Obsessive Compulsive Disorder (OCD)
What Is OCD?
Like a skipping CD, someone with OCD gets trapped in cycles of repeated worrisome thoughts or images and the actions they feel they are needed to counter these anxiety producing thoughts.
Obsessive compulsive disorder, as the name implies, is a disorder characterized by obsessive thoughts and/or by compulsive actions.
Common obsessions can include an obsessive worry about germs, a worry that the stove, or iron is on, or a worry that you caused a traffic accident. This worry causes obsessive repetitive thoughts or images that come at inappropriate times and that won’t go away, often repeating over and over again. These repetitive obsessive thoughts are beyond control and unwanted; and although someone with OCD may know that the way they worry is abnormal, they can’t keep themselves from it.
People who experience obsessive thoughts often develop compulsive behaviors or rituals that they use to manage them; to make the thoughts go away. These rituals do not give pleasure; they simply help to alleviate worry and anxiety. Someone who worries about germs, may develop a hand washing compulsion, ritualistically washing their hands until red and raw, to control the anxiety they feel. Someone who worries about leaving the stove on may count to 100 back and forth as they continually test the stove, to ensure that is off.
The ritualized compulsive act temporarily neutralizes the anxiety, but must be repeated when the thoughts again intrude. This pattern of thought and action can become very time consuming, occupying hours each day.
What Are Some Common Obsessions and Compulsions?
Intrusive thoughts can occur about a wide range of topics, but there are certain topics that are more frequently encountered.
Common obsessive topics include:
- A fear of germs or dirt
- A fear of hurting someone else
- A fear of making a mistake
- A fear of hurting yourself
- Sexual thoughts
- Religious worries, worrying about bad thoughts
Common compulsions include:
- Hand or body washing rituals
- Counting rituals
- Touching rituals
- Rechecking rituals
- Repeating certain words, prayers of phrases
- Performing a ritualized task a set number of times
- Collecting meaningless items
Do You Have OCD?
To meet a diagnosis of OCD, a person must experience either obsession or compulsion (often both)
- Uncontrollable repetitive thoughts, images or urges that cause anxiety or worry and are felt to be intrusive. These worries are not simply an exaggerated response to realistic problems in life.
- The person tries to ignore or suppress these obsessive thoughts, or develops a compulsive action to manage the anxiety produced.
- The person realizes that the thoughts are produced by their own mind (not inserted in the mind)
- The development of repetitive ritualized behaviors or mental actions that are developed to manage obsessive thoughts
- These rituals are used to mange the anxiety produced from obsessive thoughts or to prevent a terrible occurrence from happening. They are not a realistic or effective response to a real-life problem; they are excessive.
The person must realize that their compulsions or obsessions are not reasonable (children excepted) and compulsions and obsessions cannot be caused by drug or alcohol use or the use of another medication, or from another mental health diagnosis.
There is no physiological test that reveals the disorder, and most people with OCD live for a long time with the condition and visit many different doctors before receiving an appropriate and helpful diagnosis. If you suspect that you or someone you love suffers from OCD, you should seek out an assessment from a mental health professional experienced in the evaluation and treatment of anxiety disorders.
Who Gets OCD, and How Is It Treated?
Males and females are equally susceptible to OCD and about 4.5 million Americans have the condition. The age of onset can be during childhood, the teenage years or early adulthood.
The causes of OCD remain elusive. Researchers suspect that the neurotransmitter serotonin (too little serotonin) plays a role but the exact mechanisms of the disorder aren’t yet known.
Twin studies indicate that the condition has a genetic base; having a close biological relative with OCD raises your risks slightly. Environmental factors, such as stressful life events, a death in the family or major illness can also increase a person’s susceptibility.
Sudden onset childhood OCD is sometimes caused by a recurrent streptococcus infection, such as strep throat.
How is OCD Treated?
Treatment options include medication and psychotherapies, often a combination of the two.
A class of anti depressant medications known as the SSRIs increases the amount of serotonin available in the brain and has been shown to reduce the severity of OCD symptoms. Examples of SSRIs include Zoloft, Paxil, Prozac and Luvox.
These medications can take a few weeks to become fully active in the body. People have different responses to these medications, and it can take some trial and error experimentation before your doctor finds the medication that works best for you and produces the fewest/least severe side effects. You should not expect an overnight solution and you should never stop taking any SSRI abruptly; this can lead to a withdrawal like syndrome of side effects.
Cognitive Behavioral Therapy (CBT) is the most commonly recommended psychotherapy for the treatment of OCD. Exposure therapy, a subset of CBT is commonly used to reduce the intensity of the anxiety produced by an obsessive thought and in doing so, to reduce the need to perform a compulsive ritual.
For example - a person who worries about germ contamination might, under a therapist’s guidance, work on shaking someone’s hand without then performing a compulsive ritual.
Exposure therapy can produce high levels of anxiety initially, but over time and with practice can greatly reduce the intensity of the anxiety experienced by intrusive thoughts or images.
OCD can be a debilitating disease and can greatly reduce quality of life, and it is vital to avail yourself of treatments that can help so much to reduce the severity of symptoms.
In addition to formal treatments, OCD patients can also take several self-help steps to improve their functioning; such as:
- Join a self help group
- Read up on the condition
- Follow your doctor’s advice and comply with therapy. Practice CBT techniques at home
- Get enough sleep
- Learn relaxation exercise, such as deep breathing or meditation, which can help you to control or manage any anxiety you experience
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