ADAA Mental Health Blogs for the Public

We conceptualize OCD as a biologically based mental health disorder whereby a person experiences intrusive unwelcome thoughts (obsessions) and engages in rituals (compulsions) to get rid of the anxiety (or any uncomfortable feeling) associated with these thoughts.

Often overlooked in conceptualizing OCD are the physical sensations that folks may focus on, rather than a primary disturbing thought.

It’s almost Halloween!  My favorite holiday of the year – why? Because it’s not possible to be perfect on Halloween, and I embrace the imperfect. Other holidays have a perfect image we measure our own celebration by, but not Halloween! On this one day, the gory and the grimy rule. We all savor our shivers of fear about horrors we normally avoid. Terrifying movies! Ghosts! Devils! Spiders! All are out in force for Halloween.  

Irritable Bowel Syndrome (IBS), an unpleasant and often debilitating condition, is characterized by frequent, recurrent abdominal pain, as well as problems with constipation and/or diarrhea. People with IBS often experience a strong urge to use the bathroom, and may avoid going to places without easy access to one. This means that many everyday locations (malls, parks, places of worship, movie theaters, classrooms, offices) feel risky, and people might start to limit their activities as a result.

Nobody likes to be criticized but it can be particularly difficult for individuals with depression and anxiety disorders. Individuals with depression tend to be highly self-critical and frequently have an ongoing internal dialogue that is harshly judgmental of themselves. Having someone else be critical can then act like salt to the wound and trigger feelings of shame at being exposed as deficient. Individuals with anxiety, particularly social anxiety, are very fearful of being judged and being criticized can feel like being under attack in a war zone! 

Peggy, an attorney in her late 30s, establishes rituals to protect herself from aging and in her mind, becoming ugly. These rituals include 20 to 30 facial wraps a day, washing her face 40 times from morning until night, applying her cosmetics in a ritualized order, and constantly standing in front of mirrors to scrutinize the symmetry of her legs. These rituals last 8 hours a day every single day and cost over $10,000 a month to maintain.

“Do you promise you’ll pick me up later?”

“Are you sure I’m not sick?”

“Do you promise it will be OK?” 

If these questions sound familiar, your child may be engaging in excessive reassurance seeking behaviors. And unknowingly, you may be contributing to your child’s increased overall anxiety symptoms by answering those questions.