Obsessive Compulsive Disorder

Obsessive-compulsive disorder (OCD) is an anxiety disorder. People suffering from this condition have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do something repetitively. Examples of repetitive behaviors are hand washing, checking on things or cleaning. These behaviors can seriously interfere with a person’s daily activities and social interactions.

There are many people who have focused thoughts or repetitive behaviors. However, these behaviors do not alter their daily life. In case of the people suffering from OCD, their thoughts are persistent. Moreover, unwanted routines and behaviors are rigid. For these people, not doing them causes great distress. Many people with OCD consider that their obsessions are not true. There are others who may think they could be true (known as poor insight). Even if they know their obsessions are not true, people with OCD have a hard time keeping their focus off the obsessions or stopping the compulsive actions.

Signs and Symptoms

There are people with OCD who have symptoms of obsessions. Others have signs of compulsions, but there are also some who have both. These symptoms can interfere with all aspects of life, such as work, school, and personal relationships.

The literature defines obsessions as repeated thoughts, urges, or mental images that cause anxiety. The common symptoms for obsessions include:

  • Fear of germs or contamination
  • Unwanted forbidden or taboo thoughts involving sex, religion, and harm
  • Aggressive thoughts towards others or self
  • Having things symmetrical or in a perfect order

On the other hand, compulsions are repetitive behaviors that a person with OCD feels the urge to do in response to an obsessive thought. The most common compulsions include:

  • Excessive cleaning and/or handwashing
  • Ordering and arranging things in a particular, precise way
  • Repeatedly checking on things, such as repeatedly checking to see if the door is locked or that the oven is off
  • Compulsive counting

However, not all rituals or habits are compulsions. Even though everyone double checks things sometimes, a person with OCD does things a bit more different, like:

  • Can’t control his or her thoughts or behaviors, even when those thoughts or behaviors are recognized as excessive
  • Spends at least 1 hour a day on these thoughts or behaviors
  • Doesn’t get pleasure when performing the behaviors or rituals, but may feel brief relief from the anxiety the thoughts cause
  • Experiences significant problems in their daily life due to these thoughts or behaviors

In some cases, individuals with OCD have a tic disorder. Motor tics are sudden, brief, and repetitive movements. Think for example the eye blinking and other eye movements, facial grimacing, shoulder shrugging, and head or shoulder jerking. There are some people who have vocal tics. These include repetitive throat-clearing, sniffing, or grunting sounds.

The symptoms do not keep the same intensity all the time. There are symptoms that come and go, ease over time, or worsen. Usually, people with OCD try to help themselves from embarrassing situations. Therefore, they may use alcohol or drugs to calm themselves.

The most common thoughts, physical feelings or emotions that people with OCD experience are the following:

Thoughts:

  • I’m responsible for that accident
  • What if I get sick?
  • If I don’t get an A on this paper my future is ruined
  • Am I attracted to that guy? Do I find him good looking? This must mean i’m gay
  • What if I’m sick but I don’t know it and then I get my parents sick when I touch them?
  • I can’t stand not knowing!

Physical feelings:

  • Stomachaches
  • Dizziness
  • Shallow breathing
  • Racing heart
  • Shortness of breath
  • Headaches
  • Muscle tension
  • Feeling detached from one’s body (derealization)

Emotions:

  • Anxiety/worry/fear
  • Shame
  • Anger/rage
  • Sadness
  • Guilt

Behaviors:

  • Asking parents to buy extra toilet paper or cleaning supplies
  • Washing hands and body excessively
  • Making parents wash their hands before making a meal
  • Doubting something has been done correctly
  • Checking with parents that s/he didn’t make a mistake
  • Repeating certain phrases in multiples of 2 or 4
  • Avoiding touching doorknobs, handles, etc.

Causes

Even though obsessive compulsive disorder is a condition that affects 1.2% of Americans, its causes are not yet fully understood. There are, however, some theories that consider the main causes of OCD as being the following:

  • Biology. OCD may be a result of changes in your body’s own natural chemistry or brain functions.
  • Genetics. OCD may have a genetic component, but specific genes have yet to be identified. The studies made on twins and family have shown that people with first-degree relatives who have OCD are at a higher risk for developing this condition themselves. The risk is higher if the first-degree relative developed OCD as a child or teen. However, the studies are still ongoing and there is yet no clear connection between OCD and genetics.
  • Environment. Some environmental factors such as infections are suggested as a trigger for OCD, but more research is needed. In most of the cases, people who have experienced abuse or other trauma in childhood are more likely to develop OCD when they are adults.

Risk factors

There are several factors that may increase the risk of developing or triggering obsessive-compulsive disorder:

  • Family history. As we already mentioned, when first-degree relatives have this disorder, the risk for you to develop OCD is higher.
  • Stressful life events. If you’ve experienced traumatic or stressful events, your risk may increase.
  • Other mental health disorders. OCD may be related to other mental health disorders, such as anxiety disorders, depression, substance abuse or tic disorders.

Complications

OCD can bring some complications such as:

  • Health issues, such as contact dermatitis from frequent hand-washing
  • Inability to attend work, school or social activities
  • Troubled relationships
  • Overall poor quality of life
  • Suicidal thoughts and behavior

Treatment

Even though there is no curing for OCD yet, there are several methods that can help people control this disease. There are some people who may need treatment for the rest of their life. Therefore, it is very important to listen to your doctor and stick to what he recommends you. There are several ways of treatment, depending on how serious and advanced the disease is.

Psychotherapy

Many people with OCD follow the cognitive behavioral therapy (CBT). One efficient type of CBD is exposure and response prevention (ERP). It means that you will be gradually exposed to a feared object or obsession, such as dirt. This method will help you identify and learn healthy ways to cope with your anxiety.

Medications

Your doctor may recommend you certain psychiatric medications to help you cope with this condition. There are several antidepressants approved by the Food and Drug Administration (FDA) which proved to be very effective in treating OCD. They include:

  • Clomipramine which works for adults and children 10 years and older
  • Fluoxetine is great for adults and children 7 years and older
  • Fluvoxamine for adults and children 8 years and older
  • Paroxetine recommended for adults only
  • Sertraline for adults and children 6 years and older

References:

https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml

https://www.psychiatry.org/patients-families/ocd/what-is-obsessive-compulsive-disorder

http://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/diagnosis-treatment/treatment/txc-20245962

http://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/diagnosis-treatment/treatment/txc-20245962

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