I think I have obsessive-compulsive disorder (OCD)

Dear Not sure and Emma, 

Mental health conditions that cause intrusive thoughts and compulsions can be highly stressful. While obsessive-compulsive disorder (OCD) may be one cause for what you’re experiencing, there may be other reasons that you're feeling this way. Conditions such as post-traumatic stress disorder, stress and anxiety, and even psychosis may contribute to these feelings. Read on to learn more. 

OCD is a mental condition that involves the presence of intrusive thoughts, urges, or images known as obsessions. The most common obsessions include fear of contamination, fear of causing harm, sexual anxieties, religious fear, and a need to ensure things are “just right.” These obsessions are usually accompanied by compulsions, which are repetitive behaviors or mental acts that an individual does as a way to reduce the anxiety or distress brought on by the obsessions. Some of these compulsions can include counting things repeatedly; washing one’s hands over and over; checking, organizing and arranging; and reassurance-seeking. 

While performing these compulsions often offers temporary relief from intrusive obsessions, the need to perform these rituals often interferes with daily activities. On the flip side, however, being unable to complete these compulsions can often lead to intense feelings of anxiety and discomfort. 

While the exact cause of these obsessions and subsequent compulsions remains unknown, research suggests that there may be genetic factors that predispose an individual to developing OCD. Behaviors such as having an inability to cope with uncertainty and an increased sense of responsibility may also be linked to OCD. Other risk factors that may increase the risk of developing OCD can include: 

• A family history of OCD or history of other neurological disorders. 
• Gender, particularly women and those who are postpartum are more commonly affected. 
• A prior strep infection. 
• Adverse childhood experiences (ACEs). 
• Biological differences in the brain that affect the ability to control behavior and regulate emotional responses. 

In addition to OCD, there are a number of other conditions that may also contribute to the feeling of obsessive and intrusive thoughts. People with post-traumatic stress disorder (PTSD) may experience flashbacks or intrusive thoughts related to the event that caused their condition. People with PTSD may also be triggered by something in their environment that causes similar reactions to what you have described, Emma. Stress and anxiety have also been known to put immense strain on the brain and nervous system, resulting in feelings that feel foreign or unlike your normal self. They can also cause you to experience hallucinations. Psychosis can also be a possible cause of feelings such as these, as it can result in feeling like you’ve lost touch with reality. With psychosis, this false sense of reality can be accompanied by hallucinations, delusions, and disorganized thoughts and behavior, among other things. 

It can be important to note that psychosis may be a symptom of other mental health conditions and can therefore only be diagnosed by a mental health professional. Seeking out professional care can help you determine if you're experiencing OCD or another condition that’s causing you both to experience these thoughts. They can also recommend the treatment that’s most appropriate for your symptoms, if necessary. Many treatments are available to help those with OCD manage their symptoms. These can include selective serotonin reuptake inhibitors (SSRIs), antipsychotics, cognitive behavioral therapy (CBT), exposure and response prevention, and possibly even deep brain stimulation. 

Not sure, you’re not alone in being wary about seeking care from a health care provider. In fact, being scared or nervous about going to any sort of health care provider can be a common experience for many people. That said, it may be helpful to note that there are ways you can prepare for these appointments to help you feel less nervous. This can include writing down your behaviors, questions, or points you'd like to make before meeting with them. This way it can help you remember everything you’d like to say. 

You may also think about what makes you afraid in the first place. Some questions to consider include: What about going to a health care provider makes you afraid? Have you had previous negative experiences in health care settings? Are you anxious about medication or treatment? Is there someone who can support you, or better yet go with you to these visits so it takes the pressure off of you to remember everything on your own? Figuring out the answers to these questions can help you figure out where your hesitancy lies and how you can work through it. 

For more information, support, or help finding a mental health provider in your area familiar with OCD, consider checking out the International OCD Foundation. For information regarding other mental health conditions and services, you might check out the Substance Abuse and Mental Health Services Administration. These resources can help provide further information if you decide to seek care or additional support. 

All the best on your journey to finding an answer.