Home Health Symptoms, Causes, Treatment and More

Symptoms, Causes, Treatment and More

“Just right” obsessive-compulsive disorder (OCD) involves having obsessions and compulsions that involve feeling like something isn’t quite right.

Most people know the feeling that something is not quite right.

Maybe you walk into your kitchen and something just doesn’t seem right, and you realize it’s because your partner moved your toaster to a different counter. Or maybe you get into your car and something doesn’t feel quite right, and realize you’ve pushed your seat too far forward.

Most of us feel a little uncomfortable when something isn’t right. But for those with “just right” OCD, this nagging feeling can be persistent and deeply distressing.

People with “just right” OCD have obsessions and compulsions about something that is incomplete or incorrect.

For example, you may have obsessive thoughts that your floor isn’t completely clean, leading to a compulsion to clean the floor until it feels “just right.”

Or maybe you feel like your stapler isn’t in the right place on your desk, so you pick it up and put it down, repeating this compulsion until it feels “just right.”

“Just right” OCD can be disruptive to your day-to-day life, but as with all types of OCD, it is treatable.

In many cases, OCD involves an overwhelming fear of something. For example, you may be afraid that you will hurt someone or that your house will burn down. This fear can feed your obsessions and compulsions.

However, not all types of OCD are fear-driven. “Just right” OCD isn’t so much about anxiety as it is about the uncomfortable, gnawing feeling that something is:

  • incomplete
  • something off
  • not quite right

The obsessions aren’t always about avoiding a terrible outcome, but about getting rid of that uncomfortable feeling.

“Just right” OCD includes obsessive thoughts and compulsions fueled by the feeling that something is incomplete or slightly incorrect. This form of OCD is also known as Tourettic OCD (TOCD).

What is the difference or connection between perfectionism and ‘just right’ OCD?

Perfectionism is the idea that something can and should be perfect. Perfectionists often hold themselves and others to impossibly high standards and refuse to accept anything less than perfect.

OCD and perfectionism may be linked. Many OCD-related obsessions and compulsions are driven by the idea that something has to be perfect. In particular, “just right” OCD can resemble perfectionism.

Still, an important difference between OCD and perfectionism is that for those with OCD, intrusive, repetitive, and recurring behaviors and thoughts are unwanted and can cause significant distress, which is usually not the case for those with perfectionist tendencies.

In addition, those with perfectionist traits can expect others to follow the same high standards, while those with OCD tend to focus on their own behavior.

Experts also distinguish between ‘healthy’ (adaptive) and ‘unhealthy’ (maladaptive) perfectionism. Adaptive perfectionism can motivate people to do well, while maladaptive perfectionism focuses on past mistakes and the expectations of others.

Maladaptive perfectionism is the type of perfectionism more commonly seen in people with OCD. It can be grueling — especially if you feel like you can’t start or complete tasks because you’re afraid they won’t work perfectly.

Research from 2019 and 2020 suggests a link between maladaptive perfectionism and emotional dysregulation and depressive symptoms, respectively.

Still, it’s important to keep in mind that perfectionism isn’t a mental illness in and of itself, and not every perfectionist has OCD or vice versa.

What is the difference between tics and OCD?

As mentioned, “just right” OCD is also known as Touretic OCD. It can be difficult to distinguish between tic disorders and TOCD.

Tic disorders are characterized by involuntary, repetitive actions (called tics). Vocal tics may include:

Motor tics can include movements such as:

  • shocking
  • to tap
  • blinking
  • to jump
  • hopping

OCD – especially Touretic OCD – may resemble a tic disorder. One might repeat compulsions to get something “just right.”

For example, they may repeat a sentence over and over until it sounds correct, or they may pick up a pencil and put it down again to shake off the feeling that it is in the wrong place.

Someone may have a tic disorder and OCD. The diagnostic criteria for OCD in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) includes a specification to describe whether the person has a current or previous diagnosis of a tic disorder.

However, tic disorders and OCD are not the same things. According to the International OCD Foundation (IOCDF), OCD is “just right” more thought-based than tic disorders. Tic disorders are usually not fueled by obsessive thoughts that something is “not right.”

Tics and OCD can become more intense during times of stress.

The exact symptoms of “just right” OCD can vary from person to person.

“Just right” OCD is different from typical OCD. Typical OCD is usually based on the fear that something terrible will happen, while “just right” OCD is about feeling that something isn’t quite right.

So while typical OCD may be driven by fear or worry, OCD is “just right” accompanied by a disturbing sense of incompleteness.

The symptoms of “just right” OCD may include:

  • a nagging, persistent feeling that things are incomplete or just not right
  • fear of sights, smells, sounds, textures, tastes, or feelings that don’t seem right to you
  • repeating words, movements, or actions until something feels right (for example, repeating a word that sounds “off” or repeatedly touching the sleeve of your shirt because it doesn’t “feel right”)
  • not being able to identify exactly why something is wrong, incomplete, or incorrect
  • a strong urge to rearrange objects so that they are symmetrical or organized in a certain way

“Just right” OCD can interfere with daily tasks. You may get stuck on certain tasks that you have to repeat because they aren’t right for you (like writing the same email over and over).

Repeating tasks can take time, attention, and energy, making it difficult to function.

The causes of OCD are not always clear. A number of factors can increase your chances of developing OCD, such as:

  • Genetics. Genetics may play a role. OCD is a hereditary condition, meaning you’re more likely to get it if a close family member has it.
  • Personality. Certain personality traits, such as neuroticism, make you more likely to develop OCD.
  • Life changes and trauma. Major life changes or trauma can trigger OCD.
  • Other conditions. Other mental health conditions, such as anxiety disorders, can increase your chances of developing OCD.

In children, streptococcal bacteria can trigger an immune response called PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections), resulting in OCD-like symptoms.

Like other forms of OCD, “just right” OCD is treatable.

Usually, OCD is treated through talk therapy, including cognitive behavioral therapy (CBT).

A type of cognitive behavioral therapy (CBT), called exposure-response prevention (ERP), is especially common in OCD treatment. A 2019 review suggests it is effective for many people with OCD.

Other types of talk therapy, such as acceptance and commitment therapy (ACT), may also be helpful.

In some cases, a doctor may prescribe medications such as selective serotonin reuptake inhibitors (SSRIs) to treat OCD.

According to the IOCDF, treating “just right” OCD can be more difficult than treating typical OCD. This is because it is more difficult to deal with obsessions around the sense of incompleteness than it is to deal with obsessions around harm and fear.

It’s also more difficult to identify the triggers of “just right” OCD because it can be triggered by anything, while people with typical OCD tend to have more specific triggers.

Nevertheless, while it may be more challenging, “just right” is treatable OCD.

“Just right” OCD can be difficult to identify and challenging to live with, but it’s important to keep in mind that it can be treated. It is possible to live a happy and fulfilling life while having OCD.

A good first step is to find a therapist who has experience treating “just right” OCD.

You can also benefit from joining a support group. IOCDF provides a list of in-person support groups and online or telephone support groups to help you get started.

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