Obsessive Compulsive Disorder: What Is It and How Is It Treated?

Mary-Lauren O’Crowley, NCC, LPC

We all have battles within ourselves that we must face. Some may be due to past mistakes, while some may not be our fault or caused by anything which we have done. One such battle which we have practically no hand in causing is Obsessive Compulsive Disorder (OCD), a mental illness which can interfere severely with our personal, work and social life. Although we may not have caused this on ourselves, there is help and a way out. In this article we discuss Obsessive Compulsive Disorder and the nature of this condition.

Obsessive Compulsive Disorder has been classified as an anxiety disorder within the Diagnostic Statistical Manual, or the big purple book from which clinicians determine a given diagnosis (DSM-V). Both children as well as adults can experience OCD. OCD includes anxiety driven obsessions and compulsive behaviors which may induce more anxiety if their “criteria” are not met. These “criteria” include habits or compulsive behaviors which must be performed for things to feel “just right”. There can be elements of fear involved in some instances which drive the patient to act out on these obsessions or compulsions.

OCD compulsions and obsessions can be categorized under 4 headings:

• Checking – checking can include making sure doors are closed, alarms haven’t gone off, padlocks are closed, stove burners are off, etc.
• Contamination – This can include phobia of shaking hands, being in contact with sick persons, being meticulously clean, washing hands a certain number of times to feel “just right and free from germs”, etc.
• Symmetry and ordering – for example arranging all red cups together in a cupboard, followed by all green or blue cups, usually feeling terribly anxious if another color is put in between, or putting all small books together on one shelf of a bookcase, with the larger ones down below, again, feeling terribly anxious if one gets put with the other.
• Rumination and Intrusive thoughts – These may include fear of divine punishment, believing someone is out to poison you, being obsessed with violent thoughts or disturbing images such as seeing oneself dead or a loved one buried. Compulsive thoughts often include suspicions of an unfaithful partner.

         Within the context of OCD, many patients find themselves repeating actions for a fixed number of times, believing there are good numbers and bad numbers, which become so severe and rigid that life at work or within social settings are affected.

Risk Factors for OCD include the following:

• Having a parent or sibling diagnosed with OCD
• Physical or sexual abuse as a child
• Neurological differences within the brain
• Experience of Trauma
• Depression, Anxiety and Tics

Treatment for OCD includes:

Medication

While medication may not be warranted for mild OCD, severe patients may be advised by a psychiatrist to take one or several medications which may assist with the disorder. In some cases, hospitalization in a mental ward may be required. There are various classes of drugs used to treat OCD. The most used include selective serotonin reuptake inhibitors and anti-depressants.  Among these are citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine and sertraline. Risperidone, an anti-psychotic, may also be prescribed. The common wait time for these medications to become actively effective begins from 2 months up, and it is important for patients to manage and navigate throughout the adjustment period.

Psychotherapy

Psychotherapy with a licensed psychologist may also be a treatment option for patients with OCD. Exposure and response therapy, a technique used to expose patients to sources of obsessions or compulsions and then teach methods of stabilizing irrational anxieties may be used. It is important for the patient to comply and follow through with all the instructions and assignments the doctor may recommend during treatment. This may be hard and induce anxiety, however in the long run, it is beneficial and often effective.

Recreation

Exercise, meditation, deep breathing and other various hobbies also aid in reducing anxiety and tension caused by OCD. Maintaining relationships can also become beneficial as others can provide distraction from unwanted thoughts which especially rotate within one’s mind when alone.

If you or someone you know is struggling with symptoms of OCD, please reach out to the intake specialists at Symmetry Counseling today!

Sources

https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/symptoms-causes/syc-20354432 

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