Therefore, OCD is connected with two concepts, which characterize typical behavioral patterns of the patients. Overwhelming majority of people with OCD demonstrate both obsessions and compulsions.Obsessions include all the obsessive thoughts, ideas or fears, which periodically bother people with OCD and trigger the necessity of performing their ritual actions over and over again.
As a rule, obsessions are annoying, fearful, distressing and even harmful, but patients with PCD can not overcome them. Obsessions can have different motifs, starting from fear of being hurt or hurting others, fear of infections or contamination, and ending with obsessive need of making everything clean and putting everything in order. Sometimes obsessions have religious, medical, sexual or even sadistic background.
Compulsions are repetitive rituals as a reaction on obsessions, which help people with OCD in reducing the anxiety and decreasing the stress. The most common compulsions are washing hands, brushing teeth, rearranging things and items, or putting them in order, cleaning around and so on. Compulsions can take also more cognitive form, like repeating some phrases or checking out something (front door), counting to some number, asking the same question over and over again, looking for constant verbal approval of something, etc.
Some patients with OCD have simple compulsions, and some have quite complicated or changing patterns. Compulsions bring temporary relief from the obsessive thoughts or fears, but do not eliminate the reason of obsessions and can not stop the cycle. For example, if a person is afraid of germs and washes hands again and again, every washing does not make him/her believe that hands are already clean enough and there’s no danger of receiving germs anymore, so the acts of repeated washing continue.
Sudden attacks of obsessive thoughts and anxiety are frequently accompanied with some physical symptoms, like slight increase of blood pressure or body temperature, sweating, feeling cold, etc. Also, patients always feel tension and nervousness until they do not start performing their rituals and receive temporary relaxation. Besides, people with OCD may have desire to resist their obsessions and this way to avoid their repeated compulsions, considering those to be senseless.
Many OCD patients attempt to control own obsessions, especially when they are on public. Besides, patients with OCD often suffer from other anxiety or mental disorders, like different forms of phobias, panic attacks, attention deficit, or others. In many cases it is connected with recognition of own dependence on the cycles of obsessions-compulsions and inability to resist this disorder. In such situations, it is harder to diagnose OCD correctly.