Obsessive Compulsive Disorder (OCD): When Our Thoughts Take Control
"Ever seen ‘Inside Out’? With OCD, it’s like Doubt has it’s own control console". – Josey Eloy Franco
Have you ever had a really bad case of the hiccups? One of those cases where they’re so violent and loud that it physically hurts?
Imagine this scenario…
You wake up in the morning with those kinds of painful, horrible hiccups. You can get through the day with them, but no matter how hard you try to ignore the hiccups, they keep coming back. They interrupt any task you are trying to complete, demanding attention from you. Frustrated, you spend hours doing anything you can to get them to go away. You stand on your head, you chug a gallon of water, you hop up and down on one foot. You keep trying things that feel ridiculous or irrational, but you don’t care – you’re desperate to make the hiccups stop. They might stop for a few minutes, but as soon as you stop paying attention to them, they come right back. By the end of the day, you feel defeated and exhausted. You go to bed hoping and praying that when you wake up tomorrow, the hiccups will be gone. When you wake up the next morning, they’re still there and the painful cycle begins again.
This is a day in the life of someone with Obsessive Compulsive Disorder. Their thoughts are the hiccups, and all the irrational things they try doing to get them to go away are the compulsive behaviors that soothe the anxiety, but only temporarily.
There are a TON of misconceptions and misunderstandings about Obsessive Compulsive Disorder (OCD). The media often displays someone with OCD as a neat-freak with a tidy home, or someone who won’t touch anything dirty and has to wash their hands several times a day.
But OCD is so much more than cleanliness.
People frequently confuse Generalized Anxiety Disorder (GAD) with OCD. While they are similar, they are distinctly different in many ways.
How can we tell the difference? It is very important to get a proper diagnosis, as both GAD and OCD require specialized types of treatment to make the most difference for the person experiencing the pain of it.
Let’s take a closer look.
What’s making you anxious?
Anxiety in any form is largely irrational. In both GAD and OCD the individual often understands that their thoughts are illogical but can’t get their ration and actions to align.
The thoughts we see present in GAD tend to be more general, and are about real-life, worst-case scenarios. GAD thoughts may sound like this:
“What if I fail this exam?”
“What if my boss fires me?”
“My friend is acting different today, what if she decided she actually hates me?
GAD likes to take the things that are actually happening in your real life and remind you again and again how things could turn out for the worst. GAD thoughts often jump, like they’re on a trampoline, from one topic to the next, leaving you feeling overwhelmed and panicked – kind of like whiplash for your thoughts and feelings.
With OCD, the content of the thoughts tends to be a bit more bizarre and specific. OCD thoughts attach to an individual’s deepest, darkest fears. The individual may know that the thoughts are irrational, and the outcomes they are fearing are mostly impossible, but they can’t seem to convince themselves of that truth.
OCD thoughts are generally fixated on preventing something catastrophic from happening. For example, an OCD thought may sound like this:
“What if I touch this and contract a rare disease?”
“What if the ceiling falls down on my head right now and kills me?”
“What if I lose control of my anger and seriously hurt someone?”
These thoughts are specifically focused on what the person perceives as a major, world-shaking catastrophe.
Compulsions: The difference between OCD and GAD
Individuals with OCD engage in something called compulsions. These are physical or mental rituals that the person performs in a rigid manner that temporarily soothes the stress caused by the obsessive thoughts. There are 6 categories of obsessive/compulsive thoughts/behaviors:
1. Losing control – “What if I just screamed in class and threw my chair right now?”
2. Unwanted sexual thoughts – “I wonder what it would look like to see my therapist naked”
3. Contamination – “If I don’t clean my toothbrush with hot water for at least 30 seconds every time, I will catch something deadly”
4. Religious obsessions – “If I die right now was I a good enough person to go to heaven?”
5. Harm – “What if I whip my steering wheel and drove over the rails of the bridge into the water?”
6. Perfectionism – “If I don’t turn on this light switch just right, something bad will happen”
How we cope with the doubts and anxieties is the defining difference between GAD and OCD. While the thoughts someone experiences in GAD are painful and distressing, they typically do not engage in ritualistic behavior to try to soothe them. Someone with GAD may seek reassurance from friends and family as a way of soothing anxious thoughts, but do not repeat behaviors to the extent that it consumes large chunks of their time and energy.
Why OCD hurts so much
One of the most painful parts of OCD is the person suffering from it may wonder if their thoughts make them a bad person. They know that the thoughts they are having are dangerous and irrational, but still they often doubt if they are who they think they are. They might think: “what if I am a bad person? I don’t think I am, but these thoughts show me otherwise…” They feel like their brain has been hijacked by an outside source, but over time begin to doubt and wonder if these thoughts are really a reflection of who they are.
Is it possible to have both GAD and OCD?
Yes, symptom overlap is common. Here are some examples:
Catastrophizing/always assuming the worst
Trouble concentrating or completing simple tasks
Inability to rest and relax
What it comes down to:
At the end of the day, both OCD and GAD are painful disorders that interfere with a person’s life, relationships, job, and health. However, it is important to know the difference, as getting a correct diagnosis is a key part of getting the right kind of treatment.
If you are suffering from either disorder, know you are not alone. You are not a bad person because of your thoughts. Your thoughts are not who you are, and you are not beyond the reach of help. Remember to be patient and gentle with yourself, allow yourself much grace, and know that change is possible.
Be Your Best Self + Thrive Counseling uses a holistic, non-judgmental approach to help you build an alliance with your mind, body and spirit that work together for your benefit. If you are looking for a therapist who is experienced in OCD and GAD both personally and professionally, Genevieve May is a clinician who can help you explore ways to feel in control of your thoughts and learn ways to cope with your anxieties that build you up rather than tear you down. Book your free 15-minute session with her here.