Obsession

Obsessions are recurring thoughts that can be either short-term or long-term and might be related to specific situations or topics. Obsessions are rooted in thoughts, unlike compulsions, which are behaviors or actions that attempt to relieve discomfort. For example, a compulsion like double-checking locked doors may be acted upon as a means to mitigate obsessive thoughts.

To better understand obsessions, we can explore common symptoms and the neuroscience behind them. Some prevalent symptoms include an inability to control or shake off the obsessive thoughts, repetitive behaviors driven by the thoughts (such as excessive cleaning, checking, or list-making), and experiencing significant disruption to one's daily life.

Obsessions might be connected to problems in certain brain regions, such as the orbitofrontal cortex, basal ganglia, and thalamus. These brain regions may play various roles in controlling impulses and forming habits. On a chemical level, serotonin, an important brain neurotransmitter, may also be involved with obsessions. For example, an imbalance in serotonin levels may amplify obsessive thoughts.

While many people might occasionally have obsessive thoughts, it's the strength, length, and distress that come with these thoughts that turn them from mild concerns into significant clinical problems. Understanding the brain's complex networks and chemical signals may be key to figuring out why some thoughts become so dominant and intrusive.

Potential causes of obsessions may involve genetics, environmental factors, and certain life events. >

Genetics may have a significant impact on the development of obsessions. People with family history of OCD are more likely to have obsessions themselves. Research indicates that certain gene variations can play a part in starting the disorder, showing that genetic predispositions¹ or factors can increase the risk of developing obsessions.

Environmental factors and life events can also trigger or aggravate obsessions. Factors such as stress, trauma,² and significant life changes could lead to the development of obsessions or worsen existing ones. 

Obsessions vary widely, each with its own set of persistent, intrusive thoughts. Listed below are several common types of obsessions:

• Cleanliness or hygiene: A person might continuously worry about contamination or spreading germs, leading to excessive hand-washing or cleaning routines.
• Orderliness/organization: People with this type of obsession might have a strong urge for symmetry, order, or following certain rules, fearing that something dreadful might occur if things are not arranged correctly.
• Checking: The compulsive behavior of constantly checking things, such as doors, appliances, or switches, to ensure they are locked or turned off. This behavior is driven by the fear of consequences like fires, theft, or accidents.
• Counting: People with counting compulsions may repetitively count objects or perform actions a specific number of times to alleviate their anxiety and maintain a sense of order.
• Hoarding: An individual might struggle to throw items away, resulting in a messy and chaotic living space. People who hoard may be emotionally attached to objects or believe they will need them in the future.
• Harm or aggression: These obsessions involve unwanted thoughts or images of causing harm to oneself or others.
• Religious or moral obsessions: A person might excessively worry about committing a sin or violating moral principles, leading to compulsive behaviors like praying or seeking reassurance.
• Sexual: Intrusive sexual thoughts or images, which may include taboo or harmful fantasies, often cause significant distress to the affected individual.
• Body image: Obsessions about one's appearance, including perceived flaws or imperfections, can result in negative emotions and compulsive actions like mirror checking or excessive grooming.
• Health concerns: Individuals with health-related obsessions constantly worry about having or developing serious illnesses, leading to frequent medical appointments and self-exams.
• Superstitions: Obsessive beliefs in luck, omens, or other superstitions can drive compulsive rituals and avoidance behaviors.

Each type of obsession can significantly impact a person's life, and the presence of these thoughts may vary over time.

Although obsessions can occur alone, they can often be a symptom of different mental health conditions.

Obsessive-compulsive disorder

This is a long-lasting disorder where a person experiences uncontrollable, recurring thoughts (obsessions) and feels driven to engage in repetitive behaviors (compulsions) to alleviate their anxiety. Symptoms are time-consuming and can significantly interfere with daily life.

Hoarding disorder

Individuals affected by this condition have difficulty parting with possessions, regardless of their value. This can lead to excessive clutter in living spaces and create safety hazards. It’s often linked to anxiety and depressive disorders.

Body dysmorphic disorder (BDD)

Body dysmorphic disorder (BDD)³ is characterized by an individual's preoccupation with perceived flaws in their physical appearance, often leading to repetitive behaviors like mirror checking or avoiding social situations. This disorder can be related to anxiety disorders and depression.

Generalized anxiety disorder (GAD)

GAD involves excessive and persistent worry about various aspects of life. People with this disorder often experience fatigue, irritability, and muscle tension. It may coexist with OCD or other anxiety disorders like panic disorder, in which individuals experience sudden, intense episodes of fear and physical symptoms, such as heart palpitations, shortness of breath, and dizziness.

Autism spectrum disorder (ASD)

ASD is a neurodevelopmental disorder affecting an individual’s social interactions, communication, and behavior. While it’s not directly related to obsessions and compulsions, its core symptoms often include repetitive behaviors and restricted interests, which can overlap with some OCD symptoms.

Many people affected by obsessions and compulsions often struggle with coexisting mental health disorders. A mental healthcare provider might assess the severity and frequency of the obsessions, while also exploring any symptoms or behaviors that could indicate an underlying disorder.

If you’re experiencing obsessive thoughts or compulsive behavior that’s affecting your day-to-day life, it may be helpful to seek professional help to manage the symptoms, as it can be challenging to stop these thoughts or actions alone.

Several treatment options are available for individuals struggling with obsession. For example, cognitive behavioral therapy (CBT) is a well-established method that aims to change the thought patterns leading to obsessive behavior. A qualified mental health professional can provide guidance on the most suitable treatment options based on an individual's specific circumstances.

Obsession can be a challenging emotional experience that affects both the person obsessing and the subject of that obsession. Overcoming an obsession involves breaking repetitive thought patterns and redirecting thoughts and energy to more productive outlets. There are numerous strategies to help manage obsessive thoughts, ranging from psychological approaches to seeking support from professionals.