Obsessive Compulsive Disorder (OCD) affects almost 0.8% of people in India and almost 1 % of the population around the globe. OCD is a complex condition that manifests in many forms, causing significant disruption in the daily lives of individuals. Thus, knowing the various forms of OCD is crucial to correct assessment and treatment In this article, we’ll explore different forms of OCD.
Understanding OCD
People with OCD generally experience a pattern of sudden, unwanted thoughts or fears known as obsessions. The obsessions lead to emotions such as stress and anxiety. To ease or get rid of these obsessions, people often indulge in repetitive rituals or patterns of behaviour known as compulsions. Although indulging in compulsive behaviour provides a sense of relief, it lasts only for some time before the anxiety and obsessions return again. Thus, people with OCD often feel stuck in a cycle of obsessions and repetitive behaviours.
Can OCD Exist Without Intrusive Thoughts?
OCD typically involves a combination of obsessions and compulsions. However, it is possible to have only obsessions or only compulsion symptoms. The Diagnostic and Statistical Manual of Mental Disorders (DSM), a guidebook for the diagnosis of mental disorders, lists various subtypes of OCD, some of which can manifest without intrusive thoughts. They are:
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Trichotillomania
Trichotillomania is characterised by an irresistible urge to pull out one’s hair, whether from the scalp, eyebrows, eyelashes, or other body areas like armpits or the genital area. The primary method of hair pulling for most people with this condition involves using their fingers, although some may also use tweezers or other instruments.
Although trichotillomania is categorised as a subtype of OCD, it differs from OCD in many ways. While OCD is characterized by unwanted, intrusive thoughts leading to compulsions, trichotillomania involves repetitive behaviour (hair pulling) without any intrusive thought. Here, the repetitive behaviour is triggered by urges and other factors, such as stress and not by intrusive thoughts.
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Skin Picking
Similar to trichotillomania in many ways, people suffering from skin picking or excoriation disorder experience compulsive urges and growing tension until they pick their skin. Skin picking may also sometimes be carried out in response to stress or uncomfortable emotions. Here, too, there are no underlying intrusive thoughts.
Can OCD Exist Without Compulsions?
Sometimes OCD can manifest without any overt compulsive behaviours. This condition is called Purely Obsessional OCD or Pure-O in short. In this condition, people experience distressing obsessive thoughts without engaging in visible external compulsions. However, the compulsions in this condition mainly exist in the form of mental rumination. A few examples of repetitive mental rituals are counting, checking, or seeking reassurance internally. Since compulsions in Pure-O are not externally visible, diagnosing the condition can be challenging.
Can We Have Intrusive Thoughts Without OCD?
Intrusive thoughts are completely normal. In fact, a 2014 study discovered that approximately 94% of participants reported experiencing at least one intrusive thought in the three months leading up to the study. Intrusive thoughts are usually harmless as long as one recognizes that they are just thoughts and does not try acting on them.
The difference between normal intrusive thoughts and OCD is that normal intrusive thoughts are occasional, fleeting, and cause minimal distress, while intrusive thoughts in OCD are persistent, distressing, and trigger compulsive behaviours, significantly impacting daily life.
Conclusion:
OCD is a complex condition that manifests in many forms. While OCD typically causes intrusive thoughts, it can sometimes occur without intrusive thoughts as well. All forms of OCD can be treated with a combination of therapies such as Cognitive Behaviour Therapy (CBT) and Exposure and Response Prevention (ERP), sometimes treatment might involve medications as well.
References:
- Diagnostic and Statistical Manual of Mental Disorders and OCD | OCD-UK. (n.d.). Retrieved February 8, 2024, from https://www.ocduk.org/ocd/clinical-classification-of-ocd/dsm-and-ocd/
- Excoriation Disorder (skin picking disorder) | OCD-UK. (n.d.). Retrieved February 8, 2024, from https://www.ocduk.org/related-disorders/skin-picking/
- Foundation, M. of M. (n.d.). Pure O: An Exploration into a Lesser-known Form of OCD. Made of Millions Foundation. Retrieved February 8, 2024, from https://www.madeofmillions.com/articles/pure-o-an-exploration-into-a-lesser-known-form-of-ocd
- Obsessive-compulsive disorder (OCD)—Symptoms and causes. (n.d.). Mayo Clinic. Retrieved February 8, 2024, from https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/symptoms-causes/syc-20354432
- Trichotillomania (Hair Pulling Disorder) | OCD-UK. (n.d.). Retrieved February 8, 2024, from https://www.ocduk.org/related-disorders/trichotillomania/
- Why Do We Have Intrusive Thoughts? (2020, September 20). Healthline. https://www.healthline.com/health/mental-health/intrusive-thoughts
