The Complexity of Obsessive Compulsive Disorder (OCD)

Obsessive compulsive disorder (OCD) is one of the most common mental disorders in Hong Kong. It is estimated that about one in every 50 people are affected by OCD at some point in their lives.

What is OCD?

OCD is an anxiety disorder where people have recurring, unwanted thoughts or ideas (obsessions) and an urge to do something repetitively (compulsion) to relieve the discomfort or anxiety followed by the obsession, which can significantly interfere with a person's daily activities and social interactions. Four major types of OCD are checking, contamination, hoarding, ruminations and intrusive thoughts.

Looking for Certainty

For people with OCD, uncertainty causes anxiety. When people start experiencing obsessive thoughts, performing rituals may initially give them a sense of security. When the obsessions reoccur, easing the anxiety requires more counteracting rituals for a longer period of time, which is different from creating a sense of security.

Misperceptions of OCD

Many people have focused thoughts or repeated behaviors, which do not disrupt daily life and simply make tasks structured. OCD patients become trapped in repetitive and senseless thoughts and behaviors that are distressing and time-consuming. The symptoms are also persistent and tend to affect multiple areas of the person's life.

Defining OCD and Addiction

The line between OCD and addiction can be blurry, as the compulsive behavior is a hallmark of addiction. Addiction is a brain disorder characterized by compulsive substance seeking or use, or engagement in "pleasurable activities" despite the harmful consequences. Their key differences are:

  1. Pleasure 
    Obsessive behaviors that have roots in fear do not include the experience of pleasure, but a feeling of relief, whereas an addiction does. Fantasy life leads to addictive behaviors.
  2. Awareness of Reality
    OCD patients are usually disturbed by a behavior that defies logic so as to relieve their anxiety. In contrast, addiction patients deny that their behaviors are a problem and are detached from the senselessness of their actions.

While the causes of OCD include genetic, biological, personality development and adaptability factors, it is considered a treatable mental disorder but not a sign of a character flaw.

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