whenever I asked her to clean it all the way, but they never hated me for it. Ironically, I was considered to be very popular in that class. But I think they mainly liked me because I'm pretty. They all agreed I needed to get into modelling. And now here I am competing (and winning) beauty pageants! I actually have one today. And yes, I do have a lot of good luck rituals for those before I go on stage. They're working so far!

I am also a germaphobe. I refuse to do a lot of things most people don't even seem to notice. Like I will not put my hands on the sides of the escalator. I know I'm really risking falling down, but it's worth it. Time after time, I have seen so many people cough and sneeze and then put their hands on the sides. And a couple years ago, I saw a little boy purposely pee on an escalator (and his mom was laughing about it!! !). I haven't even gone on that particular one since. Doorbells and elevator buttons also make me uneasy. The biggest thing or me, though, is kissing. When I was going to get my very first kiss, I started hyperventilating out of fear to the point where I was about to pass out (I couldn't even move). In my mind, I can act on these sorts of behaviors just fine. But when it comes to the point where I am physically in that situation, I get too freaked out. I did get my first kiss six months later, but I really, really hated it. All I could think about was how disgusting it was and I do not want another one. Another really bad day was when I saw my cat about to poop in the pantry. I just freaked out big time and started hyperventilating again. Same thing happened when I lost my number I needed to wear at a previous pageant.

Here's another one I wanted to add as well. Even when I was just eighteen months old, I was already very organized. I apparently used to take all the wash cloths in the house and fold them up into neat little stacks. I did the same thing with pots and pans sized inside each other properly. And when I was four, one of my favorite games was "video store", where I would take all the videos in the house and display them properly in the living room. When I was ten, I always used to organize the Tae Kwon Do pads whenever we were finished up with class. The other kids often wanted to help, but I never let them in fear of messing up my work. Oh, and now I think I have the most organized closet in the state. It's crazy organized lol I just hate when things are out of place, and it's fun for me to fix them. There are definitely more examples of all of this.

There's still more to it, but that's basically me in a nutshell. I know my thoughts are definitely far from normal, but I really do try. If I feel determined enough, I push myself to try and get past these fears. Sometimes it does work for a while, but it doesn't always work in my favor.



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08 May 2010, 5:33 am

I remember in elementary school I had a lot of little magical thinking rituals where I would repeat things in my mind in a certain order so this good thing would happen or that bad thing wouldn't happen. I still compulsively think along those lines when I'm going through a yellow light.



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08 May 2010, 5:50 am

People stereotype everything, particularly disorders like OCD. It's something you have to get used to or you'll be getting annoyed a lot.


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08 May 2010, 5:56 am

Actually, there is some evidence for an OC spectrum: OCD, Tourette's Syndrome, Trichotillomania, anorexia nervosa, hypochondria, and a number of other conditions, all fall into the "OC spectrum" and often respond to the same drugs. See here:

http://www.neuroticplanet.com/spectrum.php

http://www.brainphysics.com/spectrum.php

http://en.wikipedia.org/wiki/Obsessive% ... e_spectrum



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08 May 2010, 8:56 am

Yeah, people misuse the term a lot in conversation and I just figure they do that because they don't know. Typically, when I hear people making light of OCD it's just because they have no idea how terrible it actually is and I don't think they're intentionally trying to be hurtful. It's not widely known that it's an anxiety disorder and I know for myself I don't even like to describe those terrible thoughts to others because they are so extremely disturbing. For me it's a true mental illness and I'd really like to heal it.



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08 May 2010, 10:22 am

Yeah. What I used to get was thoughts of someone I cared about with an axe through their head. Then I would have to do these tic-like things a certain amount of times to make it stop. Other times I would get these weird series of compulsions, reverse compulsions, and then a third thing that was neither. What I mean is like... first I would be forced to never step on cracks in the sidewalk. Then it switched to only being able to step on lines. Then it switched to a very over-calculated way of walking that would require me to pretend as if I was just walking normally without caring whether I stepped on a crack or not. But where I was really carefully calculating the length of each step and couldn't deviate without starting over.

For some reason I lost a lot of this in adolescence. But I still have little bits of it here and there. And they can have to do with cleanliness. Like at a friends house the grime where the wall meets the floor would fill my mind so intensely that I couldn't sit still or concentrate until I had crawled all over her house with a toothbrush and paper towels cleaning it up. The intrusive thought doesn't have to be as terrible as the images of people with axes through their heads. It can be a thought that repeats and repeats and repeats and repeats and fills your mind so much you can't think of anything else until you do something specific to get rid of it.


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08 May 2010, 11:31 am

It seems to be a trend to misuse psychological terms. I know people refer to anyone who keeps a neat orderly space as "OCD". Maybe it does sometimes have something to do with that- like a person who thinks the house will fall down if his/her stuff is not lined up a certain way. Just liking your house to be super clean is not OCD though.

This is like people who call someone a "psycho" if they seem a little strange to them. Or someone referring to an admirer as a "stalker". Huge difference! People can be psychotic at times and be very nice folks, not murderers. Psychopaths are not necessarily murderers either. Most serial killers are not psychopaths by a long shot.


I was watching one of the hoarding shows one day, and they referred to one man's OCD, citing his habit of washing his hands "up to 20 times a day"

Are you kidding me?

I have done it at least 20 times already today and it is only 12:30 pm here! I think i may have called it OCD before though too, so I stand corrected. I just hate having dirty hands and I worry about the germs.



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08 May 2010, 12:10 pm

I was pretty aware of what OCD is, but your post was still helpful. I have been called OCD by peers and even professionals and I know that I'm not. I don't have compulsions to do things like wash my hands a million times, I do something like organize the table at dinner and someone always spits out "you're so OCD!"



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08 May 2010, 12:27 pm

one-A-N wrote:
Actually, there is some evidence for an OC spectrum: OCD, Tourette's Syndrome, Trichotillomania, anorexia nervosa, hypochondria, and a number of other conditions, all fall into the "OC spectrum" and often respond to the same drugs. See here:

http://www.neuroticplanet.com/spectrum.php

http://www.brainphysics.com/spectrum.php

http://en.wikipedia.org/wiki/Obsessive% ... e_spectrum


There is a spectrum, I had stated that, but it's a lot more narrow than the spectrums of other disorders and there's less overlap between each thing.

For example, a person will usually either have OCD or Tourette's and only very rarely do they actually overlap. A person with OCD may feel there's a nose they have to make or motion they have to do, but the underlying provokation is almost always so "something bad" won't happen, and so it may look like Tourette's, but isn't really. People with Tourette's usually don't have this magical thinking. The two, however, are neurological neighbors in the brain.

Trichotillomania does frequently occur with OCD, on the other hand, and may be similar to anorexia in that often times the person will pull that hair because they perceive it to be out of place, and thus perceive themselves as looking "off" with it, and those with anorexia certainly do usually have perception issues, but still the two disorders rarely coincide. Anorexia is a highly socially implicated disorder as well, while OCD usually has no social factors. I recall once a rabbi was trying to explain the difference between the ferverent religious observations by orthodox Ashkenazi jews and actual OCD. Needless to say the entire orthodox community does not have OCD nor is their a higher than would be expected prevalence of it in it.

People with OCD usually do not have true hypochondria. The worry that something will happen to them or that they have something or will get something originates from the same place that makes them worry that something will happen to someone else if they do something mundane and totally unrelated. They aren't actually worried about getting whatever or having whatever, their basal ganglia has just decided to introduce this concept and send them some "virtual" anxiety along with it.

A person with OCD can actually care relatively little about themselves and still have this worry because logic is not part of the game.

A person with OCD could worry that if they pick up the red pen instead of the blue pen, the president will die, even if they have no reason to actually care if the president dies. But their brain sends them this virtual anxiety with the message "you will be responsible for this".

With OCD these thoughts tend to morph or dissipate over time, or get worse or better.

True hypochondriacs are actually worried about their health and this is a fairly fixed fear.



Chronos
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08 May 2010, 12:30 pm

astaut wrote:
I was pretty aware of what OCD is, but your post was still helpful. I have been called OCD by peers and even professionals and I know that I'm not. I don't have compulsions to do things like wash my hands a million times, I do something like organize the table at dinner and someone always spits out "you're so OCD!"


And what horrible semantics they have as well! "you're so obsessive compulsive disorder!" Tsk on them.



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08 May 2010, 4:03 pm

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It is not beyond a person with OCD to be a complete slob who only showers once a week and uses the same coffee cup every day without cleaning it. Yet this same person may still not be able to resist the compulsion to wash their hands 100 times a day, and may spend three hours every day picking pieces of hair and lint off their pillow with a magnifying glass.


That... was me!

It is good of you to tell people about the REAL OCD. The AS/TS obessive BEHAVIOURS are very different from actual factual OCD. Most people with AS/TS actually have OCB (B for behaviour) rather than the full blown condition. The main difference, as you have said, is that OCB is done for pleasure or to relax for example, but OCD is an absolute must. Failing to do so could result in something catastrophic. I used to be convinced that people/animals I knew would die if I didn't perform certain rituals. I was convinced that if I didn't wash my hands for exactly one minute, I would get a stomach bug (Incidentally I have only had 3 since I was 12...). My phobia of germs became so intense that I wouldn't leave the house during the winter (because of 'winter vomiting disease') and I would avoid places where there might be sick people. The fear of vomit/ing actually comes under another term, 'emetophobia' however the rituals I did to 'stop it' from happening were definately OCD.

It irkes me as well when people use the term OCD to describe silly little things like checking the locks twice (my mum does that but it doesn't ruin her life!) or wanting to set all the light switches to the same setting. It is when there are all these symptoms mixed together, plus more severe ones, that it becomes OCD.

I will admit though... in the past I have jokingly said 'OCD' to my mum every time she does her car checking thing! She knows about real OCD though so it's okay! :lol:


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Chronos
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08 May 2010, 11:28 pm

Jellybean wrote:
It irkes me as well when people use the term OCD to describe silly little things like checking the locks twice (my mum does that but it doesn't ruin her life!) or wanting to set all the light switches to the same setting. It is when there are all these symptoms mixed together, plus more severe ones, that it becomes OCD.


Checking the locks twice is indeed not OCD, it's just good measure.

Unlocking the door, and going back in to make sure the stove and lights are off, and everything is unplugged, once just in case, twice because you can't remember if you did it or not, and three times so the guy at the gas station won't die, and then locking the door and checking the locks twice is OCD :-)



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09 May 2010, 2:28 am

I don't have true OCD but that word gets used on me due to my obsessive thinking. It's hard for me to let things go and when something is bothering me, I can't stop talking about it. I decided to try and leave it off the forums or else it looks bad.
But it's common in aspies to have obsessive thinking. Do they call routines OCD and our obsessions and having to do them OCD? I notice everyone seems to call my obsessive thinking and me getting distracted by my thoughts OCD. I think even my psychiatrist called it that because the word was written down for me at the health clinic when they obtain my old medical record.


But as a kid I was afraid of dirt and germs and that is typical OCD and I did obsessive cleaning. I would go crazy if something was out of place. I was also afraid of getting dirty. But I outgrew all that. Sure I have some good habits like making sure I have my apartment keys before locking my door, and turning the knob making sure it's locked, and looking in my purse after I turn my car off to make sure I have my car keys, I don't call it OCD.

I remember I used to go crazy if I couldn't shower or brush my teeth and I went through a phase where I was washing my hands too much because I felt they were dirty. All it did was it dried them up and made my skin crack so my mom bought me lotion for my hands and told me washing them too much does that to my hands and lotion will help. I stopped that habit.

My school suspected me of having OCD when I was 11 because I was obsessed about staying clean and was afraid of getting all sweaty and dirty. Yeah lot of people want to stay clean but they don't go crazy over it and then it's the end of the world for them if they get sweaty and they don't start going "Oh no I'm dirty now. I gotta shower now but I have to wait till I get home to do it, oh no." Then that is all they think about till they get home.

If you're obsessing over being clean and wanting to stay clean it impairs you, then you have a problem. I think that's when it becomes OCD.