It is estimated that, in Quebec, more than 2% the population is affected by obsessive-compulsive disorder.
In our service sector, this amounts to around 4,000 people.
Obsessive-compulsive disorder, or OCD, is characterized by obsessions and compulsions. An obsession is when thoughts or images persist in an individual’s mind and are difficult to drive out. Such obsessions can range from the unpleasant to the unnerving and disturbing, and they can cause distress, fear, discomfort or disgust.
In an effort to suppress or rid themselves of these obsessions, the individual feels obligated to make repetitive, ritualistic gestures, called “compulsions.”
Obsessions and compulsions are the result of deep feelings of distress. They take up a considerable part of the individual’s day (often taking up more than an hour each day), and they interfere significantly with their regular activities.
As these compulsions do nothing but provide short-term relief, the obsessive-compulsive cycle begins again. Unlike the pleasure one might get with compulsive gambling, for example, these compulsions do not bring any pleasure to the individual.
In fact, some people pile on numerous compulsions, so much so that leaving the house, going to work or seeing family and friends become excruciating tasks. They often judge themselves severely for their condition, hiding their symptoms and withdrawing from loved ones as a result.
Someone may be considered to have OCD when their doubts and anxieties become real obsessions. Deliberate, dreadful thoughts enter the person’s mind automatically, despite their trying to fight them off. In an attempt to reduce the intense effects they have on the individual , compulsions set in.
The main obsessions are the following:
- Contamination: The fear or distress of being dirtied or contaminated through physical contact, germs or radiation. The corresponding compulsion could be for the individual to wash their bathroom wall several times a day with a brush in order to decontaminate each tile.
- Fear of making a mistake (excessive doubt): Such fears can involve losing or forgetting something, neglecting to turn off the gas or leaving the door unlocked. They may also include performing poorly or even being overly concerned with disorganization and disarray.
- Aggressive obsessions: Aggressive and violent obsessions involve a fear of hurting someone involuntarily or because the individual lost control.
- Magical thinking : Excessive superstition obsessions are based on the idea that the individual can bring misfortune to others just with their thoughts.
As is the case for several mental illnesses, OCD is the result of a mix of various biological, environmental and social factors, and all three of these should be taken into account when considering intervention and treatment options.
Some medical researchers suggest that OCD might be the result of a chemical imbalance which causes the brain to process thoughts, emotions and compulsions in a certain way. The effectiveness certain drugs have in reducing obsessions and compulsions seems to indicate that serotonin, a neurotransmitter in the brain, is the key cause of this imbalance.
Psychological researchers, on their part, have shown that the reduced anxiety that individuals feel after carrying out their compulsions is what encourages them to continually repeat the action in the future. Certain thought mechanisms, such as faulty reasoning and a tendency to overassess risk levels and responsibility, have also been identified as factors that feed obsessions.
While people with OCD are aware of the absurdity of their thoughts and behaviours, they will not be able to expel them without proper help. Their obsessions and compulsions are incontrollable.
If OCD has led to rituals that the individual cannot help but perform, they will likely need to talk to a mental health specialist. The specialist may recommend drug therapy to alleviate symptoms and reduce anxiety, and, once that has begun, commence congruent behavioural therapy to do away with other harmful aspects of the disorder.