We all get obsessions, for instance, when you stress over the thought that if you locked the door when you left your house or did you leave the stove turned on. People have focused thoughts and repetitive behaviors and those do not disturb daily life. It may add structure or make tasks easier. However, what if you obsess over those thoughts and act compulsively on them. What if you turn from the office and go all the way to check the door or the stove? People with the intensity of obsessive thoughts and obsessive compulsions might have an obsessive-compulsive disorder.
What is Obsessive-Compulsive Disorder?
Obsessive-compulsive disorder (OCD) is an anxiety disorder. People with OCD have recurring, unwanted thoughts, ideas or sensations called obsessions. It makes them feel driven to do things repetitively, which are compulsions. The repetitive behaviors, like hand washing, checking on doors or things, cleaning, can interfere with a person’s daily activities or social interactions.
People with OCD have persistent and unwanted thoughts and routines. The behaviors are rigid and prevent great distress. Most people with OCD know or think their obsessions are not true; others may suspect they could be true which is known as poor insight.
Even if the people with OCD know their obsessions are false, they have a hard time keeping their focus off the obsessions and stopping the compulsive acts.
What Are Obsessions?
Obsessions are recurrent, persistent thoughts, impulses, or images that cause distressing emotions like anxiety, guilt or disgust. Most people with OCD recognize that the thoughts, impulses, or images are the creation of their mind, are excessive and unreasonable. However, these intrusive thoughts cannot be settled by logic or reasoning. Many people with OCD aim to ignore or suppress obsessions or offset them with some other thought or action. In most cases, obsessions include excessive concerns about contamination, harm, the need for evenness or exactness, forbidden sexual or religious thoughts.
What Are Compulsions?
Compulsions are repetitive behaviors or mental acts that a person feels compelled to perform in response to an obsession. The behaviors are directed at preventing or reducing distress or a dreaded situation. Typically, in severe cases, the continual repetition of rituals may fill the day, making a normal routine impossible. The agony these compulsions cause is the understanding that the compulsions are irrational. However, the compulsion may bring some relief to the worry, the obsession returns, and the cycle repeats.
- Cleaning to reduce the fear that germs, dirt, or chemicals will pollute them. Some people spend hours washing themselves or cleaning their surroundings.
- Constantly repeating to prevent anxiety. Some people say a name or phrase and repeat a behavior several times. They think these repetitions won’t guard against injury but harm will occur if the repetitions aren’t done.
- Keep checking things to reduce the fear of harming oneself or others. For instance, not remembering to lock the door or turn off the gas stove. Some people develop checking activity.
- Ordering and arranging things to lessen discomfort. People like to arrange objects, such as books in a certain order, or arrange household items in a particular fashion.
Mental compulsions, as they take help of silent prayers as they say phrases to reduce anxiety, responding to intrusive obsessive thoughts or prevent a feared future.
What Are The Symptoms Of Obsessive Compulsive Disorder?
People with OCD have repeated thoughts, urges, mental images that cause anxiety called obsessions, like:
- Extreme fear of germs
- Forbidden thoughts about sex, religion, of harming others or self
- Need for order and arrangement
They perform repetitive behaviors in response to their thoughts or obsessions, like:
- Arranging things in a certain way
- Repeatedly washing their hands to ward off infection
- Repeating words and phrases silently
- Praying silently over and over again
- Checking actions repetitively (such as turning out the lights and locking the door)
Not everyone who has these habits have OCD. But, the person with OCD:
- Is unable to control their thoughts or behaviors. Even when they understand that they are excessive.
- Spends about an hour a day on these thoughts or behaviors.
- Does not get satisfaction or pleasure from a behavior, other than brief relief of anxiety.
- Has problems in daily life due to these thoughts and rituals.
People with OCD may also have a tic disorder like:
- Blinking of eyes
- Facial grimacing
- Shrugging Shoulder
- Jerking the head
- Clearing of the throat, sniffing, grunting sounds
How To Diagnose OCD?
A diagnosis of OCD requires the presence of obsessions and compulsions that lasts more than an hour a day. If it causes major distress, and affect work, social and other important functions. OCD seldom begins in childhood, adolescence or early adulthood. The average age in which symptoms appear is nineteen years old.
Steps to diagnose OCD include:
- Physical exam: This is done to help eliminate other problems that could be causing the symptoms and to check for other complications.
- Lab tests: These may include a complete blood count (CBC), a check of the thyroid gland function, screening for alcohol or drugs.
- Psychological evaluation: Discussing your thoughts, feelings, symptoms and behavior patterns and with the patient’s permission, talking to the family or friends is included.
What Are The Causes Of Obsessive Compulsive Disorder?
The causes of obsessive-compulsive disorder (OCD) are not fully known. Main theories are:
- Biological: OCD can be a result of the changes that occur in your body’s natural chemistry or brain functions.
- Genetics: OCD can have a genetic component, but specific genes are not identified.
- Environmental: Some environmental factors can play a role. Such as, infections can be a trigger for OCD.
What Is The Treatment For Obsessive Compulsive Disorder
Treatment for Obsessive-compulsive disorder may not result in a cure. Though, it can help bring symptoms under control. It can help the person to not get disturbed daily life. Some people need treatment for their entire lives.
The main treatments for OCD are psychotherapy and medications. Treatment is most effective with a combination of these two.
Cognitive-behavioral therapy (CBT) is a kind of psychotherapy. It is effective for many people with OCD. Exposure and response prevention (ERP), a type of CBT therapy, involves moderately exposing you to a dreaded object or obsession like dirt and then having you learn healthy ways to cope with your anxiety and to resist your urge to do the compulsion. The therapy may also be used to reduce stress and anxiety and resolve inner conflicts. ERP takes tries and exercise, but you may have a better quality of life once you have learned to manage the obsessions and compulsions.
Therapy can take place in individuals, with family or group sessions.
Psychiatric medications may help control the obsessions and compulsions of OCD. Most commonly, antidepressants are tried. Antidepressants are used to treat OCD, which is approved by the Food and Drug Administration (FDA):
- Clomipramine (Anafranil) for adults and children with the age of ten years and older.
- Fluoxetine (Prozac) for adults and children who are seven years old and older
- Fluvoxamine for adults and eight years old children and older
- Paroxetine (Paxil, Pexeva) for adults
- Sertraline (Zoloft) for adults and children who are six years old and older
Your doctor can prescribe other antidepressants and psychiatric medications too.
What to consider:
Some issues to discuss with your doctor about medications for OCD are:
- Choosing a medication: Overall, the aim is to control symptoms effectively at the lowest possible dosage. It is okay to try a few drugs before finding one that works best for you. The doctor might recommend more than one medication to control your symptoms effectively. It can take weeks to several months after starting a medication to notice any improvement in the symptoms.
- Side effects: All psychiatric medications have side effects. You need to talk to your doctor about possible side effects. And about any health monitoring, that’s needed while taking the drugs. Let your doctor know if you experience any worrying side effects.
- Suicide risk: Most antidepressants are safe, but the FDA requires that all antidepressants carry black box warnings for prescriptions. Mostly, children, teenagers, and adults under twenty-five may have increased suicidal thoughts or behavior while taking antidepressants. If you have, suicidal thoughts immediately contact your doctor and get help. Also, know that antidepressants are more likely to reduce suicide risk by improving mood, in the long run.
- Interactions with other substances: When taking an antidepressant, tell the doctor about any other over the counter medicines, herbs or supplements you take. Some antidepressants can cause dangerous reactions when combined with medications or herbal supplements.
- Stopping antidepressants: Antidepressants are not addictive but physical dependence can occur. Stopping treatment suddenly or missing several doses can cause withdrawal symptoms, sometimes called discontinuation syndrome. Do not stop taking your medication without talking to your doctor about it. Even if you are feeling better, you may have a setback of OCD symptoms. Work with your doctor slowly and safely to decrease your dose.
Discuss with your doctor about the risks and benefits of using specific medications.
Lifestyle and home remedies
Obsessive-compulsive disorder is a chronic condition. It may always be a part of your life. While OCD warrants treatment by a professional but you can do some things or remedies for yourself to build on your treatment plan:
- Take your medications as directed: Even if you’re feeling good, resist any temptation to skip your medicines. If you stop, OCD symptoms will return.
- Pay attention to the warning signs: You and your doctor may have identified issues and things that trigger your OCD symptoms. Make a plan of what to do if symptoms return. Contact your doctor if you notice any changes in symptoms or how you feel.
- Practice what you learn: Work with your mental health professional or therapist to identify techniques and skills that help manage your symptoms and practice those regularly.
OCD Vs. OCPD
These terms sound very similar: OCD and OCPD. But, in reality, OCD (obsessive-compulsive disorder) and OCPD (obsessive-compulsive personality disorder) are two different conditions. Each has its symptoms and different treatment plans. The symptoms can be controlled with appropriate treatment. They are well managed to the point that the disruption to the person’s life is minimized.
An individual with OCD has frequent upsetting thoughts called obsessions that they try to control by repeating particular behaviors called compulsions. The obsessions spark a great deal of anxiety and stress because they are not only intrusive and unwanted but also repetitive.
Whereas, individuals with OCPD tend to think their way of doing things is the right and best way. He has an overwhelming need for order, a strong sense of how things should be done and rigidity when it comes to following rules.
The individuals fixate themselves with set routines in their work or daily living even though when the routines are inefficient. These individuals are overly controlling of their environments or relationships, wanting others to conform to the rules they set even at the expense of their relationships.
This personality disorder includes maladaptive traits and behaviors. Which includes perfectionism that interferes with completing tasks, rigidly following ethical codes, and an excessive fixation with lists of rules?