OCD Self-Check: Can't Stop Checking and Washing
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Repeatedly checking if you locked the door, or washing your hands over and over because you feel they are dirty—these could be signs of Obsessive-Compulsive Disorder (OCD). A key characteristic is "knowing it's irrational but being unable to stop."
For repetitive checking and washing, SSRI treatment is also an option.
View ZoloftWhat is Obsessive-Compulsive Disorder?
Obsessive-Compulsive Disorder is a condition characterized by "obsessions," which are recurring intrusive thoughts, and "compulsions," which are repetitive behaviors performed to neutralize these thoughts. Individuals with OCD recognize these actions as irrational but are unable to stop checking or engaging in ritualistic behaviors, leading to significant time and mental burden in their daily lives.
Why "Knowing it's irrational but Being Unable to Stop"—From the Brain's Mechanism
In OCD, it is believed that the brain circuit responsible for detecting "errors" or "imperfections" (the neural circuit connecting the frontal lobe, striatum, and thalamus) is hyperactive. Normally, a single check to confirm the door is locked would bring reassurance. However, due to the excessive activity of this circuit, the doubt "Did I really lock it?" arises repeatedly. Performing compulsive behaviors (like checking or washing) temporarily calms this circuit's overactivity and provides relief, but this relief is short-lived, and the same doubt quickly resurfaces. This cycle of "temporary relief → rapid re-emergence" is why compulsive behaviors cannot be stopped, and it is a result of the brain's functional characteristics, not a lack of willpower.
Self-Check Guidelines
- Repeatedly checking locks, gas, or windows/doors.
- Excessively washing or sanitizing hands.
- Having a strong preoccupation with the arrangement or order of objects, and experiencing intense anxiety if it's disrupted.
- Repeatedly having thoughts like "something bad will happen," and engaging in actions to neutralize them.
- Spending more than an hour a day on checking or ritualistic behaviors.
- Knowing intellectually that you are overdoing it, but being unable to stop the behavior.
These are merely guidelines. If multiple items apply and significantly disrupt your daily life, consider seeking professional consultation.
Obsessions and Compulsions—Typical Combinations
Obsessive-Compulsive Disorder manifests as a pattern where anxious thoughts (obsessions) arise, followed by actions (compulsions) performed to neutralize them. Typical combinations include:
| Obsession (Anxious thought that arises) | Compulsion (Action to neutralize it) |
|---|---|
| "Did I forget to lock the door?" "Did I forget to turn off the stove?" | Repeatedly checking locks, gas, or windows/doors. |
| "My hands are dirty." "I have germs on me." | Excessively washing or sanitizing hands. |
| "If objects aren't arranged correctly, something bad will happen." | Rearranging objects in a specific order or configuration. |
| "Did I hurt someone?" | Repeatedly reviewing past actions to check. |
| "I touched an unlucky number/word." | Avoiding specific numbers, chanting ritualistic words. |
While performing compulsions temporarily alleviates anxiety, the effect is not lasting. This often leads to a vicious cycle where the same obsession reappears, prompting repeated compulsions. This vicious cycle itself significantly drains one's time and energy in daily life.
Overlooked Types: Harm OCD and Other Obsessions Beyond Checking
While OCD often brings to mind images of "checking" and "washing," it can manifest in various other ways. One particularly overlooked type is "harm OCD," where individuals suffer from thoughts about potentially harming someone. Despite having no intention to harm others, thoughts like "What if I stab someone?" might arise when seeing a knife, causing intense distress. In such cases, individuals tend to keep it to themselves, thinking "Am I abnormal?" or "Am I dangerous?", leading to delays in seeking help. Obsessions are merely "thoughts that arise" and are not desires to act on them. If distressing thoughts repeatedly occur, please seek help instead of bearing it alone.
Regarding the Saying "It's the Mother's Fault"
While some discussions attribute the cause of OCD to parenting, it is now understood that multiple factors are involved, including the function of neurotransmitters in the brain and genetic predispositions, and it cannot be solely attributed to a single cause. Rather than dwelling on "it's my parents' fault" or "my parenting was bad," it is recommended to first seek a professional evaluation.
SSRI Treatment as an Option
In the treatment of OCD, SSRIs (Selective Serotonin Reuptake Inhibitors) are a central pharmacological option. By regulating serotonin function, SSRIs are expected to calm the overactive brain circuits mentioned earlier, thereby reducing the frequency of obsessions and the urge to engage in associated compulsions. The dosage of SSRIs used for OCD treatment may be higher than that for depression, and it may take longer (several weeks to three months) to feel the effects. However, continued use can significantly reduce disruptions to daily life.
For repetitive checking and washing, SSRI treatment is also an option.
View ZoloftFrequently Asked Questions
Unlike the normal "checking just in case" that everyone does, OCD is characterized by being unable to stop even when knowing it's irrational, and it occupies a significant portion of the day, disrupting daily life.
It cannot be attributed to a single cause; rather, it is thought to involve multiple factors such as the function of neurotransmitters in the brain and genetic predispositions.
While mild cases might fluctuate, in most instances, professional treatment can significantly alleviate symptoms. If your daily life is being affected, early consultation is recommended.
No, that is not the case. Obsessions are "thoughts that arise" and are not desires to act on them. This is a common symptom in a type of OCD called harm OCD, and professional support can help reduce the distress. Please seek help instead of bearing it alone.
Yes. The manifestations are diverse, including preoccupation with object arrangement, avoiding unlucky numbers or words, and repeatedly reviewing past actions. Even if your symptoms do not fit the typical examples of "checking" and "washing," if you experience a pattern of recurring thoughts and actions to neutralize them, you may have OCD.
Forcibly stopping the behavior can actually increase the individual's anxiety. Family consultations are also available, so you can discuss response strategies with us.
It is thought that the brain circuit for detecting "errors" is overactive, and the reassurance from checking does not last, with the same doubt quickly resurfacing. This is not an issue of willpower.
In OCD treatment, a higher dosage may be required than for depression, and it can take several weeks to about 3 months to feel the effects. It is a treatment that requires patience.
