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This isn’t me—it’s OCD.
Do you have thoughts that repeat themselves over and over? Are you 
plagued by repetitious habits that are getting out of control? If so, you may 
have a problem called obsessive-compulsive disorder (OCD). Just by 
distinguishing constructive worries from unfounded obsessions and healthy 
habits from unnecessary compulsion, you can start to change! Excessive 
concern about doing something wrong, being sick, hurting others, looking 
just right, saving things, being clean, orderly, or germ-free, and preventing 
misfortune are common sources of obsessions and compulsions.

Relabeling concerns and tiresome habits as obsessions and compulsions 
reduces their power and sets the stage for change:

I know my fear that dirt will infect me is just an obsession and that my hands 
aren’t actually contaminated, even though I’m compulsively washing them.

DISTINGUISH OCD FROM RELATED DISORDERS

OCD is easy to confuse with related disorders. Misdiagnosis can cause 
additional worries and delay proper treatment. Knowing what OCD is not will 
help relabel what actually is troubling you or help you find additional 
needed treatment:

• Depression can cause people to have repetitive thoughts of being 
  bad, defective, or unworthy. Excessive feelings of guilt, self-hate, and 
  shame are a part of depression. In more severe cases, people may 
  seriously consider suicide. Although, people with OCD fear that they 
  may hurt themselves, they have no desire to do so. The stress of 
  OCD can lead to symptoms of depression: decreased energy, 
  interest, and desire to be with people and even crying spells.

• Panic disorder can cause people to have constant concern about 
  dying, going crazy, or appearing foolish because of unnecessary 
  concern about symptoms that result from a surge of adrenaline. 
  When people with OCD are unable to (perform rituals that) ensure 
  cleanliness, safety, and security, they may feel such intense anxiety 
  that they panic.

• Trichotillomania causes people to repeatedly pull out their hair 
  resulting in noticeable loss. Because low levels of the 
  neurotransmitter serotonin may be a factor in trichotillomania, OCD, 
  panic disorder, and depression, the same medications can reduce 
  symptoms in each of them.

• Problems with impulse control can cause people to give in to urges. 
  Yielding to cravings to overeat, have sex, spend money, or gamble 
  temporarily relieves stress. People with OCD strive for perfection and 
  are constantly battling the possibility of “undesired” impulse. Rather 
  than indulging impulses, they are often overcontrolled.

• Personality disorders can cause people to act compulsively. They 
  may clean, wash, check, or hoard unnecessarily. Instead of feeling 
  exhausted, they feel good about their rituals or they place many 
  demands on others. Their compulsions may help them avoid feeling 
  worthless or having contact with others.

• Neurological tics cause repetitive movements and sounds. These 
  happen automatically and have no thought or intention associated 
  with them. Compulsions are purposeful and attempt to relieve anxiety 
  related to an obsessive thought. Often, people with tics also have 
  obsessions and compulsions. In both conditions, the part of the brain 
  that controls muscle movement and error detection may not be 
  properly regulated. However, obsessions and compulsions can fade 
  when they are postponed, but the “urge” to tic increases when it is 
  delayed. Therefore, each of these problems requires different 
  treatment approaches.

Tic Checklist

Directions: Help recognize repetitious behaviors that are tics rather than 
compulsions. Check any of the following that you do.

Simple motor:

Eye blinks
Jaw jerks
Arm movements
Grimacing        
Eye widening
Hand jerks
Finger movement
Tongue thrusting        
Nodding
Shoulder jerks
Leg movements
Tensing body parts        
Head turning
Stomach jerks
Other:

Complex motor:

Tapping
Hopping
Stomping
Squinting        
Hitting self
Slamming things
Pushing on eyes
Grooming hair        
Funny expressions
Cracking joints
Touching body parts
Counting        
Obscene gestures
Picking at things
Other:

Simple vocal:

Coughing
Hawking
Squeaking        
Snorting
Grunting
Squealing        
Throat clearing
Gnashing teeth
Blowing across upper lip        
“Aaaaaa”
“Ttttuh”
“Uh uh uh”
Other:

 

Complex vocal:

“Uh huh”
“You bet”
“All right”
“Yeah, yeah”        
Swearing
Racial slurs
Common insults
Obscene noises        
Repeating sentences after others        
Repeating one’s own sentences
Other

Sometimes, people can be trained to substitute an inconspicuous toe twitch 
for more obvious tics.  “Practicing” a tic at a convenient time may reduce 
the need to produce it when it would be bothersome.  The same 
medications are not generally used to treat tics and OCD.

TOURETTE RESOURCES

Tourette Syndrome (TS) is a neurological disorder characterized by tics—
involuntary, rapid, sudden movements, or vocalizations that occur 
repeatedly in the same way. The cause is genetic and may be related to 
how the neurotransmitters, dopamine and serotonin are used in the body.

For further information see:

Http://members.tripod.com/~tourette13
www.fairlite.com/trich

alt.support.tourette—an online newsgroup dedicated to Tourette Syndrome.

Living with Tourette Syndrome by Elaine Shimberg, (Simon & Schuster, 
1995).

Children with Tourette Syndrome, A Parent’s Guide by Tracy Haerle and 
Eisenreich, (Woodbine House, 1992).


Reference

Jeffrey M. Schwartz identifies relabeling as one of the “4-R’s of recovery” 
from OCD in his book Brain Lock (HarperCollins, 1996). The rhyme “This 
isn’t me, it’s my OCD” also comes from Brain Lock.