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Compulsions Reduce Anxiety
For the majority of sufferers, compulsive behaviours are performed in an attempt to manage the anxiety produced by obsessions.
Compulsions are Repetitive
Typically sufferers of OCD feel compelled to repeat a behaviour. For example, repetitive hand washing, tidying, counting or ordering.
Avoidance
Behavioural Characteristics
Sufferers tend to try and manage their OCD by avoiding situations that trigger anxiety. This avoidance can lead people to avoid very ordinary situations and can interfere with leading a normal life.
DSM-5 Categories of OCD
- OCD - Characterised by either obessions and/or compulsions.
- Trichotillomania - Compulsive hair pulling
- Hoarding Disorder - The compulsive gathering of possessions and the inability to part with anything, regardless of its value
Anxiety and Distress
Obsessive thoughts are unpleasant and frightening, and the anxiety alongside this can be overwhelming. The urge to repeat a behaviour creates anxiety.
Guilt and Disgust
OCD sometimes involves other negative emotions such as irrational guilt, for example over minor moral issues, or disgust, which may be directed against something external or at the self.
Emotional Characteristics
Cognitive Characteristics
Obsessive Thoughts
For around 90% of sufferers, the major cognitive feature of OCD is obessive thoughts. These vary considerably from person to person but are always unpleasant.
Accompanying Depression
People suffering OCD are usually plagued with obsessive thoughts but they also adopt cognitive strategies to deal with these.
Anxiety can be accompanied by low mood and lack of enjoyment in activities. Compulsive behaviour tends to bring some relief from anxiety but this temporary.
Cognitive Strategies
Sufferers respond by adopting coping strategies, for example rituals. This may help manage anxiety but can make the person appear abnormal to others and can distract them from everyday tasks.
Insight into Excessive Anxiety
OCD sufferers experience catastrophic thoughts about the worst case scenarios that might result if their anxieties were justified. They also tend to be hypervigilant, in other words they maintain constant alertness and keep attention on potential hazards.