I can remember my OCD starting around the time I was 10 years old, just finishing up elementary school. It started with just obsessive thoughts, but then the rituals followed soon after. Growing up my OCD was always about doubting myself- seeing myself as a bad person and unworthy of love from being bullied- and my rituals would help “keep me in check” to make me a good person so that others would like me. By the time I was 13 it had become severe and uncontrollable, ruling nearly every other thought and action that I did in my life. It’s taken a lot of work over many years to get me past the need of my OCD to see myself as a good person and to love myself. But OCD is still a hard habit and compulsion to break, and never pleasant to deal with; especially since the spring of last year my OCD theme switched from self-doubt to germs.
Honestly, after the euphoria of realizing I was no longer anxious about being liked wore off, it had me beyond pissed. Just when I felt like I didn’t need to have rituals guiding my life anymore, a new set of obsessive worries and rituals appeared, and these ones were unfamiliar to me and I didn’t know how to cope with them. But it started getting me thinking why this happens; why didn’t my OCD just go away entirely? And how common is it for OCD to switch themes like this? I did the research and turns out, it can be quite common for those with OCD to switch themes or gain multiple themes to their OCD. Here’s why:
There are many different psychological perspectives to take on when looking at OCD- the behavioral aspect (rituals), the cognitive aspect (obsessive thoughts), the neurochemical aspect (serotonin), the abnormal aspect (anxiety) and the humanistic aspect (individual)- and an integral view of all of them are extremely necessary to understand the whole, complex picture of a disorder like OCD. Obsessive Compulsive Disorder’s roots are within anxiety- a feeling of worry, nervousness, or unease about an imminent or uncertain future event (obsessions) and trying to find a way to cope or escape it (compulsions). Up until the release of the DSM-V, Obsessive Compulsive Disorder had been classified as an anxiety disorder, now being classified as its own major category alongside other anxiety disorders (Zupanick, 2014). With OCD, specifically, whatever you are feeling anxious about or obsessing about coming is what your mind will find rituals to morph around to maintain a sense of control of your situation (which is a LIE).
While we know that about 2% of the world population truly has OCD, there is a lot that is still unknown about OCD today- including what specifically causes OCD to develop (why not another anxiety disorder? and why anxiety at all?) (NIMH, 2016). Some studies link low levels of serotonin- a neurotransmitter that effects mood- and different genetic factors to developing this particular mental disorder. Medication such as SSRI’s have been proven to help with this aspect of treating the disorder, but medication alone is never enough to help stop the obsessions and rituals. While many studies are still uncovering these genetic and medical markers to indicate what predetermines a chance of OCD forming, new research and psychotherapeutic practices are uncovering another mode to look at OCD with- the mindset perspective of OCD. How OCD and anxiety as a whole are as much a trained mindset of an individual as they are a reaction of the nervous system.
It has to do with anxiety being as much about a person’s mindset as their neurochemistry. After going through a stressful or traumatic event, we naturally develop an anxiety about that event happening to us again for our own self-preservation. And sometimes, this anxiety can grow to affect your entire mindset- learning to look at multiple things, or everything, through anxious lenses and it never seems to turn off. (This is where the disorder part of a natural reaction of the nervous system comes into play). When learning to calm an anxious mindset with therapy or meditation or mindful practices, you learn to train your brain to let go of anxiety as the “go-to” way of seeing a situation. Some of the most common types of therapies used on OCD are Cognitive-Behavioral, Exposure and Response Prevention, Mindfulness meditation, and Acceptance Based Therapy- which are also used on other anxiety disorders to de-sensitize the automatic anxious response from the mind and nervous system, and find healthier, more advantageous ways to react and cope instead. All of these methods of therapy and re-wiring the brain deal with Self-Directed Neuroplasticity (Ware, 2015). Neuronal firing of different neurotransmitters based on our senses- thoughts, feelings, images, body sensations- can either lift or depress our mood, and these connections formed between the neurons strengthen the more certain transmitters are sent through (either positive or negative). We are biologically hardwired to focus on the negative thoughts, anxieties and stresses to ensure our survival- physically and emotionally. So, when we practice mindful (present-time awareness) and positive thinking, it literally helps to change the neural chemistry of our brain. We can train our brain and our mindset to react differently to many factors of life with time and dedication.
The mindset component of OCD can explain why ritual themes can change over time. As we change as people, our anxieties change with us, and thus it can make sense why OCD can change themes as well. The OCD is just a coping mechanism for anxious feelings, a tool of the mind to make it feel like it has control of situations and a “quick -fix” way to relieve and avoid what’s really causing the worry within us. As one OCD ritual is worked out or an anxiety is processed and quelled (i.e. my past anxiety about being bullied and liked by others), another anxiety will appear and new rituals will appear around it as well (i.e. the current anxiety about germs) because that is just life. These new anxieties can be brought about by traumatic or stressful events that make us feel out of control and that make us worry about our future all over again- if what we are anxious about will and could happen again and again to us. So, this new OCD of mine is just a new anxiety that has come into my life and the OCD is an old coping mechanism I am using to help me navigate my way through this anxiety (even though, logically, it doesn’t really work that way).
What do you think about the different kinds of coping mechanisms people come up with to deal with stressful events? What can be done to make information about healthier coping techniques and lifestyle practices easier to reach for everyone?
NIMH. (2016). Obsessive Compulsive Disorder. Retrieved January 06, 2017, from https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml
Ware, D., Ph.D. (2015, August 26). Positive Neuroplasticity. Retrieved January 06, 2017, from http://www.dailyshoring.com/positive-neuroplasticity/
Zupanick, C. E. (2014, February 24). The New DSM-5: Anxiety Disorders And Obsessive-Compulsive Disorders. Retrieved January 06, 2017, from https://www.mentalhelp.net/articles/the-new-dsm-5-anxiety-disorders-and-obsessive-compulsive-disorders/
http://www.markfreeman.ca/there-are-no-ocd-sub-types-or-themes-only-ocd-and-llamas/ (not a website that I used, but one that I read and thought explained OCD types PERFECTLY)