Obsessive compulsive disorder (OCD) is a type of anxiety disorder that involves recurrent thoughts and actions. The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) defines an obsession as an intrusive thought, image or impulse that persists in the mind and provokes anxiety. This anxiety is believed to be relieved by repetitive actions known as compulsions. Mild symptoms of OCD include obsessions and compulsions that do not interfere with daily functioning.
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An increased awareness of germs is a mild symptom of OCD. Fear of contracting an illness when there is reasonable evidence to believe one is at risk can result in obsessive thinking. Frequently washing one's hands to kill germs is a common compulsion. Someone with a mild obsession for cleanliness may be uncomfortable in places that are dirty, dusty or grimy but able to withstand being there. Scrubbing one's body until the skin becomes raw, on the other hand, is an extreme measure suggestive of a serious condition.
Obsessions about safety and fear of harm can lead to the development of checking. Checking is a type of compulsion characterized by uncontrollable urges to repeatedly check that something was done. Checkers may fear that their house will burn down because they left the oven on. They may need to constantly check their doors at night to ensure they are locked in order to fall asleep. In mild cases, reassurance is provided by checking or double-checking at which point the worry no longer consumes the mind.
The accumulation of unnecessary items complied with a refusal to discard such items is considered hoarding. The thought of throwing things away is anxiety-provoking to a hoarder because they are afraid that they might need the item in the future. The International OCD Foundation has identified papers, books, clothing and containers as the most common possessions that are hoarded. In severe cases, hoarders amass more stuff than they have room for and even then the hoarding does not stop. Pack rats with a minimal amount of clutter have the potential to become hoarders if they are unable to control it.
Individuals obsessed with order become anxious when things are out of place. They are compelled to put things back exactly where they belong by facing objects in a particular direction or lining items up in some methodical way. At home, the labels of all of the cans, jars and bottles in a pantry or kitchen cabinet must be facing forward. At work, as pens, paper, phone and stapler must be located on certain parts of the desk or in a particular drawer. The amount of distress caused by disarray is indicative of the severity of this symptom. Being slightly annoyed by disorganized spaces is not a major cause for concern.
Engaging in a routine pattern of behavior is characteristic of OCD. These routines are more than just habits. They are ritualistic behaviors that are performed for a specific reason. Sufferers of OCD may believe that failure to engage in ritualistic behavior makes them susceptible to harm. Therefore, they feel they must perform chores in a certain way and go through steps in a specific order. Such rituals may involve steps taken when getting dressed, cooking a meal or getting ready for bed. Creatures of habit have only mild symptoms of OCD since disruptions in routine are able to be handled.