Obsessive compulsive disorder is an anxiety disorder where the individual experiences intrusive obsessions and unwanted compulsions that they cannot control. The obsessions that they experience tend to stay “stuck” in their brain and put on repeat. They have a great deal of difficulty with trying to ignore or work past what are often irrational and painful thoughts.

After someone with this disorder experiences an obsession, that particular obsession will usually be accompanied with a self-esteem damaging and sometimes embarrassing compulsion. The obsessions that individuals experience are not pleasant. The term “obsession” often tends to be used as falsely synonymous with the term “rumination”, which means to deeply think of something. An obsession is defined as a continuous thought that intrudes on a person’s mind.

There is nothing pleasant about the obsessions these individuals experience. For example, they may obsess about getting contaminated with germs. So, in an attempt to try and “help” themselves to stay “safe” from germs, they may go to painstaking efforts to avoid places, objects, and people. These are the compulsions.

So, they may wash their hands 50 times a day to ensure that their hands are clean or they may shower 20 times a day even though there is no logical reason to do so. They may throw away plates or cups that they feel are “contaminated” even when there is nothing wrong with them.



Unfortunately, all of their time-consuming efforts to try and relieve their anxiety only makes the symptoms of their obsessive compulsive disorder worse as they begin to convince themselves that they need to perform the bizarre and painful compulsions in order for them alleviate their anxiety and to finally move on to the next thought.

They may feel “stuck” in thought at times, where all they can think about is their obsession, which is usually some irrational and often “catastrophic” dilemma that they can’t ignore or rationalize their way out of, regardless of their intelligence. So, oftentimes a vicious cycle is developed where the individual is literally trapped within their own mind of irrational obsessive thoughts and compulsive urges.

Causes of obsessive compulsive disorder

About 3.3 million adults and about 1 million children and adolescents in the U.S. have obsessive compulsive disorder. The exact cause of obsessive compulsive disorder is unknown. However, there are several risk factors which may indicate a predisposition for developing this mental illness. Obsessive compulsive disorder develops due to a chemical imbalance in the brain where the individual gets “stuck” in thought. Abnormalities, or an imbalance in the neurotransmitter, or brain chemical, serotonin, could also be to blame [1].

Environmental factors are very significant as there are sometimes correlations with obsessive compulsive disorder and past abuse. People who have experienced abuse (physical or psychological) in childhood or other trauma are at an increased risk for developing obsessive compulsive disorder [2]. Genetics also play a part in someone developing this illness. If you have a family history of this mental illness or another anxiety disorder, then this may increase your risk for developing this condition.

Symptoms of obsessive compulsive disorder

Symptoms for obsessive compulsive disorder are comprised of either obsessions or compulsions. Obsessions are the repetitive and intrusive thoughts that inflict pain and anxiety within the individual. A compulsion is the urge that is associated with the obsession in an attempt to relieve the painful anxiety that the obsession has manifested. Some common symptoms are:

Obsessions

  • Fear of germs or becoming contaminated
  • Having unwanted, repetitive thoughts that evoke anxiety
  • Inability to ignore thoughts
  • Needing things to be symmetrical
  • Denoting certain numbers or letters as “good” or “bad”
  • Overbearing fear of other people’s judgments
  • Fear that if you don’t perform a compulsion something very terrible will happen
  • Replaying experiences in your mind over and over
  • Overthinking situations/obsessing over details
  • Difficulty with making decisions

Compulsions

  • Checking repeatedly if things are turned off
  • Cleaning things that are already clean (i.e. your hands, dishes, etc.)
  • Rereading words or lines in a book because you “may” have overlooked them
  • Checking repetitively if the doors are locked
  • Having to perform a task a “certain” number of times
  • Hoarding things that will never get used
  • Constantly having to arrange things a certain way
  • Nervous ticks (e.g. cracking neck, wrist, fingers, etc.)
  • Touching things a certain number of times

Diagnostic Criteria of obsessive compulsive disorder

To get diagnosed with this disorder, a psychological evaluation must be prompted. This includes discussing your thoughts, feelings, symptoms and behavior patterns [3]. Your symptoms must give you a significant amount of distress throughout the day and it must interfere with your day to day life over the course of several months for you to be diagnosed with obsessive compulsive disorder. Merely having some quarks or tendencies will not merit you being obsessive compulsive. This anxiety disorder is very debilitating and causes a great deal of pain and mental anguish toward its sufferer.

It is not uncommon for individuals who have this disorder to also get diagnosed with other mental illnesses such as generalized anxiety disorder or major depression, among others. To get diagnosed, the patient will need to seek out professional help from an accredited therapist/psychologist or a psychiatrist.

Treatments of obsessive compulsive disorder

Fortunately, there are many different types of treatments for someone who has been diagnosed with this disorder. While some people may significantly benefit from behavior therapy and others are helped by medication therapy, it may be very beneficial for someone with obsessive compulsive disorder to engage in both forms of therapy simultaneously. Medication can be very helpful for individuals looking to experience some relief from their symptoms.

Selective Serotonin Re-uptake Inhibitors (SSRI’s) are the types of medications that are typically used to help treat obsessive compulsive disorder. They are also sometimes given to individuals who suffer from other mental illnesses, such as depression or social anxiety disorder as these drugs may be able to help with many different symptoms. Some common medications to help relieve symptoms of this condition are Paxil, Luvox, and Zoloft, among many others.

Cognitive behavioral therapy (CBT) is often the type of therapeutic technique used to help individuals who suffer from this disorder. Essentially, this type of therapy helps you to have a better understanding of the many thinking-errors that are associated with this illness. Besides CBT, mindfulness meditation can also be effective at helping you to relieve your symptoms and anxiety too.

Scrupulosity OCD

Scrupulosity OCD is a facet of obsessive compulsive disorder characterized by obsessing about religion, sinning, and morality. This illness is not restricted to one single religion. Someone with scrupulosity OCD may be in constant fear of angering god or of going to hell. This constant fear of sinning brings forth immense anxiety, guilt, and self-loathing.

Though much of their inability to decipher which way they should live their lives and what is considered a sin and what isn’t is partly due to the vagueness of the thousands of different religious doctrines that exist, the majority of their despair comes from their inability to think rationally.

Someone with scrupulosity OCD may take extreme measures in a desperate attempt to help them ease the amount of anxiety they constantly experience. If scrupulosity OCD is left untreated, then self-hatred may develop, as well as suicidal thoughts. This is a very insidious form of obsessive compulsive disorder that can cause other disorders to develop such as major depression for example.

Someone who has developed scrupulosity OCD may walk around in their day to day life in constant fear and worry that god is angry with them or that they are worthless. Regardless of there being no scientific evidence that a god exists, their disorder makes it very difficult for them to consider these other possibilities.



With any form of obsessive compulsive disorder, for every obsession, there is an equally painful compulsion that evokes them constantly. Such compulsions may be to not wear clothes with mixed fabrics, to grow their beard no shorter than the length or their fist (both of which are professed rules in the bible), to shut out friends and family who don’t think exactly as they do, to isolate themselves from the world, to harm or punish themselves, etc.

Though these compulsions give them some relief of their anxiety, this relief is only momentary. Giving into their obsessions by following through with their compulsions only justifies their scrupulosity OCD and makes their illness worse.

Causes of Scrupulosity OCD

The exact reason as to why someone would develop scrupulosity OCD is not entirely understood. However, one’s environment and family history may both play significant roles in someone developing this disorder, especially if they already have a genetic predisposition for developing it. Someone who is religious or who actively practices their religion and has obsessive compulsive disorder may naturally develop scrupulosity OCD.

Obsessive compulsive disorder typically intertwines itself into important aspects of one’s life for whatever reason. So, someone who is already religious or who is a theist and develops obsessive compulsive disorder may develop scrupulosity OCD simply due to their religion being something they already think a good deal about throughout the day.

Symptoms of Scrupulosity OCD

Someone who has scrupulosity OCD may experience crippling anxiety that greatly hinders their ability to experience joy and even contentment in life. They may live their day to day life with an underlying feeling or belief that regardless of what they do in this life, they are inevitably doomed to burn in hell forever.

They may spend much of their time thinking about their morality. For instance, if someone with scrupulosity OCD does something wrong or commits a “sin”, regardless of how minuscule it may be, then they will often blow it out of proportion and believe that from that one event, they are now doomed for eternal torment in hell.

If someone with scrupulosity OCD does not carry out the painful, and often embarrassing compulsion, then they will often remain in constant fear that something of catastrophic proportions will happen to them. So, with this irrational logic, they are then able to convince themselves that they must perform the compulsion in order to keep god’s wrath at bay. Scrupulosity OCD is not that different from traditional obsessive compulsive disorder in that it is just a more specific type of OCD.

  • Constant fear of sinning
  • Fear that god is unhappy with them
  •  Self-loathing/self-hatred
  • Obsessing about morals
  • Constant fear of going to hell
  • Extremely judgmental and self-critical

References

BetterHelp

MayoClinic

OCDUK

NIH.gov