最後更新日期 六月 7, 2021.
You’ve probably heard of obsessive compulsive disorder (OCD). Recently, psychologists conducted a meta-analysis targeting OCD patients and to their surprise, it was found that the average age of OCD patients has become younger. This finding may have suggested that younger people are at higher risk of having OCD in their lifetime than older adults. Here is an inclusive guide to OCD that will help you to gain a deeper understanding of the causes, symptoms and treatments of OCD.
What is 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 the anxiety that arises from obsession.
What are the causes of OCD?
The OCD cycle can be used to explain the causes of OCD. In brief, the OCD cycle suggested that OCD patients have the need to maintain obsessions and compulsions because their actions are driven by both relief and anxiety. Obsessions and compulsions are part of an entwined process which makes the cycle difficult to escape if patients do not receive appropriate treatment.
The 4-step process of OCD
- Firstly, when an obsessional thought intrudes the person’s thinking, an obsession is formed. Repetition of this obsession leads to the patient experiencing anxious feelings.
- As the patient hopes to reduce anxiety, they develop compulsive behaviors to manage the anxiety.
- By performing these compulsive behaviors, the anxiety is temporarily ameliorated.
- After a while, the obsession returns and creates anxiety again. The patient will have to repeat compulsive behaviors to gain relief and to reduce anxiety.
What are the symptoms of OCD?
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.
Common examples of obsessions include:
- Obsessional thoughts – repeated intrusive thoughts
- Obsessional imagery
- Obsessional impulses
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:
- Excessive hand washing
- Unstoppable action (e.g., going in and out of a door)
- Frequent checking behavior (e.g., check if the door is locked)
How mental health professionals diagnose OCD?
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:
- Unpleasant thoughts come into my mind against my will and I cannot get rid of them.
- I wash and clean obsessively.
- Even when I do something very carefully I feel that it is not quite right.
What are the treatment options for OCD?
There are various intervention approaches for treating OCD. Some common approaches for OCD are discussed as follows:
Since the primary goal of cognitive behavioral therapy (CBT) is to help the patient to identify their thought patterns, CBT can be used to treat patients with OCD by encouraging them to identify their irrational thoughts. For example, CBT therapists may help patients with OCD to realize that they are not responsible for suffering from these irrational thoughts and obsessive thinking. By changing their thought patterns, the CBT can effectively help OCD patients by reducing their obsessions, and hence anxiety.
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. Maladaptive behaviors are associated with neuroanatomic circuitry. By interrupting the neuronal activity in the brain areas corresponding to the compulsion, patients will find it less difficult to stop the compulsion. However, this treatment approach is only applicable for patients with severe OCD as it involves a high risk of side effects. Therefore, it is important for patients to evaluate different treatment approaches before seeking help from an OCD therapist.