What is Obsessive Compulsive Disorder?
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies Obsessive Compulsive Disorder (OCD) as a condition wherein there is a presence of either obsessions or compulsions, and sometimes both.
- Obsessions are defined as recurrent or persistent thoughts, urges, impulses, or mental images that intrude in a person’s day to day life. These are typically intrusive or unwanted and tend to be uncontrollable for the patient.
- Compulsions are repetitive behaviors or acts that a patient has no control over. Patients tend to feel the urge to do these acts in response to their obsession or to rigidly applied rules.
The condition can sometimes be characterized with preoccupations and the urges or behaviors elicited by this preoccupation. Some obsessive compulsive disorders are also characterized by repetitive behaviors targeting one’s own body, such as hair pulling, skin picking, nail biting, etc., along with repeated and failed attempts at decreasing or stopping these behaviors.
How is Obsessive Compulsive Disorder Diagnosed?
The diagnostic criteria for obsessive compulsive disorder requires 4 things.
- The presence of obsessions, compulsions, or both
- These compulsions or obsessions take a considerable portion of a person’s time (more than one hour a day)
- These obsessions or compulsions are not due to taking substances or as part of a medical condition separate from obsessive compulsive disorder.
- Other mental conditions, such as anxiety disorders, do not explain the obsessions or compulsions
What are the Symptoms of Obsessive Compulsive Disorder?
Patients with obsessive compulsive disorder experience obsessions that give them urges to unwillingly act on compulsions related to those obsessions. These thoughts and acts take a considerable portion of their time, or cause them clinically significant distress, making it a relevant psychiatric condition.
The obsessions that people develop will differ, as will the compulsions they have towards those obsessions. However, in general, there are common themes to these obsessions. Among these are:
Cleaning
Patients may compulsively clean due to an obsession over being contaminated. In this case, the obsession is germs or being germ-free while the compulsion is to clean or sanitize.
Symmetry
An obsession with symmetry can lead to compulsions where people tend to repeat things in order or count repetitively.
Taboo thoughts
Obsessions with aggressive, sexual, or religious nature can lead to several types of compulsions like collecting related items or making sure to check on the subject (e.g. shrine, image, video) a particular number of times each day.
Harm
Obsessions related to receiving or inflicting physical or mental harm on other people can lead to checking or hoarding compulsions.
What Causes Obsessive Compulsive Disorder?
The development of OCD in an individual involves a very complex interplay among neurobiology, genetics, and the person’s environment. Doctors suggest that serotonin, glutamate, dopamine, and other neurochemicals play a role in the development of this disorder. They also theorize that events that occur in a person’s life (environmental stressors) can change the gene expression for these neurotransmitters, causing a change in the functions and circuitry of the brain.
Do People with OCD Experience Other Mental Disorders?
It is not uncommon for patients with OCD to have other comorbid mental conditions. Around 90% of patients with OCD may develop or already meet the criteria for diagnosis with at least one other psychiatric condition. Typically, these include the following:
- Anxiety Disorders – Such as panic disorder, social phobia, or PTSD
- Mood Disorders – Especially major depressive disorder (depression)
- Impulse Control Disorders
- Substance Use Disorders
Due to the high rate of comorbidity, patients may be at risk of committing suicide. An estimated 63% of patients with OCD have experienced suicidal thoughts, with 26% having attempted to commit suicide.
Treatment
Several cognitive and psychopharmacologic therapies are available for patients with OCD. Remissions may take time to occur (weeks to months).
These include:
CBT
Mental care professionals use Cognitive Behavior Therapy (CBT) to treat OCD. Particularly, Exposure and Response Prevention Training under CBT is one of the evidenced-based treatment for OCD. It helps patients learn to control their compulsive behavior in response to the anxiety-provoking stimuli or obsessions.
Dialectical Behavior Therapy
Related to CBT, dialectical behavior therapy (DBT) is another psychotherapy that can be effective for patients with OCD and other mental disorders. This type of therapy is especially effective for patients who are extremely in-tune with their emotions and combines somewhat contradicting approaches. A therapist will help their patient accept these qualities about themselves while also helping them change certain behaviors which may be hindering them.
SSRIs
The first line of pharmacologic treatment for patients with OCD involves the use of a Selective Serotonin Reuptake Inhibitors (SSRIs). Successful medical therapy should last for at least around 1 to 2 years, if not indefinitely. Patients may use SSRIs to prevent relapse, but these may be unnecessary depending on the patient’s response to therapy.
Key Takeaway
Patients who develop OCD should seek help from a mental health professional and receive prompt therapy and treatment. Given the anxiety associated with the condition and the nature of some obsessions, not all patients will willingly seek consultation. If you know someone who may suffer from this condition, encouraging them to seek consultation can help their wellbeing in the long run, especially when their condition affects their life considerably.
Learn about Other Mental Health Issues here.
