You’ve probably heard of obsessive-compulsive disorder (OCD). Recently, psychologists conducted a population-based study targeting OCD patients and to their surprise, there is an increased OCD prevalence with older age. This finding may have suggested that as people age, they become more susceptible to OCD. Here is an inclusive guide to OCD that will help you to gain a deeper understanding of the causes, symptoms and treatments of OCD.
According to the American Psychological Association, obsessive-compulsive disorder (OCD) is defined as a mental illness where patients experience recurring, unwanted thoughts, ideas or sensations which make them feel driven to act repetitively. The mental disorder is characterized by the occurrence of obsessive thinking and compulsive repetitive behaviors. Patients with OCD have to cope with undesired thoughts in their brain, which are difficult for them to resist.
As its name suggests, OCD comprises “obsession” and “compulsion.” Obsession refers to a persistent thought and impulse which can lead to anxiety. Compulsion refers to an irresistible need to perform specific actions to reduce the anxiety. The majority of OCD patients perform compulsive behaviors because they hope to reduce anxiety that arises from obsession.
The OCD cycle can be used to explain the causes of OCD. In brief, the OCD cycle suggested that OCD patients feel the need to carry out the compulsions because their actions lead to relief of their anxiety. Obsession and compulsion are an entwined process which makes the cycle difficult to escape if patients do not receive appropriate treatment.
OCD patients experience obsessions that are associated with specific themes. Common obsession themes include dirt, contamination, aggression, bodily functions, the need for order and symmetry in lives, the need to do things in a particular sequence and a specific number of times.
According to the American Psychiatric Association, there are some common obsessions that OCD patients experience:
Furthermore, patients with OCD show compulsive behaviors which as mentioned, are conducted to reduce anxiety. Therefore, compulsive checking is a common form of compulsion in many OCD patients. Compulsive behaviors are also known as coping mechanisms to reduce the anxiety caused by obsessive thoughts. Examples of compulsions include:
When obsessions and compulsive behaviors occupy the majority of your time, you may consider seeking help from OCD therapists. In general, OCD therapists rely on diagnostic manuals such as the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and conduct diagnoses through the use of psychiatric assessments. One example of the assessments would be the Obsessive-Compulsive Inventory (OCI), which measures the frequency of 1) washing; 2) checking; 3) doubting; 4) ordering; 5) having obsessional thoughts; 6) hoarding; and 7) mental neutralizing.
Examples of questions include asking the patient to rate their agreement on the following statements:
There are various intervention approaches for treating OCD. Some common approaches for OCD are discussed as follows:
Cognitive-behavioral therapy (CBT) can help patients identify their thought patterns and the associated emotions and behavior. One specific type of CBT is known as exposure and response prevention (ERP). Exposure treats obsessions by directly exposing the patient to thoughts, images, objects and situations that lead to anxious feelings and obsessions. By repeated exposure, the treatment allows patients to experience the fear until it subsides. Response prevention treats compulsions. To take washing hands as an example, ERP eliminates the rewarding effect of handwashing. Ultimately compulsive hand washing will become extinct.
Medications are often used to treat OCD. Examples of antidepressants commonly used to treat OCD include selective serotonin reuptake inhibitors (SSRIs) and clomipramine. These medications are used to treat OCD by increasing the concentration of serotonin in the brain.
In more severe cases, biological treatments are often combined with other approaches to treat OCD. One example of biological treatments would be surgery. Surgery is exceedingly rare. A typical surgery for treating OCD is deep brain stimulation. However, this treatment approach is only applicable for patients with severe OCD as it involves a high risk of side effects. Therefore, patients need to evaluate different treatment approaches before seeking help from an OCD therapist.
OCD is a type of anxiety disorder characterized by unwanted thoughts and repetitive behaviors. Other common types of anxiety disorders include generalized anxiety disorder, panic disorder, post-traumatic stress disorder (PTSD) and social anxiety disorder.
Like any other mental illness, if patients with OCD do not receive appropriate treatment, they may have higher chances of experiencing negative consequences of OCD, which are detrimental to them and their family members. Common consequences would be disrupting daily social functioning, reducing the quality of life, causing an emotional burden in caregivers of OCD patients and functional impairment like increased use of healthcare services and lower quality of life.
For a brief diagnosis, you may check if you are at risk of OCD using the Obsessive-Compulsive Inventory. However, it is recommended that if you suspect you have OCD, you should speak to your general practitioner, who should be able to refer you to a psychologist or psychiatrist for further assessment.
This article was independently written by Healthy Matters. It is informative only and not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be relied upon for specific medical advice.
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