Is It OCD? Repetitive Thoughts and Behaviors

Q: Is It OCD? Repetitive Thoughts and Behaviors

Hello： It seems that she has been troubled by this uncomfortable feeling in her head for some time. <br>It is indeed possible that it could be a symptom of obsessive-compulsive disorder (OCD), but a face-to-face evaluation is necessary for a definitive diagnosis. <br>The techniqu

Is this obsessive-compulsive disorder (OCD)?

Hello, doctor! I have a relative (20 years old) who repeatedly questions whether she is her parents' biological child and frequently checks with them about certain physical traits to see if they align with dominant and recessive inheritance patterns (like whether she has dimples, for example).
Even after confirming this and feeling a sense of calm (she feels reassured and happy at that moment), she finds herself worrying again a few hours later, creating an infinite cycle.
Although she feels distressed and wants to break free, she feels trapped, which has led to a loss of appetite and poor sleep quality.
She reports that new intrusive thoughts continuously invade her mind, and even though she is reluctant to continue thinking about them, she cannot stop.
When her test results align with her expectations, she feels normal and is generally a cheerful person; however, if the results do not meet her expectations, she falls into a low mood.
Her parents had her DNA tested when she was younger and assured her that she is 100% their biological child.
Logically, she understands this, but she still feels fear and anxiety.
Recently, she has become fixated on a story she read as a child about parents adopting the child of an enemy, and she worries about what would happen if she found herself in such a situation.
She questions whether she might do something morally wrong, and although she finds these thoughts absurd, she cannot stop worrying.
She has started to repeatedly check her birth certificate and obsessively scrutinize every word to determine the document's authenticity, feeling relieved only when it aligns with her expectations.
She is in distress and desperately wants to find relief.
Before this situation escalated, she expressed a deep love for her mother and often thought about how she would do anything to ensure her mother's safety; their relationship is not strained.
This cycle of worry began when she discovered she could roll her tongue, and at that moment, she was indeed busy and did not have time to adjust her emotions, leading to an outburst.
She has experienced some obsessive thoughts and behaviors before, but never to this extent; previously, she managed to process them internally.
This time, her family noticed her unusual behavior, prompting her to start her cycle of repeated checks.
I would like to ask how I can help her? How can she change her mindset? Is this a symptom of obsessive-compulsive disorder or something else? Thank you!

Xiao Xiao, 20~29 year old female. Ask Date: 2021/05/14

Dr. Liang Sunyuan reply Psychiatry

Hello: It seems that she has been troubled by this uncomfortable feeling in her head for some time.
It is indeed possible that it could be a symptom of obsessive-compulsive disorder (OCD), but a face-to-face evaluation is necessary for a definitive diagnosis.
The technique of cognitive reframing often involves redirecting attention to her interests or other tasks she wishes to accomplish.
If she continues to feel significantly distressed, it is advisable to seek medical assistance.

Reply Date: 2021/05/14

More Info

Understanding the complexities of mental health, particularly conditions like Obsessive-Compulsive Disorder (OCD), can be quite challenging. Based on the description of your relative's experiences, it appears that she is grappling with symptoms that are characteristic of OCD. OCD is a mental health condition marked by persistent, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that individuals feel driven to perform in response to their obsessions.

In your relative's case, her compulsive behavior of repeatedly confirming her biological connection to her parents and checking physical traits aligns with the compulsive aspect of OCD. The cycle of reassurance-seeking—where she feels temporarily relieved after confirming her concerns but then quickly falls back into anxiety—further illustrates the nature of OCD. This cycle can be exhausting and distressing, leading to significant impairment in daily functioning, as you've noted with her loss of appetite and poor sleep quality.

The fact that she understands rationally that she is indeed her parents' biological child, yet still feels compelled to seek reassurance, highlights a common feature of OCD: the inability to trust one's own thoughts and feelings. This can lead to a relentless pursuit of certainty, which is often unattainable. The new obsession with the idea of being adopted or the fear of acting immorally, despite her loving relationship with her mother, indicates that her mind is fixating on irrational fears, which is another hallmark of OCD.

To help your relative, it is crucial to encourage her to seek professional help. A mental health professional, particularly one experienced in treating OCD, can provide her with the necessary support and treatment options. Cognitive-Behavioral Therapy (CBT), especially a specific type called Exposure and Response Prevention (ERP), is considered the gold standard for treating OCD. ERP involves gradually exposing the individual to their fears while helping them refrain from engaging in compulsive behaviors, thereby reducing anxiety over time.

In addition to therapy, medication may also be beneficial. Selective Serotonin Reuptake Inhibitors (SSRIs) are commonly prescribed for OCD and can help alleviate symptoms by increasing serotonin levels in the brain. A psychiatrist can evaluate her situation and determine if medication is appropriate.

As a supportive friend or family member, you can help by being patient and understanding. Encourage her to express her feelings and fears without judgment. It’s important to avoid engaging in reassurance-seeking behaviors with her, as this can reinforce the cycle of OCD. Instead, gently remind her of the rational understanding she has about her situation and encourage her to focus on her treatment.

In summary, while your relative's symptoms do appear to align with OCD, a thorough evaluation by a mental health professional is essential for an accurate diagnosis and appropriate treatment plan. Supporting her in seeking help and being there for her during this challenging time can make a significant difference in her journey toward recovery.

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