My husband and I are physicians with numerous patients with OCD. We’re also parents of a child who had severe, acute onset OCD from PANS. Needless to say, we have a lot of experience with the devastating effects OCD obsessions can have in a person’s life, to themselves as well as loved ones and family members.
The good news is that we have had great success helping people overcome what we like to refer to as the “bully in their brain” with our 5 Step Fully Functional® Process. Mental illness, like physical illness, does not have to be a life sentence for misery.
OCD Quick Facts
What is OCD? Obsessive-compulsive disorder, or OCD, is a type of anxiety disorder in which obsessions with a particular thing lead to compulsions (repetitive behaviors). It’s a potentially disabling health condition and people who suffer from OCD symptoms often recognize their actions are unreasonable, but are unable to stop even when it impacts daily life.
How common is OCD? Between 1-3% of people around the world have OCD at any given time.
What are the types of OCD? The DSM-5 updated their title of OCD in 2013 to be “Obsessive-Compulsive and Related Disorders” (OCRDs). The main diagnosis of OCD can be accompanied by a “symptom subtype” that covers specific obsessions with their accompanying compulsions. In addition, they split out various former “subtypes” into their own disorders.
The 4 symptom subtypes of OCD are:
- Contamination obsessions with washing/cleaning compulsions
- Harm obsessions with checking compulsions
- Obsessions without visual compulsions (these are often sexual obsessions or other intrusive thoughts that you can’t always see acted out)
- Symmetry obsessions with ordering, arranging, and counting compulsions
Other OCRDs that have distinct diagnostic criteria include:
- Skin pricking disorder (excoriation)
- Hair-pulling disorder
- Body dysmorphic disorder (including muscle dysmorphia) — this is often where eating disorders related to OCD stem from
- Tic-related Obsessive-Compulsive Disorder — a tic disorder is common in around half of OCD patients
- OCD and related disorders induced by a substance/medication or due to another medical condition — this is where PANS and PANDAS come in for pediatric OCD
How are pediatric and adult OCD different? Treatment options for OCD change a lot when you’re talking about kids. “Standard” treatments, like SSRIs (selective serotonin reuptake inhibitors, such as fluoxetine), come with dangerous side effects when used by children — suicide being the most alarming.
In addition, the more recent classifications of PANS/PANDAS show that childhood OCD is often an autoimmune condition. OCD during childhood years is also much more likely to go away before/during adulthood.
Common Obsessions & Compulsions in OCD
The most common compulsions and obsessions are seen in many cases of OCD, regardless of the age of diagnosis.
To be an obsession, a thought must be time-consuming (disrupting daily activities) and cause “significant distress” to the patient.
According to the International OCD Foundation, common OCD obsessions include:
- Contamination: Fear of germs, bodily fluids, household/environmental toxins, or dirt
- Unwanted sexual thoughts: “Forbidden or perverse” images or thoughts that involve sexual acts, orientations, encounters, etc. (sometimes includes a bent towards aggressive sexual behavior)
- Losing control: A fear of what you may do or not do in the future, including self-harm, violence, unwanted thoughts, offensive speech, or theft, and/or that you may harm a loved one or a stranger in the process
- Harm: Specifically, a fear of causing harm to people or property by accident
- Religious obsessions (scrupulosity): Concerned about performing blasphemy, offending a religious figure or deity, or obsession with right and wrong
- Obsessions related to perfectionism: Often about symmetry, “exactness,” remembering or knowing particular facts, indecisiveness, or losing possessions
Compulsions are behaviors or “mental acts” meant to reduce the anxiety caused by obsessing over these thoughts. The most common OCD compulsions are:
- Washing and cleaning
- Checking/verifying that you haven’t done something wrong
- Repeating, often in specific routines
- Mental compulsions, like consideration of past events, praying, counting, or “undoing” an action mentally or verbally
- Other compulsions, like rearranging things, confession for reassurance, or situational avoidance
How OCD Obsessions Are Like a Schoolyard Bully
Imagine you’re in middle school, walking down the hallway, and you see the school bully in the hallway. He’s eyeing for you, and you know it.
Your heart beats faster and you try to avoid making eye contact with him… but you know he sees you and is coming towards you.
As he approaches, he demands your lunch money. Before you can hand it over, he tells you that if you don’t give him the money he will beat you up. At this point, your heart is beating a million miles a minute.
So, how is OCD like a bully in your brain?
You have a thought — perhaps that your hands are dirty and if you don’t wash them that people will get sick. Your heart starts to beat faster at the thought of this and you feel compelled to wash your hands.
If you don’t listen to your bully in your brain, you go into panic mode and begin worrying continuously about the “what ifs.” What if you don’t wash your hands and someone gets sick, or worse, someone dies? What if there isn’t a sink nearby and you can’t immediately wash your hands? What if there isn’t soap? What if the soap doesn’t work?
From here, it goes on and on. OCD isn’t rational and it doesn’t just go away.
What happens when you give the bully your lunch money? He leaves you alone, right? Not so much.
For the moment, he’ll be satisfied and go away, so your heart pounding subsides. But guess what? The next day, before you even see the bully, your heart is racing and you’re worrying about seeing him. Sometimes you even think about pretending you’re sick so you don’t have to go to school and see him.
When he sees you, he makes his way over quickly and now not only demands your lunch money but also demands you give him your new jacket. You’re afraid to refuse, so you hand both over and he goes away and eventually your heart stops pounding.
This is exactly what happens with the OCD handwashing scenario. Last time you washed your hands at the demand of the “bully in your brain,” you felt relieved. You don’t want to experience the bully again, so you think about avoiding situations where you might encounter him.
In this case, you might consider not leaving your house — but you can’t stay there forever. Now, you’re worried about getting dirty or having access to a sink before you even see the bully. This time when you do see the bully, the demand is bigger and now the handwashing needs to happen for a longer period of time or be repeated several times in a row.
Otherwise, the bully isn’t satisfied… and you don’t get to calm down until he is.
Do you see how OCD is like a bully in your brain? You’re afraid because the bully is stronger than you and threatening. Bad things will happen if you don’t listen to the bully. Or so you think.
So, each day you fear contact with the bully and try to avoid him. There is constant worry that you might see him. When you do see him, your fear level is off the charts. You will do whatever he tells you. He knows that you’re afraid, so he looks for you every day. That’s what bullies do, of course. They prey on the weak. He’s thrilled to have such an easy target.
Defeat OCD Obsessions with Fully Functional® Tips
Guess what? Bullies are actually cowards. They pick on those that appear weak and that they feel they can reign over.
If they approach you and you refuse to give them your lunch money and actually stand up to them, they usually back down and go away. They don’t want the hassle or the fight. They just want to control someone weak so that they can feel stronger.
Telling a bully no is NOT easy. It will certainly make your heart beat like crazy… but the fear will eventually subside. Even more amazing: You will have a new found confidence. You will be able to say “no” more easily the next time and don’t have to stay intimidated.
Here are our Fully Functional® tips for dealing with and overcoming the bully in your brain (OCD):
1. IDENTIFY the bully.
You need to understand that the obsessive thoughts are irrational and are coming from a tormentor who wants nothing more than to control you. You can’t overcome unless you identify first.
Pay attention to situations in which your heart rate speeds up and what thoughts you are having at the time — these are the thoughts that continue no matter what you do.
When you recognize those situations and the thoughts that occur, remember that those thoughts want nothing but to zap your joy.
2. REDUCE the stress.
This does not mean to avoid the bully. Don’t stay home to avoid situations where you will see the bully. That just gives him strength! Also, giving in to the bully in your brain by following through with the compulsive behavior actually feeds the confidence that the bully has.
If you wash your hands and it reduces your stress in the moment, it actually bolsters the bully’s confidence. This will lead to more and more compulsive behaviors and less and less freedom.
Reducing the stress actually happens when you confront the bully. This temporarily causes more stress but leads to long-term peace. Here’s how this is done: Let’s use the hand washing, for example:
- You have a thought that you need to wash your hands… or else. This is you seeing the bully or even anticipating seeing the bully of an OCD obsession.
- Your heart starts to race and the level of anxiety would increase — let’s say your baseline worry is 2 or 3 out of a scale of 10. The thought of ‘what if’ I need to wash my hands brings that to a 5/10. Once the idea of “I must wash my hands” sets in, your heart would be pounding at the level of anxiety would be an 8 or 9/10.
- This is where the work begins — you must not wash your hands. Allow your heart to race and the level of anxiety to get to a 10 out of 10. This is incredibly hard to do, but a necessity. It will subside.
This is you standing up to the bully. This is you saying, “No, I will not give you my lunch money. You will not threaten me anymore. I am willing to fight you about this.” Can you imagine saying that to a bully? It would take incredible guts to do it. But you can and you must!
If you do this, and allow yourself to be very uncomfortable — sometimes to the point of feeling like you will die — it will subside. The anxiety level will start to drop and your confidence will increase.
You will see that no one gets sick if you don’t wash your hands and no one dies. The irrational thoughts start to dissipate. The more you do this, the easier it will be. You are a strong, powerful person. You have what it takes to overcome this.
The next time the bully in your brain tells you to wash your hands, you will find it easier to say “no” and walk away from the mental ritual. At some point, the bully won’t look for you or talk to you because you’re not worth the hassle because you are STRONGER and MORE POWERFUL than them.
This kind of response actually has a name: Exposure and Response Prevention Therapy for OCD (ERP). When you see a mental health professional to combat symptoms of OCD, ERP is a very common technique he or she may teach you to utilize.
3. OPTIMIZE your physical and mental health.
Overcoming OCD obsessions isn’t a one-time experience. However, the more you deny the bully in your brain, the more power you’ll have over him each time.
A vital part of this is to optimize your health, both physically and mentally. A therapist, for instance, can help walk you through both ERP and CBT (cognitive behavioral therapy) in order to manage the condition. Behavior therapy is the first-line treatment for OCD by most medical professionals and is known to be a very effective treatment.
Herbal and natural remedies can help improve your health, reduce anxiety, and resolve underlying triggers for your condition. OPTIMIZING is all about increasing your body’s ability to detox and heal!
In general, this means:
- Follow a clean, nutrient-dense diet. Ditch processed foods, inflammatory fats/oils, grains/gluten, dairy, pork, shellfish, sugar, and anything else that irritates your gut and doesn’t provide clean nutrition.
- Talk to your doctor about supplements that can benefit you. Some natural dietary supplements show promise in helping with OCD, like inositol, N-acetyl cysteine (NAC), glycine, milk thistle, borage oil, zinc, and iron. *Not all supplements are right for everyone, and they can interact with medications — always talk to a healthcare provider before starting a new supplement regimen.
- Stay active. Exercise is good for all of us, but OCD patients in particular see a drastic improvement in symptoms with regular exercise.
- Practice mindfulness. Very similar to steps 1 & 2 above, mindfulness techniques focus on learning to let go of unhelpful thoughts and behaviors by recognizing them. It can help reduce OCD symptoms, according to a 2008 pilot trial.
- Sleep well. Every single person needs to get restful sleep for optimal functioning. Turn off blue light devices at least an hour before bed, and talk to your doctor and dentist about mouth breathing or snoring to keep an eye out for sleep apnea.
- De-stress your life. Do you find peace in spiritual activities like church or prayer, spending time in nature, or time with family? Whatever helps you reduce stress levels, lean into those things.
4. SUPPORT your mind and body.
Even after conquering your OCD obsessions, it’s important to give your body and mind the support they need to thrive.
First of all, take the time to talk to your healthcare provider about the best ways to support your immune system with diet and lifestyle.
Next, find a loving, supportive community to walk through life with. Your friends and family make a huge difference when combating serious medical or mental health issues! When obsessions come in, it’s important to have someone you can talk to about them. These relationships can not only offer help for your condition, but also redirect your attention to more important things in life.
Finally, we encourage each patient to find your purpose in the SUPPORT phase of becoming Fully Functional®. Passions, dreams, and the reason you exist are one of the most potent remedies to a life that was once chained to anxiety.
5. PERSONALIZE your healthcare.
For the best long-term health plan, find a certified Functional Medicine physician. He or she can not only assist in your OCD treatment, but also in helping you understand how to stay as healthy as possible throughout your life.
Are you in the Indiana area? At Vine, both of our physicians are fully licensed doctors in addition to certified in functional medicine. We’d love to meet you — just schedule an appointment.
- OCD obsessions are the anxious and fearful thoughts in obsessive-compulsive disorder that lead to compulsions.
- These thoughts are a bully in your brain — always trying to scare you, and never satisfied when you give in.
- By learning to turn down the bully, you’ll gain control over your thoughts and your joy once again.
- In our extensive experience, the most effective way to take down the bully in your brain is through our Fully Functional® approach:
- IDENTIFY the bully.
- REDUCE the stress.
- OPTIMIZE your physical and mental health.
- SUPPORT your mind and body.
- PERSONALIZE your healthcare.
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