- obsessions – ideas that get stuck in head, same ones over and over
- compulsions – need to do things in a CERTAIN way, often repeatedly in an attempt to get it ‘right’
OCD can be associated with irritability and oppositional behaviour and while it can look like the opposite of ADHD – neat freak, highly organized, never impulsive, in practice the two can co-exist impotenzastop.it. OCD is about an intolerance of uncertainty.
The obsessions of OCD tend to be relatively few, but quite intense. It could be an irrational fear of molesting a child, even when the idea is revolting to you and there’s no way you would do it, or it could be fear of cancer, even in the presence of lots of evidence to the contrary “but the doctor COULD be wrong”.
Compulsions are activities that must be done to reduce anxiety, but even doing them moe than once may not eliminate the uncertainty – but did I turn the lock the right direction? it can be counting, checking, doing things in certain orders, hand washing to the point of bleeding, or doing things in exact patterns that must be done to perfection or start all over.
We break OCD into personality – neat freaks, if only every one else was as tidy, life would be great, and disorder, where the obsessive thoughts are intrusive, the compulsive actions stressful and making you late. it can be mild and nothing needs to be done, or severe and very damaging.
OCD patients don’t tolerate stimulant medications well and we often have to get the OCD under better control before tackling the ADHD.
Treatment of OCD is a combination of counselling – learning to tolerate uncertainty, as well as medication. Often both are needed to really turn things round. OCD can come and go, or get better with time.