What mental illness is obsessed with someone?
Obsessions are intrusive thoughts that repeatedly surface. Often people with OCD will try to reduce the obsessions by acting out certain rituals (compulsions).
Everyone has bothersome worries now and again. Worries that consume a person are called obsessions. Obsessions are uninvited or intrusive thoughts, urges or images that surface in the mind over and over again. People with obsessive-compulsive disorder (OCD) usually know that their obsessions are creations of their own minds, but they can’t control, ignore or get rid of them.
Often people with OCD will try to reduce or suppress their obsessions by acting out certain rituals. Many people have rituals or specific ways of doing things. For people with OCD, however, rituals may become «stuck» and last for hours. When taken to this extreme, rituals are called «compulsions.»
When obsessions and compulsions get out of control, it is called obsessive-compulsive disorder.
OCD is an anxiety disorder that affects about one adult in 40. OCD exists throughout the world and affects men and women at an equal rate. OCD usually begins gradually. Approximately two thirds of people with OCD develop the disorder in adolescence or early adulthood.
Signs & Symptoms
The main symptoms of OCD are recurrent obsessions or compulsions that interfere with a person’s life. The symptoms:
- are time-consuming (e.g. take more than one hour per day) or
- cause clinically significant distress or impairment in social, occupational or other important areas of functioning (American Psychiatric Association, pp. 235–237).
Common obsessions include:
- fear of contamination (fear of dirt, germs, body fluids or diseases)
- repeated doubting (e.g., whether the stove is turned off)
- focus on exactness and order
- preoccupation with religious images and thoughts or fear of having blasphemous thoughts
- fear of harming oneself or others
- fear of blurting out obscenities in public
- forbidden or unwanted sexual thoughts, images or urges.
Common compulsions include excessive:
- cleaning/washing (e.g., washing hands too often, cleaning household items or other objects)
- checking (e.g., repeatedly checking paperwork for mistakes)
- ordering/arranging (e.g., making sure objects are in a certain order)
- hoarding (collecting seemingly useless items, such as paper, magazines, towels, bottles or pieces of garbage)
- mental rituals, such as praying, counting or repeating words.
Causes & Risk Factors
OCD appears to be caused by a combination of psychological, biological and genetic factors.
One theory suggests that people with OCD associate certain objects or situations with fear, and that they learn to avoid the things they fear or to perform rituals that help reduce the fear. Another theory suggests that people with OCD misinterpret their thoughts to an extent that they are threatened and frightened by them.
Research into the biological causes and effects of OCD has revealed a link between OCD and certain brain chemicals, or neurotransmitters, such as serotonin, dopamine and glutamate. Serotonin plays a role in regulating mood, aggression, impulse control, sleep, appetite, body temperature and pain.
Researchers have also found that people with OCD appear to have more than usual activity in areas of the brain that are thought to be involved in controlling feelings and actions.
OCD seems to «run in the family.» It is believed that genetic factors play an important role in the tendency to develop obsessions and compulsions. Research studies indicate that there is no one gene specifically linked to OCD. Rather, it appears that multiple combinations of different genes can contribute to the total risk of developing OCD.
Diagnosis & Treatment
People with OCD should get treatment that is specific to OCD from a fully qualified therapist. Some forms of traditional psychotherapy do not relieve symptoms of OCD.
Treatment for OCD ideally involves a combination of counselling (cognitive-behavioural therapy is the most common) and medication (usually antidepressant medication, sometimes anti-anxiety medication).
Group therapy (with people who have similar concerns) can also help.
While cognitive-behavioural therapy and medication usually help to reduce the symptoms of OCD, the process of recovery, like the onset of the illness, is gradual and ongoing. Continuing with treatment, even when symptoms have improved, can help maintain these gains and prevent relapse. People who are recovering from OCD may also benefit from individual, group or family therapy or a support group.
Adapted from Obsessive-Compulsive Disorder: An Information Guide © 2016 Centre for Addiction and Mental Health
Related Programs and Services
- Treatment at CAMH: Access CAMH
- Help for families from CAMH
Obsessive-Compulsive Disorder (OCD) in Children
Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. Obsessions are recurring thoughts. Compulsions are recurring behaviors.
A child with OCD has obsessive thoughts that are not wanted. They are linked to fears, such as touching dirty objects. He or she uses compulsive rituals to control the fears, such as excessive handwashing.
As children grow, rituals and obsessive thoughts normally happen with a purpose and focus based on age. Preschool children often have rituals and routines around meals, bathing, and bedtime. These help stabilize their expectations and view of their world. School-aged children often create group rituals as they learn to play games, take part in team sports, and recite rhymes. Older children and teens start to collect objects and have hobbies. These rituals help children to socialize and learn to deal with anxiety.
When a child has OCD, obsessive thoughts and compulsive rituals can become very frequent and strong. They may interfere with daily living and normal development. OCD is more common in teens.
What causes OCD in a child?
The cause of OCD is not known. Research suggests it’s a brain problem. People with OCD don’t have enough of a chemical called serotonin in their brain.
OCD tends to run in families. So it may be genetic. But it may also occur without a family history of OCD. In some cases, streptococcal infections may trigger OCD or make it worse.
What are the symptoms of OCD in a child?
Each child may have different symptoms. These are the most common symptoms:
- An extreme obsession with dirt or germs
- Repeated doubts, such as whether or not the door is locked
- Interfering thoughts about violence, hurting or killing someone, or harming oneself
- Long periods of time spent touching things, counting, and thinking about numbers and sequences
- Preoccupation with order, symmetry, or exactness
- Ongoing thoughts about doing offensive sexual acts or forbidden, taboo behaviors
- Troubled by thoughts that are against personal religious beliefs
- A great need to know or remember things that may be very minor
- Too much attention to detail
- Too much worrying about something bad occurring
- Aggressive thoughts, urges, or behaviors
Compulsive behaviors are the repetitive rituals used to ease anxiety caused by the obsessions. They can be excessive, disruptive, and time-consuming. They may interfere with daily activities and relationships. They may include:
- Repeated handwashing (often 100 or more times a day)
- Checking and rechecking many times, such as making sure that a door is locked
- Following firm rules of order, such as putting on clothes in the very same order each day
- Hoarding objects
- Counting and recounting a lot
- Grouping objects or putting things in a certain order
- Repeating words spoken by oneself or others
- Asking the same questions again and again
- Repeatedly using four-letter words or making rude (obscene) gestures
- Repeating sounds, words, numbers, or music to oneself
The symptoms of OCD may seem like other health problems. Have your child see his or her healthcare provider for a diagnosis.
How is OCD diagnosed in a child?
A child psychiatrist or other mental health expert can diagnose OCD. He or she will do a mental health evaluation of your child. To be diagnosed with OCD, your child must have obsessions and compulsions that are continuous, severe, and disruptive. They must harm your child’s day-to-day living.
In most cases, the activities of OCD such as handwashing or checking the locks on doors use up more than 1 hour each day. They also cause mental health distress and affect how your child thinks. In most cases, adults realize that their actions are not normal to some degree. But often children can’t see that their behavior is irrational and abnormal.
How is OCD treated in a child?
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
Treatment for OCD often includes a combination of the following:
- Therapy with cognitive and behavioral methods. Cognitive methods help a child identify and understand his or her fears. They also teach a child new ways to better resolve or reduce those fears. Behavioral methods help the child and their family make pacts or rules to limit or change behaviors. One example is setting a maximum number of times a compulsive handwasher may wash his or her hands.
- Family therapy. Parents play a vital role in any treatment process. A child’s school may also be included in care.
- Selective serotonin reuptake inhibitors (SSRIs). These medicines help raise serotonin levels in the brain.
- Antibiotics. Your child may need these medicines if his or her OCD is found to be linked to a streptococcal infection.
Teens with OCD may also have one or more types of eating disorders. These will also need treatment.
How can I help prevent OCD in my child?
Experts don’t know at this time how to prevent OCD in children and teens. But if you notice signs of OCD in your child, you can help by getting an evaluation as soon as possible. Early treatment can ease symptoms and enhance your child’s normal development. It can also improve his or her quality of life.
How can I help my child live with OCD?
OCD can be treated, often with a combination of one-on-one therapy and medicines. You play a key supportive role in your child’s treatment. Here are things you can do to help your child:
- Keep all appointments with your child’s healthcare provider.
- Talk with your child’s healthcare provider about other providers who will be included in your child’s care. Your child may get care from a team that may include counselors, therapists, social workers, psychologists, and psychiatrists. Your child’s care team will depend on your child’s needs and how serious the OCD is.
- Keep strong and open lines of communication with your child. Children with OCD can feel embarrassed about their disorder.
- Tell others about your child’s disorder. Work with your child’s healthcare provider and school to create a treatment plan.
- Reach out for support from local community services. Being in touch with other parents who have a child with OCD may be helpful.
Key points about OCD in children
- OCD is a type of anxiety disorder. A child with OCD has obsessive thoughts that are not wanted. They are linked to fears, such as touching dirty objects. The child uses compulsive rituals such as handwashing to control the fears. These rituals may feel rational or irrational to the person doing them. The child may not understand why they do these rituals. They may feel embarrassed that the behaviors occur and can’t be controlled.
- The exact cause of OCD is unknown. Children with OCD don’t have enough of a chemical called serotonin in their brain.
- Obsessive symptoms include repeated doubts and extreme preoccupation with dirt or germs.
- Compulsive behaviors include hoarding objects and checking things often.
- A mental health evaluation is needed to diagnose OCD.
- Treatment includes therapy and medicine.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.
OCD and Mental Health in a Time of Illness
Periods of public health crises such as the current coronavirus outbreak can upend one’s way of life, and introduce a great deal of uncertainty and fear into day-to-day activities. With expert international health agencies such as the World Health Organization (WHO) declaring COVID-19 (also known as novel coronavirus) to be a global pandemic, many are putting an important emphasis on the way they interact with one another, as well as their level of hygiene.
Such precautions are understandable and indeed necessary to protect both ourselves and our loved ones. However, for the millions of individuals already facing anxiety-centered mental health conditions, such as OCD, the raised level of stress due to the present health situation can interact with established sensitivities, causing them and those around them to greatly suffer as a result.
OCD: Basic Traits and Symptoms
Obsessive-compulsive disorder, or OCD, is an anxiety-based disorder that normally combines obsessive thoughts and compulsive behaviors, which eventually cause the individual facing them a significant amount of suffering.
OCD-based thoughts can be diverse, and over time induce many patients with OCD to develop methods to calm themselves, in the form of repetitive actions and rituals. For example, someone whose OCD manifests through an obsession to order and cleanliness may develop the compulsive ritual of sweeping the floor each time they get an alarming, intrusive thought. However, as over time this form of self-soothing becomes ineffective, individuals with OCD find that the repetitive rituals add to their anxiety, instead of relieving it.
Increased OCD-Based Anxiety Over Health Emergencies
Anxiety acts as a central symptom for OCD, and normally persists when the condition itself is left untreated. Although the anxiety experienced during OCD can be very disconcerting, OCD as a whole is believed to develop from a basic survival mechanism that became overgrown and ineffective: for example, the same OCD obsession over cleanliness and its accompanying anxiety over infection can, when managed and moderated, keep an individual healthy and safe from illness. It is precisely this attention to health, sterility and sanitation that makes people with OCD—particularly OCD-focused cleanliness—extremely susceptible to increased anxiety in times of health crises.
Reports from around the world cite patients with OCD, as well as general anxiety disorder and hypochondria, as being vulnerable to increased anxiety over the current coronavirus epidemic. Calls for increased vigilance when it comes to personal hygiene have at times referred to OCD rather carelessly, stating that “this is the time for OCD.” Such statements have triggered criticism from mental health advocacy groups, which stress that for those facing this condition’s various debilitating symptoms, OCD is no laughing matter.
Effective OCD therapy is more relevant for individuals battling this condition, and as such, empirically proven treatments such as Deep TMS serve an ever-increasing purpose. The only non-invasive medical device to be FDA-cleared to treat OCD, Deep Transcranial Magnetic Stimulation (or Deep TMS) utilizes magnetic fields to safely and effectively regulate the neural activity of brain structures that have been found to be associated with OCD. Its ability to offer empirically-based symptom relief is helping a growing number of patients maintain and improve their quality of life in an otherwise tumultuous time.
The heightened, global attempts to protect against infection play on the anxieties of individuals battling cleanliness-centric OCD, who even before the current epidemic faced significant distress over the possibility of contracting an illness. Adding to that is the fact that many of these individuals are working to diminish their OCD-based anxiety through evidence-based treatments such as cognitive behavioral psychology (CBT), or exposure-response therapy (ERP), both of which include exposure to the very stimuli that cause them anxiety—i.e. less sterile environments. To protect themselves against corona, patients with cleanliness-obsessed OCD must therefore focus even more on their own hygiene, which would likely increase the frequency and intensity of their symptoms.
For many patients with anxiety-based conditions, and particularly those battling cleanliness-focused OCD, the present coronavirus scare is a nightmarish, real-life manifestation of their most powerful inner fears. Empathy, a stable support network and an effective treatment course are vital components of their road to coping with the recent changes to our reality. And for this reason, it is important to communicate with one another over our shared and personal concerns, and help each other receive the tools and comfort we need.