Are Obsessions filling Your Thoughts?


Obsession or Preoccupation?

People struggle against other unwanted and distressing thoughts that are other than obsessions. There are worries, ruminations, preoccupations and daydreams that can impact our emotional state. How can you know if your thoughts are just daydreams or actually obsessions?

Obsessions and the DSM-5

The DSM-5 or the Diagnostic Criteria for Obsessive Compulsive Disorder is the handbook that health care professionals use in the United States and much of the world as the authoritative guide to diagnosing mental disorders. DSM includes descriptions, symptoms, and other criteria in order to diagnose mental disorders.

DSM-5 Diagnostic Criteria for Obsessive-Compulsive Disorder (300.3) A.

Presence of obsessions, compulsions, or both:

Obsessions are defined by (1) and (2):

  1. Recurrent and persistent thoughts, urges, or impulses that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress.
  2. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion).

Compulsions are defined by (1) and (2):

  1. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly. 2.The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive.

Note: Young children may not be able to articulate the aims of these behaviors or mental acts.

  1. The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. C. The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition. D. The disturbance is not better explained by the symptoms of another mental disorder (e.g., excessive worries, as in generalized anxiety disorder; preoccupation with appearance, as in body dysmorphic disorder; difficulty discarding or parting with possessions, as in hoarding disorder; hair pulling, as in trichotillomania [hair-pulling disorder]; skin picking, as in excoriation [skin-picking] disorder; stereotypies, as in stereotypic movement disorder; ritualized eating behavior, as in eating disorders; preoccupation with substances or gambling, as in substance-related and addictive disorders; preoccupation with having an illness, as in illness anxiety disorder; sexual urges or fantasies, as in paraphilic disorders; impulses, as in disruptive, impulse-control, and conduct disorders; guilty ruminations, as in major depressive disorder; thought insertion or delusional preoccupations, as in schizophrenia spectrum and other psychotic disorders; or repetitive patterns of behavior, as in autism spectrum disorder). Specify if: With good or fair insight: The individual recognizes that obsessive-compulsive disorder beliefs are definitely or probably not true or that they may or may not be true. With poor insight: The individual thinks obsessive-compulsive disorder beliefs are probably true. With absent insight/delusional beliefs: The individual is completely convinced that obsessive-compulsive disorder beliefs are true. Specify if:

Tic-related: The individual has a current or past history of a tic disorder.

One of my Obsessions and Compulsions

At a former job, I would get in my mind that I did not prepare the mail the right way going to the courthouse. I thought I either left out a pleading, the copies or a letter or even a self-addressed stamped envelope. This belief or obsession drove me crazy. I would post the mail, go back to my desk, get that sinking feeling and run back to the bundle of mail, pull out my envelope(s) addressed to the court clerk and open it to check if I left anything out. Nine out of ten times, everything was there.

Then, I decided to star checking and rechecking and rechecking again for a third time, a fourth time, a fifth, etc. My production level slowed down immensely. My boss even made a comment to me about the amount of work I was doing vs. times before. But, I could not help it! I thought if I would only check myself, “x” amount of times, I would have certainty. It never did make me feel reassured. There were always doubts until the obsession with this particular situation lessoned.

Suggestion to Help Cope with OCD

During this time in my life when I was having extreme difficulty with OCD, I learned some great coping mechanisms that I use to this day.

The Step-By-Step List/Check-Off List

This was a God send. I began making lists for everything. Using this tool was actually two-fold. I was beginning to have problems remembering things and the check-off list would help me to see that I DID include the correct items in the court clerk’s envelope. I still use step-by-step list when dealing with multiple directions or multiple parts.

Help for OCD

If this sounded like a friend of yours, remember you are not a mental professional. You cannot diagnose. But you can find help for them. The best thing you can do is be there and be a friend.


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