Many findings have shown that those with OCD also suffer from sleep disturbances.
OCD is a terribly exhausting mental health condition. Sufferers can find themselves trapped in a spiral of painful obsessions and intrusive thoughts and lose hours of their day performing compulsive behaviors in the hope of finding a moment’s peace.
But it doesn’t end there.
Beyond having to manage those obsessions and compulsions day in and day out, they also have to manage heavy feelings of uncertainty, guilt, shame, and unworthiness.
Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by intrusive thoughts, obsessions, and compulsions that can significantly impact a person’s daily life.
For individuals struggling with OCD, finding ways to manage their symptoms and maintain a sense of control feels crucial.
However, some individuals may turn to alcohol as a means of coping with their OCD, which raises an important question: Does alcohol make OCD worse?(more…)
“Does stress make OCD worse?” is a common question among our OCD clients.
The simple answer here is, yes, stress can make OCD symptoms worse.
If you struggle with OCD and you notice that your obsessions and compulsions have intensified during a particularly stressful time, then please know that this is very common.
While stress does give OCD new fears to latch onto (thanks, OCD!), there are highly effective ways of managing and reducing stress which in turn will alleviate OCD symptoms.
“Will my OCD get worse over time?” is a common question asked by those with obsessive-compulsive disorder.
In this article, we’re going to explore what may increase the severity of OCD symptoms, and the many options that are available to you to combat those symptoms.
It’s important to understand that we cannot predict when or how OCD will worsen, only that certain components can play a significant role. Stress, comorbidities, life circumstances, and – you guessed it – engaging in compulsions can all increase the severity and intensity of OCD symptoms.
Reassurance is defined as words or advice of comfort intended to make someone feel less worried, according to the Cambridge Dictionary. It is common for us as humans to seek reassurance from one another as a way to navigate and relieve the anxiety that arises in times of uncertainty and doubt.
Because of this, it makes complete sense that OCD and reassurance-seeking often come hand in hand.
Rumination is a core feature of OCD that causes the sufferer to spend excessive time and effort trying to figure out, analyze, fix, clarify, or gain control over a particular obsession or theme.
Rumination is not a subtype of OCD in and of itself.
It is a compulsion that occurs within all OCD subtypes and is a key contributing factor to maintaining the OCD cycle.
There are two core elements that contribute to the cycle of OCD: obsessions and compulsions. Except not all compulsions are visible. Some are ritual-like behaviors that occur in our minds. These are called mental compulsions.
Specific OCD subtypes can experience the groinal response as a physically intrusive and unwanted sensation.
While everyone experiences groinal responses, in relation to OCD, they are confusing and distressing as they appear in response to an obsession in which the context often disturbs the individual.
One of the key components involved in maintaining the cycle of OCD is compulsions. Being compulsive, however, is not to be confused with being impulsive which is an entirely different behavior. The question is, how can you tell the difference?
Compulsions are typically found in OCD. Both mental compulsions and/or physical compulsions help us manage the intense anxiety that arises from those unwanted thoughts, images, feelings, sensations, and urges (obsessions).
Impulsivity is not so specific to any one mental health disorder.
All of us act impulsively, and for most, it isn’t a source of distress. However, even impulsivity can become a symptom of a mental health condition if the effects of impulsive behavior begin to negatively impact our lives.
What does impulsive mean?
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According to the Oxford Dictionary, impulsivity is the act of doing something without forethought.
When someone is impulsive, they act spontaneously, without carefully considering the consequences of their actions.
Sometimes, these impromptu actions are helpful! It could be argued that they help us with quick decision-making. Imagine seizing an opportunity that may otherwise slip through our hands.
This type of positive and beneficial impulsive behavior is sometimes referred to as ‘functional impulsivity’. To some, this may even be a character trait to admire.
Yet, the flip side of this is something we call ‘dysfunctional impulsivity‘, or ineffective impulsivity.
In this instance, impulsive decisions are made in situations where it is not beneficial and the consequences may have a negative impact. It has also been suggested that there is a correlation between those with dysfunctional impulsivity and sensation seeking.
Examples of Impulsive behaviors
If we focus here on impulsive behaviors from the standpoint of dysfunctional impulsivity (as this is how it appears as a symptom in association with mental health disorders), here are some examples to show how it may present itself:
Eating – Eating just because the food is in front of you. Even though you already ate and aren’t hungry, which leaves you regretting what you’ve eaten because you ‘didn’t really need or want it’
Shopping – Spontaneously buying things that you don’t need and end up never using.
Casual sexual encounters – Having unplanned sexual interactions with a stranger on a night out, even though you had planned to go home with friends.
Anger – Sudden outbursts of rage that you feel unable to control
Drinking – Drinking alcohol in a situation where we hadn’t planned or didn’t really want to.
Should I be worried if I show signs of impulsivity?
To a certain degree, impulsivity is incredibly common and for most, isn’t a cause for great concern.
We have all done something at some point where we later thought, “I just did it without thinking!”
Sometimes we have to deal with negative consequences and other times, we greatly benefit from acting in the moment.
However, when those impulsive behaviors appear in day-to-day life and the consequences are mostly negative or unhelpful, it could be a sign of an underlying mental health condition that needs to be addressed.
What does compulsive mean?
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According to the Oxford Dictionary, the simple definition of ‘compulsive’ is a behavior that is difficult to stop or control.
A mental or physical compulsion is a ritual-like behavior that you feel an intense urge to perform in order to alleviate overwhelming feelings of anxiety, uncertainty, and distress.
Unlike impulsive behavior which can sometimes be useful (functional impulsivity), compulsive behavior is a central feature of problematic human behavior mostly associated with OCD. The motivation behind such mental or physical rituals sometimes feels illogical and nonsensical and leaves sufferers wondering why they feel compelled to do them.
In contrast to impulsive behavior which is often done without thought or foresight, compulsive behavior can be premeditated or simply 100% habitual; a repetitive behavior performed with the understanding that it will relieve us of intense stress and anxiety.
Examples of Compulsive behaviors
The most common examples of compulsive behaviors are as follows:
Hand washing – Excessively washing your hands to ‘make sure’ they are clean.
Checking – Constant checking of locks, doors, lights, electrical appliances, etc. ‘just in case’ something bad happens if we don’t.
Counting – Physically counting objects or things, or counting in our head.
Orderliness – More than just ‘needing things neat and tidy’, but organizing things in a certain way ‘just in case’ something happens if we don’t.
Skin picking – Excessive picking of nails, cuts, loose skin, or scratching their skin excessively.
Hoarding – Feeling the urge to keep hold of seemingly unimportant objects even when they aren’t needed.
Mental rumination – Finding ourselves in a mental loop of ‘what if’ thoughts, for example.
Avoidant compulsions – Purposefully avoiding people, places, or things that cause anxiety
Reassurance-seeking compulsions – Searching for external reassurance from others or giving ourselves excessive self-reassurance.
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Compulsions and Impulsivity within different disorders
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Although there can be some overlap, there are specific mental health disorders that we associate with compulsivity over impulsivity and vice versa.
Let’s take a look at them below:
Mental health conditions associated with compulsivity
OCD – Obsessive Compulsive Disorder is characterized by three main components; obsessions (unwanted thoughts, feelings, urges, images or sensations), anxiety (the fear that is triggered by these obsessions), and compulsions (the ritualistic behaviors performed to relieve the anxiety). OCD has various subtypes and many other compulsive-focused disorders are considered to land on an OCD spectrum.
Body Dysmorphic Disorder – People with BDD spend an inordinate amount of time worrying and obsessing over their body image.
Hoarding – People with hoarding disorder struggle to part with possessions despite having no real need for them.
Compulsive Buying Behaviour – CBD or oniomania is characterized by a person’s need’ to shop or buy items even when there is no real need for them, and the consequences of the purchase may have a negative impact.
Exercise Addiction – Considered a behavioral addiction, exercise addiction transpired when the risk of exercising outweighs the benefits but the sufferer feels compelled to continue with a rigorous exercise routine.
Compulsive drinking – The uncontrollable urge to drink in large quantities.
Trichotillomania – The repetitive behavior of compulsive hair pulling
Skin picking – Repetitive picking of skin (scars, loose skin, nails, skin tags) to the point of tissue damage.
Mental health conditions associated with impulsivity
Conditions associated with impulsivity are known as ‘impulse control disorders’. For the person who struggles with impulse control, their behaviors are very much ‘in the moment’ and can have a negative impact on those around us, as well as ourselves.
Examples of mental health conditions associated with impulsivity:
Intermittent explosive disorder – Characterized by sudden and intense outbursts of rage or aggression.
Kleptomania – Impulsive and uncontrollable urges to steal items that are not required for personal use.
Pyromania – Deliberately setting things on fire on more than one occasion.
Body-Focused Repetitive Behaviors – (BFRB‘s are intense urges like biting, scratching, and skin picking. Trichotillomania and skin picking can be considered both compulsive and impulsive.
Impulse buying – Buying items that are more than what we can afford, or buying items that we do not need and will likely never use.
Borderline Personality Disorder – Characterized by a person’s loss of emotional control and ability to regulate their emotions.
Addiction – Addictions such as drug and alcohol addiction are categorized as impulse control disorders.
Can you be compulsive and impulsive at the same time?
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As you can see from the mental health conditions above, both can be present and overlap among certain disorders.
What is important to note here is that they are two very different and distinct types of behavior. The intention behind one or the other is very different. In the case of OCD, all patients perform compulsive behaviors (a core element that keeps the OCD cycle going).
Both impulsivity and compulsivity share the same intention of getting short-term relief, but ultimately both cause long-term negative consequences.
“Over time, impulsive behaviors may become compulsive (driven behaviors without arousal) and compulsive behaviors may become impulsive (reinforced habits)” – Psychiatric Times
Coping Strategies
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Whether you struggle with compulsivity or impulsivity, there are ways to help yourself manage both effectively so you can live a life where you are in control.
Here are some of our top suggestions:
1. Therapy
Seek the support of mental health professionals. A qualified therapist will be able to offer the support and guidance you need to move you through the recovery process. CBT (cognitive behavioral therapy) is a highly effective treatment for both compulsive and impulse disorders.
If you are based in the state of California , our friendly and highly qualified clinicians will be able to help you on your road to recovery with 1:1 therapy. Click here to submit an initial inquiry, and let’s see how we can support you today.
2. Online Programs
Where possible, we would always advise getting the help of a qualified specialist who can support you in a 1:1 setting. However, this isn’t accessible to everyone. And so, there are many online programs available that act as a self-study guide.
Be sure to do your due diligence and find a program that has been created by an expert in their field. When in-person therapy isn’t available, these can make for an incredibly helpful option.
Kimberley Quinlan is a top OCD specialist in her field and runs online programs available to those who are seeking an accessible alternative to 1:1 therapy.
The ERP School will walk you through the exact steps you would take if you were working together in a private setting, to help you resist the urge to do compulsions and stop letting intrusive thoughts control your life.
You will learn how to apply ERP (exposure response prevention) to your own specific obsessions and compulsions so you can manage your anxiety, uncertainty, and discomfort and drastically increase your quality of life.
The BRFB School (Body-Focused Repetitive Behaviours) for hair-pulling and skin-picking will help you change your relationship to your thoughts, feelings, and behaviors (because BRFB recovery is about looking at the WHOLE person, not just the specific behaviors).
You will gain access to the tools Kimberley uses with her one-to-one clients so that you can apply them to your own life and stop these behaviors from negatively impacting how you feel on a daily basis.
Medication
Medication often gets a bad rep, but the reality is that it has been an incredible source of relief to many who have to navigate the extreme distress of living with these disorders on a daily basis.
It isn’t for everyone, so please contact your local medical professional so they can walk you through the correct diagnostic procedure. They will advise as to whether medication is an option for you.
It is entirely possible to recover from OCD without medication, however this should be a decision made with your medical professional.
Support groups
Support groups are hugely underrated. There’s really nothing like managing a mental health disorder alone. So, if you can find a relevant support group of like-minded individuals, then you can surround yourself with people who genuinely ‘get it’.
From an emotional perspective, just knowing that you are not alone in your struggle can be a huge help.
We can do what we can to help ourselves, but we can also allow others to support us too.
OCD is a common psychiatric disorder that presents itself in up to 2% of the global population. It is no wonder then that you may ask yourself, is OCD hereditary?
You may have a close family member who suffers from OCD – perhaps a parent or sibling – and wonder whether this makes you more vulnerable to the disorder.
Alternatively, you may have an OCD diagnosis yourself and question whether you can or can’t pass it on to your children.
To answer simply, OCD is considered a familial mental health disorder.
Conducted twin studies demonstrate that one varying factor in the onset of OCD could be genetics. At this point, it is worth stressing that we do not know definitively what causes OCD. Likewise, despite these studies showing convincing evidence that genetics may have a part to play in a person’s susceptibility to this condition… The results are not conclusive.
The two key components that keep us stuck in the OCD cycle are the fear-inducing unwanted thoughts, images, feelings, sensations, or urges (obsessions) and the mental or physical ritual-like behavior we perform to relieve the extreme anxiety caused by these obsessions (compulsions).
Almost everyone who has a brain experiences intrusive thoughts or images at some point.
Yet, the non-OCD sufferer can accept the uncertainty that comes along with these mental intrusions. While someone with OCD can get lost in the ‘what if’ thoughts.
What if I don’t do A,B,C?
What if it does mean something about me?
What if X,Y,Z is true?
The sense of discomfort and unsafety that arises during rumination over those fearful obsessions causes great distress. And so, if you find yourself stuck in this cycle, it is understandable to want to know WHY. Especially when 97-98% of people with intrusive thoughts can seemingly move on with their day without thinking twice about them.
OCD and Genetics: The History
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The first OCD diagnosis was over 100 years ago. A lot of people find themselves wondering whether OCD has become more common in modern-day society. However, the likelihood is that there is simply greater awareness.
Since its discovery, clinicians have suspected that DNA has a part to play in the onset of OCD.
Maudsley Hospital in London facilitated the first report in English Literature based on fifty cases of ‘obsessional neurosis’. It concluded that 21% of siblings and 37% of parents of those diagnosed typically suffered from similar symptoms. A Hopkins OCD family case study showed strikingly similar results.
Multiple studies have proven to offer similar results suggesting that genetics can play a significant role in the development of OCD.
One study shows a prevalence of 7% to 15%in first-degree relatives with another showing 11.7% prevalence compared to only 2.7% in those without a familial connection to the disorder.
Twin studies are always an effective and helpful way to research whether DNA may have a part to play in any one psychological disorder. DNA is identical in maternal twins compared to fraternal twins who are genetically only as similar as regular siblings.
When OCD is present, up to 80% of identical twins can both have the disorder with non-identical twins only sharing the disorder up to 50% of the time. Other studies claim that identical twins have up to 90% chance of both presenting with OCD, the statistics are quite convincing.
NOTE: What we cannot ignore here is the environmental factors that influence us all, including identical twins.
Identical twins brought up under different conditions and varying outside influences can be more or less vulnerable to OCD depending on those differentiating factors, genetics is not the only possible cause we should take into account.
If one were to be an athletic enthusiast and the other an online gamer, then although they ‘should’ physically be very similar, the athlete is likely to be bigger and more muscular.
What are the chances of me passing OCD on to my child?
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This is a common and understandable question to have.
Whatever psychiatric condition we may be living with, parents will always want to protect their children from having to live through the same struggles they experience every day. The World Health Organization calls OCD one of the 10 most distressing conditions in the world.
If you’ve experienced this, then you already know this to be true and so it only makes sense you would want to shield your child from that.
A more recent Johns Hopkins study claims that brothers, sisters, and parents of those with diagnosed OCD are up to five times greater risk of having the condition themselves.
Yet this is a moment to reiterate – we cannot ignore environmental factors and influences.
Having OCD yourself does not guarantee that your child will also have it. Just as not having OCD doesn’t guarantee your child won’t have it. Genetical influence is just one of many factors and whilst there does appear to be a correlation, it is still not definitive.
What are possible OCD genes?
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Four specific genes have been identified and associated with OCD through several studies. Final results suggest that these four specific genes are absent in those without OCD and are found in three specific parts of the brain in those with OCD – the thalamus, cortex, and striatum.
222 were proven to be present in lab mice that compulsively groomed
196 were found in individuals with autism who engaged in repetitive behaviors to relieve anxiety.
56 genes were detected in a study of canines that engaged in compulsive behaviors such as chasing their tails.
The following four genes were apparent in all cases and take us one step closer to understanding the connection between OCD and DNA.
NRXN1 – A protein coding gene.
HTR2A – A gene involved in the chemical regulation of the brain
CTTNBP2 – A gene involved in neural activation and synapse formation
REEP3 – A gene that affects neurons, how they form, and how they function
For an affordable alternative to 1:1 therapy, visit ERP School.
We walk you through the exact steps you need to stop intrusive thoughts from ruling your life and overcome your OCD using science-backed methodologies proven to work!
The underlying theme and key message of this article is that genetics count for very little without environmental influence. Although we are in a continuous process of learning and understanding the root cause of this particular condition, one thing that many professionals can agree on is that the presentation of OCD is triggered by both genetics and external factors.
Mayo Clinic suggests that OCD can even be learned.
As we grow up, we learn to walk, speak, and behave by observing the people around us and mimicking their behavior. Of course, for the most part, this is an incredibly useful function. Our ability to learn and absorb this information through our keen observational skills is what makes us so adept as a species.
Yet we can learn unhelpful behavior and thinking patterns as much as we can learn helpful ones.
According to learning theory, a child may adopt the fears of a parent and perform the same ritual-like behaviors. For example, if a parent is overly fearful of someone breaking into their home at night, they may compulsively check the locks and feel compelled to survey their surroundings through the window. This is behavior a child could, in theory, learn through observation.
Just as a child can learn to try new things, they can also learn the behavior of avoidance.
However, do not mistake this to mean that if you have OCD your child will adopt those thinking and behavior patterns. Observational learning is just one small aspect of childhood growth and experience, not to mention, there will always be an array of people in their lives to learn from.
Different types of OCD
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With these advances in the genetic field of OCD, we’re keen to know whether or not there is specific DNA that triggers a particular OCD subtype.
The underlying components of OCD are present across all subtypes: obsessions, anxiety, and compulsions. But the obsessions vary depending on the subtype, different fears are present for different individuals.
Contamination OCD is the most well-known of all subtypes, yet there are many others that do not have the same level of awareness.
Here are a handful of other common OCD subtypes:
Harm OCD: Obsessions are typically focused on the fear of hurting others or themselves (self-harm OCD).
Religious (Scrupulosity/Moral OCD): Obsessions are focused on the fears of behaving in a way that goes against their religious values
Pedophilia OCD: Obsessions are focused on the fear of committing sexual harm toward a child.
Relationship OCD: Obsessions are focused on fears that they don’t love their partner enough, that they will do something to ruin their relationship, or that their partner is lying to them or cheating on them.
Sexual Orientation OCD: Obsessions are focused on fears of being homosexual, heterosexual, pansexual, or other sexualities when they are in fact, the opposite (it can also challenge their gender orientation)
When we take a look at the different subtypes, this is where it becomes even more clear that DNA alone cannot possibly be the sole underlying cause of OCD. OCD is a mental illness where unwanted obsessions are not aligned with the individual’s inherent values.
It attacks what the individual knows to be true about themselves and leaves them questioning their own self-concept and identity. This is what is known as egodystonic (which is why OCD is considered an egodystonic condition).
If we then zoom in on this knowledge, it is clear that there must be different triggers for different people depending on their values.
For example, someone who grew up in a religious household may live their lives according to their religious values. When an unwanted thought or image arises to challenge that, they may be left questioning why they would think such a thing as someone who is devout in their religious beliefs.
Likewise, if someone grew up in a household where they, unfortunately, adopted negative views toward homosexuality, an unwanted urge that may arise toward someone of the same sex can then be confusing and invoke feelings of shame. Especially if the parents of this person have strong negative feelings toward homosexuality, they may fear what they think of them as well as what they think of themselves.
The reason OCD is so distressing within particular subtypes like the ones above is precisely that it attacks our values and leaves us questioning who we really are.
It is true, OCD can manifest in a way that is entirely illogical and has nothing to do with our values. Yet, with these particular subtypes, researchers are intrigued to understand whether or not there is a genetic component involved.
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Conclusion: Does OCD run in the family?
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Ultimately, yes, genetics do appear to be just one of the many factors involved in the onset of OCD. But, it is likely that they only make someone more vulnerable to developing the condition and not a root cause of the condition in and of themselves.
Environmental factors must be taken into account. Where this particular condition is concerned, it could all boil down to one simple combination: a genetic predisposition and an environmental trigger.
Sharing DNA with a first-degree relative with OCD does not guarantee that you will also trigger the condition. Although there are four genes that have currently been identified as being present in OCD sufferers, OCD does not have a specific ‘OCD gene’ in and of itself.
It may be present in multiple generations of your family, but this does not ensure that you will develop this condition.
