Understanding the Types of OCD: A Comprehensive Guide

Obsessive Compulsive Disorder (OCD) is a psychological condition characterized by recurrent, intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that are performed to alleviate the anxiety caused by these thoughts. While OCD is a complex condition, it can manifest in various forms, each carrying unique experiences and challenges for those who live with it. This article aims to provide a comprehensive guide to the different types of OCD, helping individuals and loved ones understand and navigate this condition more effectively.

What is OCD?

Technically, OCD is a mental health disorder in which a person is compelled to perform a certain ritual or task to temporarily relieve anxiety or to stop anxious/intrusive thoughts (obsessions). However, there are several main categories of OCD that people often fall into:

Obsessive Checking

People with obsessive checking are often preoccupied with the idea that something needs to be checked, verified, or routinely monitored. This can manifest in various ways, such as repeatedly checking if the door is locked, if lights are turned off, or if important documents have been stored correctly.

Thoughts of Contamination

This type of OCD involves persistent thoughts of being contaminated, whether physically or mentally. Individuals may develop intense anxiety or fear of germs, illnesses, or ‘ contaminating’ themselves with impurities, often leading to compulsive cleaning or avoidance behaviors.

Need for Symmetry, Cleanliness, or Order

People with OCD often have a persistent need for things to be symmetrical, clean, or orderly. This can manifest as a compulsion to arrange items in a specific way, to perform rituals such as folding clothes a certain number of times, or to maintain an extremely clean and structured environment.

Ruminations and Intrusive Thoughts

Intrusive thoughts and ruminations can involve repetitive, unwanted thoughts that can be frightening or distressing. These thoughts often revolve around themes such as aggression, sexual content, religion, or the fear of contamination. Examples might include thoughts about harming oneself or others, uncontrollable sexual imagery, or racing fears about the future.

Hoarding

Hoarding is another common type of OCD. Individuals with hoarding disorder struggle with the inability to discard, part with, or organise their possessions, often leading to cluttered living spaces and significant distress.

Lesser-Known Types of OCD

Some lesser-known types of OCD include:

Dermatillomania/Excoriation

This is a skin-picking disorder where a person repeatedly picks, scratches, or otherwise damages their own skin. It can lead to sores, infections, and other skin issues.

Trichotillomania

A compulsion to pull out hair from the head, eyebrows, eyelashes, arms, or legs, often resulting in bald patches or noticeable hair loss.

Eating Disorders (Some)

In some cases, OCD can intertwine with eating disorders, such as eating only certain foods at specific times, or having a precise amount of food each day.

Personal Experiences of OCD

Individuals with OCD may find themselves experiencing more than one type of symptom. For instance, a person with OCD might experience obsessive contamination, orderliness, and intrusive thoughts simultaneously. OCD often revolves around specific 'themes' such as religion, violent thoughts, sexual thoughts, contamination, or the fear of making mistakes that could lead to catastrophic outcomes.

Personal Example

For example, my struggle with OCD involves themes of contamination, orderliness, intrusive thoughts, and dermatillomania. Some of the distressing scenarios I face include:

There is a wall in my room that I cannot touch, as touching it would cause my family and friends to die. On my way to work, I cross the street with a little boy and suddenly feel the urge to scratch my arm nine times to prevent him from being run over. Every Thursday, I obsessively check and prepare ingredients, flicking lights on and off, and preheating the oven to avoid any perceived danger. After my mother hugs me, I must scratch my arms to avoid contamination, despite not understanding what I might have been contaminated with. I start counting my steps and become fixated, causing me to fear stopping at any moment. Recurring intrusive thoughts about violence or sexual assault lead to physical harm (e.g., biting my lip until it bleeds). My routine includes meticulous adjustment of the shower knobs to the perfect positions, even if it means using up all the hot water. Mental breakdowns from repacking the same pallet repeatedly due to missed medication. Squeezing my leg repeatedly to prevent a train crash, exacerbating my anxiety over intrusive thoughts related to incest. Scratching myself to mimic taking medication, unaware of the actual status of my mental state. Chronically tensing and relaxing my shoulders due to anxiety over intrusive thoughts. A panic attack triggered by forgetting to click the light on and off upon leaving for work.

Conclusion

While OCD can manifest in many forms, each type carries its unique set of challenges and experiences. Understanding and acknowledging these types can help in seeking appropriate support and treatment. If you or someone you know is struggling with OCD, it’s crucial to seek help from a mental health professional who can provide guidance and a structured treatment plan tailored to the individual's needs.