Understanding Obsessive-Compulsive Disorder

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Obsessive-compulsive disorder (OCD) is a common mental condition marked by obsessive thoughts and compulsive behaviors. It is a psychological condition in which people have recurring, intrusive thoughts, ideas, or sensations (obsessions). OCD is typically a life-long (chronic) illness, but symptoms may appear and disappear over time.

Obsessions and compulsions affect everyone at some point in their lives. We usually check the stove or the locks twice. People also casually use the phrases "obsessing" and "obsessed" in everyday conversations. However, OCD is more severe. It can consume hours of a person's time. It interferes with normal life and activities. Obsessions with OCD are unwelcome, and people with OCD dislike engaging in compulsive behaviors.1 Many people who do not have OCD experience distressing thoughts or repetitive behaviors. However, these are not usually disruptive to daily life. Thoughts are persistent and intrusive in people with OCD, and behaviors are rigid. Not performing the behaviors frequently causes significant distress, which is frequently linked to a specific fear of serious consequences (to oneself or loved ones) if the behaviors are not completed. Many people with OCD are aware or suspect that their obsessional thoughts are not believable; others may believe they are true. Even if they are aware that their intrusive thoughts are unreal, people with OCD struggle to disengage from the obsessive thoughts or quit the compulsive behaviors.

Men and women, as well as children, can suffer from OCD. Some people develop symptoms as early as adolescence, but it is more common in early adulthood. OCD can be disturbing and interfere with your life a lot, but treatment can help you stay under control.2

Symptoms of obsessive-compulsive disorder (OCD)

The primary symptoms of OCD are obsessions and compulsions that interfere with daily activities. Symptoms, for example, may frequently prevent you from arriving at work on time. Alternatively, you may struggle to get ready for bed in a sufficient amount of time. You may be aware that these symptoms are troubling, but you have no control over them. OCD symptoms may come and go, improve, or get worse over time.3 If you or your child are having OCD symptoms that are interfering with your/their daily life, you should see a specialist.

Obsessions

Obsessions are persistent thoughts, urges, or visions that bring on unpleasant feelings like fear, anger, and worry. Many OCD sufferers are aware that these excessive or unreasonable thoughts and behaviors are the result of their minds. Unfortunately, using logic or reasoning cannot lessen the discomfort these intrusive thoughts cause. The majority of OCD patients utilize compulsions to calm their uncomfortable obsessional thoughts or to disprove any perceived dangers. People might also make an effort to repress or dismiss their obsessions, or they might try to focus on something else.4 Common examples include:

  • The fear of coming into contact with contaminated substances, such as germs or dirt.
  • Fear of causing harm to yourself or others because you are not being careful enough or will act on a violent impulse.
  • Unwanted sex-related thoughts or mental images.
  • Fear of making a blunder.
  • Excessive moral concern ("right or wrong").
  • Feelings of distrust or disgust.
  • Concerns about your sexual orientation or gender identity are out of proportion.
  • The desire for order, neatness, symmetry, or perfection.
  • Constant reassurance is necessary.

Compulsions

An obsession-related compulsion causes a person to engage in recurrent behavioral or mental behaviors. An individual's obsession-related distress is typically temporarily relieved or stopped by the behaviors, and they are then more prone to repeat them in the future. Compulsions might include overreacting in ways that are either completely unrelated to an obsession or explicitly related to it (for example, washing one's hands excessively out of fear of contamination). In the worst cases, a day could be filled with repetitive procedures that prevent you from carrying out your regular activities.5 Compulsions include:

  • Hand washing, showering, brushing teeth, or toileting that is excessive or ritualized
  • Cleaning of household items regularly
  • Arranging or ordering things in a specific order
  • Checking locks, switches, appliances, doors, and so regularly.
  • Always looking for approval or reassurance
  • Number-related rituals, such as counting, repeating, excessively preferencing, or avoiding specific numbers
  • People with OCD may also avoid people, places, or situations that cause them distress and, as a result, trigger obsessions and/or compulsions. Avoiding these things may worsen their ability to function in life and may be harmful to other aspects of their mental or physical health.

Causes of Obsessive-Compulsive Disorder (OCD)

Researchers aren't sure what causes OCD. However, they believe that several factors, including:

  • Family History: if a family member has OCD, you are more likely to develop it, possibly due to genetic differences in the brain. some people with OCD have areas of unusually high activity in their brains or low levels of a chemical called serotonin.
  • Life Events: OCD is more common in people who have been harassed, abused, or neglected, and it can begin after a major life event such as childbirth or bereavement.
  • Personality: neat, diligent, systematic, and logical people with high personal standards, as well as people who are generally quite anxious or have a significant sense of responsibility for themselves and others, are more likely to develop OCD.
  • Childhood trauma: Some studies link childhood trauma, such as abuse or neglect, to the development of OCD.6

Treatment Options for Obsessive-Compulsive (OCD)

After receiving appropriate treatment for their OCD, clients usually experience improvements in their functioning and quality of life. Treatment may enhance a person's ability to perform at work and school, create and value relationships, and engage in leisure activities. Options for treatment include:

Psychotherapy

The term "psychotherapy," commonly known as "talk therapy," refers to several therapeutic procedures that aim to help you in recognizing and altering undesirable feelings, ideas, and actions. You connect with a mental health specialist, like a psychologist or counselor. There are many forms of psychotherapy but the most common and effective therapy for treating OCD is as follows:7

  • Cognitive behavioral therapy (CBT): A therapist will work with you to evaluate and understand your ideas and feelings during CBT. During the course of several sessions, CBT can help in changing destructive ideas and stopping bad habits, possibly in replacement for better coping skills.
  • Exposure and response prevention (ERP): With ERP, a therapist has you confront your feared events or visuals while asking you to fight the desire to carry out a compulsion. For instance, your therapist might instruct you to handle filthy objects but restrict you from washing your hands afterward. You discover that your nervous thoughts are merely thoughts and not necessarily reality by remaining in a dreaded circumstance without anything bad happening.
  • Acceptance and commitment therapy (ACT): ACT teaches you to remove the power of obsessive ideas by learning to accept them as simple thoughts. You can learn to live a purposeful life despite your OCD symptoms with the support of an ACT therapist.

Medications

Certain psychiatric medications can be used to control the obsessions and compulsions of OCD. Usually, antidepressants are used first. A group of medications called selective serotonin reuptake inhibitors (SSRIs), which are typically recommended to treat depression, can effectively cure OCD. When treating OCD, SSRI dosages are frequently higher than when treating depression. The full benefit usually takes six to twelve weeks or longer to become apparent. Depending on the client's preference, cognitive capacity, and level of insight, as well as the presence or absence of co-occurring mental illnesses, clients with mild to moderate OCD symptoms are often treated with either CBT or medication.8 Other treatment options may also be available.

Psychologist

Ms Lanurse Chen is a counselling psychologist who received her professional training in Australia. Over her decade long career as a psychologist in a local tertiary hospital, she has worked extensively with individuals, ranging from young adults to elderly, presented with anxiety, depression, OCD, trauma, grief and loss, pain as well as adjustment issues.



References

1.Stein, D. J. (2002). Obsessive-compulsive disorder. The Lancet, 360(9330), 397-405. https://doi.org/10.1016/S0140-6736(02)09620-4

2. Stein, D. J., Costa, D. L., Lochner, C., Miguel, E. C., Reddy, Y. J., Shavitt, R. G., ... & Simpson, H. B. (2019). Obsessive–compulsive disorder. Nature reviews Disease primers, 5(1), 52.

3. Tolin, D. F., Brady, R. E., & Hannan, S. (2008). Obsessional beliefs and symptoms of obsessive–compulsive disorder in a clinical sample. Journal of Psychopathology and Behavioral Assessment, 30, 31-42.

4. De Putter, L. M., Van Yper, L., & Koster, E. H. (2017). Obsessions and compulsions in the lab: A meta-analysis of procedures to induce symptoms of obsessive-compulsive disorder. Clinical Psychology Review, 52, 137-147.

5. Gershuny, B. S., Baer, L., Radomsky, A. S., Wilson, K. A., & Jenike, M. A. (2003). Connections among symptoms of obsessive–compulsive disorder and posttraumatic stress disorder: a case series. Behavior Research and Therapy, 41(9), 1029-1041.

6. Attiullah, N., Eisen, J. L., & Rasmussen, S. A. (2000). Clinical features of obsessive-compulsive disorder. Psychiatric Clinics of North America, 23(3), 469-491. https://doi.org/10.1016/S0193-953X(05)70175-1

7. Abramowitz, J. S. (2006). The psychological treatment of obsessive—compulsive disorder. The Canadian Journal of Psychiatry, 51(7), 407-416.

8. Hembree, E. A., Riggs, D. S., Kozak, M. J., Franklin, M. E., & Foa, E. B. (2003). Long-term efficacy of exposure and ritual prevention therapy and serotonergic medications for obsessive-compulsive disorder. CNS spectrums, 8(5), 363-371.


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