- Obsessions are repetitive thoughts or images that are experienced as intrusive and unwanted and cause anxiety or distress.
- Compulsions (also called rituals) are repetitive behaviors or mental acts that individuals with OCD perform to decrease their anxiety.
OCD cleaning, which is one of the many subtypes of OCD, goes beyond a simple need to maintain an orderly, hygienic home. People who suffer from compulsive cleaning may have a pervasive feeling of contamination by dirt, germs, environmental contaminants or chemical toxins. OCD cleaning can be treated by a combination of medication, therapy and other medical interventions.
OCD cleaning is characterized by:
- Handwashing compulsively or using hand sanitizer is so prevalent in OCD that "washers" is now a widely accepted category of OCD patients. The urge commonly stems from a fear of germs (the most common obsession seen in OCD), but it also can be rooted in fears of making others sick or being impure or immoral.
- Overzealous cleaning is typically seen in people who fall into the "washers'' category. As with handwashing, house cleaning is often a way of easing germaphobia or feelings of impurity. Although cleaning can help chase these obsessive thoughts away, the relief does not last and the urge to clean is often even stronger the next time.
What are the signs and symptoms of OCD?
Someone with obsessive-compulsive disorder (OCD) cleaning may show the following signs and symptoms:
- Feeling disgusted or afraid of certain objects or substances, including dirt, illness, body secretions, trash or chemicals
- Believing people can be contaminated by magical or spiritual means, such as by saying certain names or numbers
- Having a strong urge to wash the hands or shower frequently
- Using a very specific process or ritual for washing themselves or their surroundings
- Changing clothes several times a day
- Avoiding places or people that may have been infected
- Conducting precise decontaminating rituals
- Refusing to allow others into their safe spaces
- Damaging their skin or body through excessive cleaning
How can OCD cleaning be treated?
Obsessive-compulsive disorder (OCD) cleaning symptoms can be treated in the following ways:
- Cognitive-behavioral therapy (CBT): an effective treatment where patients meet with a therapist who can help them decrease their anxiety by identifying thought patterns that distort their view of reality and cause stress. The therapist can help people learn how to restructure these thoughts in productive ways. CBT strengthens connections throughout the brain, especially in areas that deal with the ability to control thinking and balance emotions.
- Exposure and response prevention (ERP): another type of therapy where patients and therapists work together to identify external and internal triggers that cause stress and a need to behave compulsively. The patient is asked to describe their obsessive thoughts and compulsive behaviors. The therapist then helps them gradually practice facing stressful situations both in their imagination and in real life without using compulsions.
- Deep brain stimulation (DBS): the doctor may recommend DBS if more conservative treatment methods aren’t working. During DBS, doctors implant electrodes in targeted areas of the brain. The electrodes produce electrical pulses that may help change thoughts and behaviors.
- Medication: psychiatric drugs, called selective serotonin reuptake inhibitors, help many people control their obsessions and compulsions. They might take two to four months to start working.
- Transcranial magnetic stimulation (TMS): the TMS unit is a non-invasive device that is held above the head to induce a magnetic field. It targets a specific part of the brain that regulates OCD symptoms.
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Greenberg WM. Obsessive-Compulsive Disorder. Medscape. https://emedicine.medscape.com/article/1934139-overview
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