You might worry about germs, being careful to wash your hands throughout the day. Or maybe you make sure your shoes are carefully lined up under your bed each night. Or maybe you have a set morning routine - and if it is disrupted you feel as if your whole day is "off." Many people have rituals that make them feel better or certain ways of doing things but it doesn’t necessarily mean you have OCD if you like your clothes hung up in a particular order or never leave the house without your hand sanitizer. But, if these rituals or behaviors are causing a problem or interfering with your daily life, you may be like 1 percent of the U.S. population and have OCD. The following are some of the common types of compulsions and when you should talk to your doctor.
Hand washing is one of the most well-known symptoms of OCD. But everyone that washes their hands often doesn’t have OCD. It is not the hand washing behavior that signals OCD but the fear of germs that drives you to continually wash your hands. You should consider talking with your doctor if:
- You worry about germs and contamination immediately after you washed your hands.
- You worry that you aren’t scrubbing hard enough or your hands are red and chapped from continuous washing
- You worry about catching a disease by touching a shopping cart, a handrail or other objects in a public place so much so that you don’t touch anything while you are out or use hand sanitizer over and over
- You have a ritual for washing your hands to make sure you get every area, such as washing each finger in a specific order or washing your hands a certain number of times
Checking and Rechecking
Another very common behavior in OCD is checking and rechecking behaviors, for example, checking to see if you locked the door or turned the oven off. These types of behaviors are sometimes driven by fears, such as the house burning down or someone breaking in or could be caused by self-doubts, such as "I am so forgetful, I know I forgot to turn off the oven." You should seek help if:
- Checking causes you to lose sleep (getting up continuously to check the front door) or be late for work or other obligations because you have to go back in the house several times to make sure the oven is turned off.
- You have created rituals around checking behaviors, such as needing to check the door four times before going to bed.
Compulsive housecleaning, like hand washing, often stems from the fear of germs or uncleanliness. Sometimes cleaning the house will take the fears away for a short time but the urge to clean the house normally comes back, stronger, even if you have just cleaned the house yesterday. You should speak with your doctor if:
- You spend hours every day cleaning the house.
- You feel a need to clean the house and become anxious if you are unable to do so.
- You worry about germs or uncleanliness even after you have cleaned the house.
Counting can take several forms in OCD. You may place a special significance on a certain number and have a need to complete actions in sets of this number. For example, you may use the number four and need to check the front door four times, have four sodas lined up in the refrigerator, four pillows on your sofa or have to brush your teeth four times each morning. You feel anxious if you are not able to complete the set of four. Other people count as they do something, for example counting steps or ceiling tiles and feel anxious if someone interrupts their counting. Counting can be said aloud or mentally. You should discuss this with your doctor:
- If the counting bothers you or others.
- If the counting interferes with daily tasks, for example, being late to work because you must complete each step of getting ready a certain number of times.
- If you are worried or disturbed by your counting.
Ordering and Arranging
Many people with OCD have the need to order or arrange objects until it feels right. You may need to have your clothes hung in your closet by length. You may have your food pantry arranged alphabetically or line your shoes up according to color. If objects are not lined up perfectly and the way you feel is best, you may feel anxious or "incomplete." Some people combine counting and order, arranging objects in sets of a certain number. You should talk with a medical professional if:
- You are unable to complete daily tasks because of your need to arrange and order your objects.
- You become angry if someone changes the order of the objects or doesn’t put something back in the right order.
- You feel anxious if your items are not arranged in a certain way.
These are some of the common compulsions, but by no means are the only compulsions. Like many mental illnesses, symptoms are unique in each person. Other common compulsions include creating elaborate rituals -physically or mentally or constantly creating lists. If your behaviors and compulsions are interfering with your ability to complete daily tasks, interfere with your job or relationships, it is probably time to talk with a doctor.
For further information:
"The Different Types of Obsessive-Compulsive Disorder," Date Unknown, Staff Writer, OCD-UK
"How Do I Know If I Have Obsessive Compulsive Disorder," 2006, Wayne Goodman, M.D. PsychCentral.com
"Obsessions and Compulsions," 2012, Staff Writer, International OCD Foundation