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obsessive-compulsive disorder (OCD)

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Obsessive-compulsive disorder (OCD) has two components. The first is obsessions, which are intrusive preoccupations (often called intrusive thoughts) about a particular subject. The second is compulsions, repetitive behaviors that someone does or has the urge to do as a response to obsessive or intrusive thoughts. A person with OCD may be unable to redirect their thoughts or focus on anything else until they perform a compulsive behavior. 

OCD is a serious psychiatric condition, not a personality trait. It can affect a person’s emotions, memory, and even their ability to control their thoughts. Using the term casually can increase stigma around the condition, trivialize the experiences of people living with OCD, and discourage people from getting help. 

OCD was first described not in medical research, but in religious literature. The condition was called scrupulosity, as it was thought to be caused by too many scruples (moral limits). Today, scrupulosity is recognized as a subtype of OCD and is more frequently called religious OCD.

By the 19th century, clinicians began to recognize OCD as a psychiatric condition. Around the same time, OCD symptoms with cleanliness or safety themes became more prevalent. One in four cases of lifetime OCD have contamination-related symptoms and 79 percent involve checking-related symptoms (such as triple-checking that one locked the front door).

There are several subtypes of OCD, which may be lesser-known and thus harder to recognize and diagnose. One subtype involves “forbidden thoughts.” An individual’s mind obsesses over a taboo subject, such as adultery, pedophilia, or violence. They will then feel an overwhelming need to perform certain rituals, either physical or mental, in order to cancel out those thoughts or make sure that they have not “lost control” and committed the taboo. These obsessive thoughts can spark extreme stress, as few people realize right away that they are experiencing OCD.

The term “pure O,” or “purely obsessional OCD,” refers to obsessive or intrusive thoughts that may be accompanied by mental compulsions such as mentally repeating specific words, rather than outwardly observable physical behaviors. Though some advocates say the term is valuable in discussions of less-recognized OCD symptoms, the DSM-5 does not recognize “pure O” as a distinct subtype of OCD. If using the term, providing some explanation is helpful for audience understanding.

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Obsessive-compulsive disorder is characterized by persistent, unwanted thoughts (obsessions) and repetitive rituals to “neutralize” said thoughts (compulsions). Using OCD as a casual shorthand outside of the context of the actual disorder and its diagnosis can increase stigma around the condition, trivialize the experiences of people living with OCD, and discourage people from getting help.