http://en.wikipedia.org/wiki/Obsessi...lsive_disorder
Obsessive–compulsive disorder
Obsessive–compulsive disorder (
OCD) is an
anxiety disorder characterized by
intrusive thoughts that produce uneasiness, apprehension, fear or worry (obsessions), repetitive behaviors aimed at reducing the associated anxiety (compulsions), or a combination of such obsessions and
compulsions. Symptoms of the disorder include excessive washing or cleaning, repeated checking, extreme
hoarding, preoccupation with
sexual, violent or religious thoughts,
relationship-related obsessions, aversion to particular numbers and nervous
rituals such as opening and closing a door a certain number of times before entering or leaving a room. These symptoms can be
alienating and time-consuming, and often cause severe emotional and financial distress. The acts of those who have OCD may appear
paranoid and potentially
psychotic. However, OCD sufferers generally recognize their obsessions and compulsions as irrational and may become further distressed by this realization.
The phrase obsessive–compulsive has become part of the English lexicon, and is often used in an informal or caricatured manner to describe someone who is excessively meticulous, perfectionistic, absorbed, or otherwise fixated.Although these signs are present in OCD, a person who exhibits them does not necessarily have OCD, but may instead have obsessive–compulsive personality disorder (OCPD), an autism spectrum disorder, or disorders where perseveration (hyperfocus) is a feature in ADHD, PTSD, bodily disorders, or just a habit problem.
Obsessions
Obsessions are thoughts that recur and persist despite efforts to ignore or confront them. People with OCD frequently perform tasks, or
compulsions, to seek relief from obsession-related anxiety. Within and among individuals, the initial obsessions, or intrusive thoughts, vary in their clarity and vividness. A relatively vague obsession could involve a general sense of disarray or tension accompanied by a belief that life cannot proceed as normal while the imbalance remains. A more intense obsession could be a preoccupation with the thought or image of someone close to them dying or intrusions related to "
relationship rightness." Other obsessions concern the possibility that someone or something other than oneself—such as God, the Devil, or disease—will harm either the person with OCD or the people or things that the person cares about. Other individuals with OCD may experience the sensation of invisible protrusions emanating from their bodies, or have the feeling that inanimate objects are ensouled.
People with OCD understand that their notions do not correspond with reality; however, they feel that they must act as though their notions are correct. For example, an individual who engages in
compulsive hoarding might be inclined to treat inorganic matter as if it had the sentience or rights of living organisms, while accepting that such behavior is irrational on a more intellectual level.
Primarily obsessional
OCD sometimes manifests without overt compulsions. Nicknamed "Pure-O", or referred to as Primarily Obsessional OCD, OCD without overt compulsions could, by one estimate, characterize as many as 50 percent to 60 percent of OCD cases. Primarily obsessional OCD has been called "one of the most distressing and challenging forms of OCD." People with this form of OCD have "distressing and unwanted thoughts pop into [their] head frequently", and the thoughts "typically center on a fear that you may do something totally uncharacteristic of yourself, something ...potentially fatal...to yourself or others." The thoughts "quite likely, are of an aggressive or sexual nature."
Rather than engaging in observable compulsions, the person with this subtype might perform more covert, mental rituals, or might feel driven to avoid the situations in which particular thoughts seem likely to intrude. As a result of this avoidance, people can struggle to fulfill both public and private roles, even if they place great value on these roles and even if they had fulfilled the roles successfully in the past. Moreover, the individual's avoidance can confuse others who do not know its origin or intended purpose, as it did in the
case of a man whose wife began to wonder why he would not hold their infant child. The covert mental rituals can take up a great deal of a person's time during the day.
Some people with OCD perform compulsive rituals because they inexplicably feel they have to, others act compulsively so as to mitigate the anxiety that stems from particular obsessive thoughts. The person might feel that these actions somehow either will prevent a dreaded event from occurring, or will push the event from their thoughts. In any case, the individual's reasoning is so idiosyncratic or distorted that it results in significant distress for the individual with OCD or for those around them. Excessive skin picking (i.e.,
dermatillomania) or hair plucking (i.e.,
trichotillomania) and nail biting (i.e.,
onychophagia) are all on the Obsessive-Compulsive Spectrum. Individuals with OCD are aware that their thoughts and behavior are not rational, but they feel bound to comply with them to fend off feelings of panic or dread.
Some common compulsions include counting specific things (such as footsteps) or in specific ways (for instance, by intervals of two), and doing other repetitive actions, often with atypical sensitivity to numbers or patterns. People might repeatedly wash their hands or clear their throats, make sure certain items are in a straight line, repeatedly check that their parked cars have been locked before leaving them, constantly organize in a certain way, turn lights on and off, keep doors closed at all times, touch objects a certain number of times before exiting a room, walk in a certain routine way like only stepping on a certain color of tile, or have a routine for using stairs, such as always finishing a flight on the same foot.
The compulsions of OCD must be distinguished from
tics; movements of other
movement disorders such as
chorea,
dystonia,
myoclonus; movements exhibited in
stereotypic movement disorder or some people with
autism; and the movements of
seizure activity. There may exist a notable rate of comorbidity between OCD and tic-related disorders.
People rely on compulsions as an escape from their obsessive thoughts; however, they are aware that the relief is only temporary, that the intrusive thoughts will soon return. Some people use compulsions to avoid situations that may trigger their obsessions. Although some people do certain things over and over again, they do not necessarily perform these actions compulsively. For example, bedtime routines, learning a new skill, and religious practices are not compulsions. Whether or not behaviors are compulsions or mere habit depends on the context in which the behaviors are performed. For example, arranging and ordering DVDs for eight hours a day would be expected of one who works in a video store, but would seem abnormal in other situations. In other words, habits tend to bring efficiency to one's life, while compulsions tend to disrupt it.....
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