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Obsessive compulsive disorder (OCD)

How does OCD manifest itself?

Obsessive thoughts can be either verbal thoughts (e.g. "This might be contaminated." or "What if I am a paedophile?"), an image (e.g. imagining stabbing a loved one with a knife or imagining violent scenes in one’s mind) or a motive (e.g. an urge to fix a picture that is out of alignment on the wall or an urge to touch something). People experience obsessive thoughts as unwelcome and intrusive and do not want to have these thoughts. These thoughts often revolve around what stands closest to them to and they experience as horrible thoughts, which causes them to become frightened of these thoughts. A common example of this is when a new parent gets obsessive thoughts about harming their child.

Obsessive thoughts always evoke an uncomfortable feeling, such as anxiety, fear, feeling of disgust or guilt. Sometimes the feeling is impenetrable and is best described as uneasiness or that "something is not as it should be" feeling.

Compulsive behaviour serves the purpose of getting rid of the obsessive thoughts and discomfort they cause and in some cases to prevent something bad from happening. Compulsive behaviour can be noticeable behaviour, such as washing your hands after touching a door handle or checking the front door to make sure it is locked. Compulsive behaviour can also be an invisible behaviour that occurs in the mind, such as repeatedly going over what one was saying to their girlfriend to make sure that they did not say something hurtful or to say some kind of prayer, mantra or comfort ("Nothing bad will happen." or "I've checked, it's fine."). People often feel it is necessary to perform the compulsive behaviour in a fixed manner, to do things in a certain order or to do things a certain amount of times before they can stop.

The vicious circle of obsessive compulsive disorder describes itself as something triggering an obsessive thought, such as seeing a knife, then up comes an obsessive thought "What if I stab my husband?" that arouses fear. Then, the person responds with compulsive behaviour, such as removing the knife or reassuring themselves ("No, I would never do that, I love my husband!"). In doing so, the person in question experiences relief, but only temporarily. Within a short while, another obsessive thought arises ("What if the chicken is infected with salmonella?") accompanied by a feeling of disgust and a need to perform a compulsive behaviour.

When an obsessive compulsive disorder becomes severe, obsessive thoughts and compulsive behaviour take up a lot of time and sometimes the whole day. When symptoms are milder, the obsessive thoughts and the compulsive behaviour is sometimes more dependent on the situation and takes up less time.

Although many may recognise the feeling of wanting to wash their hands after touching something or checking their locks a few times or even getting obsessed with something for a while, there is a big difference between that and having an obsessive compulsive disorder. The person with obsessive compulsive thoughts feels uncomfortable getting these obsessive thoughts and, although the person in question experiences relief after performing the compulsive behaviour, they do not feel well. Thus, the person who likes to keep their surroundings clean and who experiences pleasure after cleaning their apartment does not have an obsessive compulsive disorder. People who suffer from an obsessive compulsive disorder do not experience pleasure after performing a compulsion, they never feel like they are done.