The Dangers of Double-Checking

Introduction: Obsessive-Compulsive Disorder

Do you feel the need to check and re-check things over and over? Do you have the same thoughts constantly? Do you feel a very strong need to perform certain rituals repeatedly and feel like you have no control over what you are doing?

If so, you may have a type of anxiety disorder called obsessive-compulsive disorder (OCD).

What is OCD?

Everyone double checks things sometimes. For example, you might double check to make sure the stove or iron is turned off before leaving the house. But people with OCD feel the need to check things repeatedly, or have certain thoughts or perform routines and rituals over and over. The thoughts and rituals associated with OCD cause distress and get in the way of daily life.

The frequent upsetting thoughts are called obsessions. To try to control them, a person will feel an overwhelming urge to repeat certain rituals or behaviors called compulsions. People with OCD can't control these obsessions and compulsions.

For many people, OCD starts during childhood or the teen years. Most people are diagnosed by about age 19. Symptoms of OCD may come and go and be better or worse at different times.

What causes OCD?

OCD sometimes runs in families, but no one knows for sure why some people have it, while others don't. Researchers have found that several parts of the brain are involved in obsessive thoughts and compulsive behavior, as well as fears and anxiety associated with them. By learning more about fear and anxiety in the brain, scientists may be able to create better treatments. Researchers are also looking for ways in which stress and environmental factors may play a role.

What are the signs and symptoms of OCD?

People with OCD generally:

• Have repeated thoughts or images about many different things, such as fear of germs, dirt, or intruders; acts of violence; hurting loved ones; sexual acts; conflicts with religious beliefs; or being overly tidy
• Do the same rituals over and over such as washing hands, locking and unlocking doors, counting, keeping unneeded items, or repeating the same steps again and again
• Can't control the unwanted thoughts and behaviors
• Don't get pleasure when performing the behaviors or rituals, but get brief relief from the anxiety the thoughts cause
• Spend at least 1 hour a day on the thoughts and rituals, which cause distress and get in the way of daily life.

How is OCD treated?

First, talk to your doctor about your symptoms. Your doctor should do an exam to make sure that another physical problem isn't causing the symptoms. The doctor may refer you to a mental health specialist.

OCD is generally treated with psychotherapy, medication, or both.

Psychotherapy. A type of psychotherapy called cognitive behavioral therapy (CBT) is especially useful for treating OCD. It teaches a person different ways of thinking, behaving, and reacting to situations that help him or her better manage obsessive thoughts, reduce compulsive behavior, and feel less anxious. One specific form of CBT, exposure and response prevention, has been shown to be helpful in reducing the intrusive thoughts and behaviors associated with OCD.

Medication. Doctors may also prescribe medication to help treat OCD. The most commonly prescribed medications for OCD are antidepressants. Although antidepressants are used to treat depression, they are also particularly helpful for OCD. They may take several weeks—10 to 12 weeks for some—to start working. Some of these medications may cause side effects such as headache, nausea, or difficulty sleeping. These side effects are usually not severe for most people, especially if the dose starts off low and is increased slowly over time. Talk to your doctor about any side effects you may have.

It’s important to know that although antidepressants can be safe and effective for many people, they may be risky for some, especially children,teens, and young adults. A “black box”—the most serious type of warning that a prescription drug can have—has been added to the labels of antidepressant medications. These labels warn people that antidepressants may cause some people to have suicidal thoughts or make suicide attempts.Anyone taking antidepressants should be monitored closely, especially when they first start treatment with medications.

In addition to prescribing antidepressants, doctors may prescribe other medications such as benzodiazepines to address the anxiety and distress that accompany OCD. Not all medications are effective for everyone. Talk to your doctor about the best treatment choice for you.

Combination. Some people with OCD do better with CBT, especially exposure and response prevention. Others do better with medication. Still others do best with a combination of the two. Many studies have shown that combining CBT with medication is the best approach for treating OCD, particularly in children and adolescents. Talk with your doctor about the best treatment for you.

What is it like having OCD?

"I couldn't do anything without rituals. They invaded every aspect of my life. Counting really bogged me down. I would wash my hair three times as opposed to once because three was a good luck number and one wasn't. It took me longer to read because I'd count the lines in a paragraph. When I set my alarm at night, I had to set it to a number that wouldn't add up to a 'bad' number."

"Getting dressed in the morning was tough, because I had a routine, and if I didn't follow the routine, I'd get anxious and would have to get dressed again. I always worried that if I didn't do something, my parents were going to die. I'd have these terrible thoughts of harming my parents. I knew that was completely irrational, but the thoughts triggered more anxiety and more senseless behavior. Because of the time I spent on rituals, I was unable to do a lot of things that were important to me."

https://www.nimh.nih.gov/health/publications/obsessive-compulsive-disorder-when-unwanted-thoughts-take-over/index.shtml

Checking and rechecking fogs the memory, making it harder to recall specifics and leaving your memory in doubt.

Did I remember to turn the stove off? I'll check one more time. Do I still have the plane tickets with me? I'd better look again. Did I remember to lock the front door? I should really get out of bed and make absolutely sure.

We all feel the need to double-check sometimes, to reassure ourselves that we didn't overlook something crucial or neglect a possibly dangerous problem. When we're under pressure or worried about something, it's especially common to double- or even triple-check. That's normal, but for many people, the habit of repeated checking becomes a dangerous and undermining habit.

For people with obsessive-compulsive disorder, checking can consume hours every day, driven by intense fears of unlikely scenarios. A teacher continually searches the floor, obsessed with the idea that a dropped needle or pin lurking in the carpeting might injure her students. A man spends two hours every morning verifying that all the doors, windows and electrical plugs of his apartment are normal before he leaves for work.

These are extreme cases. But mildly anxious or worried people may get caught in similar unhappy loops. "If I look once more," they tell themselves, "I'll be sure everything is OK."

Yet the double-checking doesn't solve the problem. People feel better for a moment, but soon the worry creeps back—and builds. Doubt grows: did I really turn off the burner? The worrier searches his mind, and finds only uncertainty.

Why does double-checking backfire? According to psychologist Adam Radomsky of Quebec's Concordia University, repeated checking actually fosters doubt by making it harder to remember.

In one study, his team of researchers asked ordinary college students to first turn off, then repeatedly check an electric stove set up in the testing lab. Afterward, the students were asked whether or not the stove had been turned off, how clear their memory was of the situation, and how sure they were that they remembered accurately what had happened.

Students who checked the stove 10 or 15 times correctly remembered that it was off—but the memory was nowhere near as vivid, and they had much less confidence in their own memory. Because of the checking, they began to doubt what they had seen with their own eyes.

"The more you check something, the less vivid and less detailed it is, and the less confident you are in your memory," says Radomsky. "Checking, which is supposed to make you more confident in what's going on, makes you less confident."

Double-checking fogs memory because instead of a clear, memorable, one-time occurrence, the checker is confronted with a series of similar events that tend to blur together. It's much harder to recall the specifics after repeating the same action 10 or 15 times. That's when doubt sneaks in.

Continually looking for reassurance is a close cousin to double-checking; it, too, can amplify health fears and other worries. An anxious person concerned about a minor medical symptom that had already been examined by a doctor often continues to seek more information in the hopes of calming his or her fear. The new information is temporarily reassuring, but the effect soon wears off, and the worrier starts looking for more reassurance. Trouble is, she's searching for something she'll never find—absolute certainty.

People with full-blown OCD can often be helped with drugs or through cognitive and behavioral therapy, in which they learn to tolerate anxiety, change fearful thinking, and gradually abandon the habit of checking. Guided by a therapist, they eventually come to realize that they shouldn't give in to the temptation to double-check, especially when it's the thing they most want to do.

Those who may not have OCD, but are bothered by their own tendency to check and worry can also learn to master the habit. Books such as Getting Control: Overcoming Your Obsessions and Compulsions by Harvard psychologist Lee Baer, or When Once Is Not Enough: Help for Obsessive-Compulsives, by Boston University psychologist Gail Steketee and psychiatrist Kerrin White, provide helpful strategies.

https://www.psychologytoday.com/articles/200603/the-dangers-double-checking

Introduction To Obsessive-Compulsive Spectrum Disorders\

What is an Obsessive-Compulsive Disorder?

Obsessive-compulsive spectrum disorders are a group of similar psychiatric disorders characterized by repetitive thoughts, distressing emotions, and compulsive behaviors. The specific types of thoughts, emotions, and behaviors vary according to each disorder

ome examples of these disorders include:

1. Obsessive-compulsive disorder (OCD).
2. Body dysmorphic disorder (BDD).
3. Hoarding disorder.
4. Hair-pulling disorder (trichotillomania).
5. Skin-picking disorder (excoriation).

What are Obsessions?

Obsessions are recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted. Common obsessional themes include:

• Concerns about contamination.
• Harm happening to oneself or others.
• Intrusive sexual thoughts.
• Religious preoccupation and rituals.
• Repeated and excessive doubts about safety and security.
• The need for symmetry and order.
• Perfectionism.

Because obsessions are unwanted, they create anxiety and distress when they occur. To reduce this discomfort people perform compulsions.

What are Compulsions?

Compulsions are behaviors or mental acts that a person feels "driven" to perform in response to an obsession. Common compulsions include:

• Excessive hand-washing.
• Re-ordering objects in a specific way.
• Checking on safety and security (a door lock, an electric appliance).
• Counting (aloud or silently).
• The ritualistic repetition of prayers in one's mind.

Obsessive-compulsive spectrum disorders share many similar features. However, there are also important differences. The following example illustrates the importance of these differences.

https://www.mentalhelp.net/articles/about-introduction-to-obsessive-compulsive-spectrum-disorders/