Can OCD be considered a delusional disorder?

[lammers1980]

I was just pondering this question lately and I thought I'd ask it to the general audience here. I myself suffer from OCD to varying degrees, and it almost always involves contamination fears regarding AIDS.

The reason I bring up the idea of delusion is that my mind often invents things that are not true, but cannot be dismissed, regardless of evidence to the contrary. No matter how many times I look, I still get scared I'll sit on a needle in a public place. Sometimes I will think I did, even if I didn't see or feel one. I often think that somehow I will become infected and not even know how, as if I had amnesia.

There are even times that I do get convinced that I have HIV, even though there is no rational reason to believe it. This seems like delusional thinking to me.

 

[David Baxter PhD]

It's not really delusional thinking, in my opinion.

I would characterize it more as "worrying gone wild" -- an overreacting "flight-fight reaction", which is often based on some genuine worry.

For example, it would be foolish these days NOT to worry somewhat about diseases like HIV -- most people are able to frame that worry as a worry and not overreact to it. The physiology of the OCD sufferer is such that the worry goes out of control, takes on special "predictive" powers, and goes into a sort of vicious cycle of overreaction generating more worry stimulating the fight-flight reaction further and etc., etc.

 

[dog5000]

Twice in my lifetime, I convinced myself that I had HIV or AIDS despite the fact that the chances of me actually having the disease were pretty much 0. The powers of my imagination combined with my OCD made me believe that I was infected--it was worrying gone wild! I invented situations in which the seat I was sitting on in lecture was somehow contaminated with HIV and just by sitting on the seat, I would somehow get the disease. I still do this from time to time--I try hard to fence in my imagination and not let the OCD get the better of me. I also don't think it's delusional--it's just your fears wreaking havoc. Everybody has fears, but with OCD, they're just more prevalent. We notice them more than those who don't have OCD. Thanks for posting an interesting topic!

 

[DeusExObsessional]

In the course of my OCD I have thought I have had:

* Brain tumor (several)
* Appendicitis
* Cancer
* Muscle damage to my left arm
* 'Skeletal calcium loss'

I eventually realized when at the age of 22 I would lie awake in bed at night worrying that my bones were deteriorating that I might have a little bit of a mental problem. But even my shrink said that these sorts of thoughts aren't 'delusional'. He said a delusion is when you can't realize how ridiculous your thoughts are, or at least even accept the possibility that what you think is true, isn't.

I think that's why people with OCD aren’t called 'psychotic', because they still have a 'reality test', they just cant control their thoughts.

 

[David Baxter PhD]

Exactly. OCD is normal worrying spiraling out of control.

 

[Tempered Tense]

Wow, this thread actualy sort of answers my question...in a way. Though my obsession, or rather persistant fear is so bizarre that I still question it. I do agree that OCD in general is worrying gone wild. However I have heard or rather read about a fairly new diagnosis: OCD with delusional disorder or with delusions, where the person is often times unaware that their obsessions are unrealistic. I know this thread is old though.

 

[lammers1980]

Wow, this thread actualy sort of answers my question...in a way. Though my obsession, or rather persistant fear is so bizarre that I still question it. I do agree that OCD in general is worrying gone wild. However I have heard or rather read about a fairly new diagnosis: OCD with delusional disorder or with delusions, where the person is often times unaware that their obsessions are unrealistic. I know this thread is old though.

I could see how such a diagnosis can occur. For instance, sometimes when I have a very persistent obsession, I start to believe that the "what if" may have actually occured, if only temporarily. I could see how someone could lose all perspective and have their obsession cross the line into delusion. To me, an obsession is like a transluscent delusion, one which is definitely visible, and which obscures yet does not completely block out reality. That is the only way I can describe it.

 

[Tempered Tense]

Very true indeed. I believe there are many different levels of severity when it comes to obsessions. From mild to severe. I can see how it may be possible if one was experiencing a very severe form of obsession, that it may even if temporarily mirror a delusion. I think at some point though , they eventualy come down and realize that it isn't real.

 

[mico]

Can OCD be considered a delusional disorder

I have read that ocd has something to do with a defect in the frontal lobes of the brain. I've also heard that the part of the brain that is responsible for filtering out inappropriate thoughts or sensations fails to work and the mind gets flooded with anxieties. If this is true, can ocd be cured by simply ignoring the content of the worries?

 

[David Baxter PhD]

I have read that ocd has something to do with a defect in the frontal lobes of the brain. I've also heard that the part of the brain that is responsible for filtering out inappropriate thoughts or sensations fails to work and the mind gets flooded with anxieties. If this is true, can ocd be cured by simply ignoring the content of the worries?

At this point, those should be considered interesting hypotheses rather than conclusive.

I'm not sure the cure is "simply ignoring" but OCD can be helped by the use of techniques like cognitive reframing and improved stress and anxiety management. I think medication in the initial stages of treatment is also important.