Obsessive-compulsive disorder (OCD)
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As a psychologist I would like to tell you that Obsessive compulsive
disorder is the most common, chronic, and long-lasting type of neurodevelopmental
disorder in which a person has uncontrolled reoccurring thoughts and behaviour
that he feels the urge to repeat it over and over. Furthermore, It is the type
of disorder that has some related to other disorders such as body dysmorphic
disorder, hoarding disorders, hair pulling disorder, excoriation disorder and
other obsessive compulsive disorders are also included in it.
When we talk about obsessive-compulsive disorder we can say that Obsessive-compulsive
disorder (OCD) is a condition where a person has obsessive thoughts and
compulsive behaviours. Furthermore, it features a pattern of unwanted thoughts
and fears that are called obsessions that lead you to do repetitive behaviours
that are called compulsions. These obsessions and compulsions interfere with
daily activities and cause distress and many other type of psychological
issues.
“If
you want to get over Obsessive compulsive disorder you need to be as strong as
the disorder.”
People with
Obsessive Compulsive Disorder:
People having OCD
has obsessive thoughts and compulsive behaviour that induce distress in his
daily life activities. Moreover, person having OCD has an excessive fear of
getting contaminated by germs. To ease his contamination fears and because of
it he may compulsively wash his hands until they are sore and chapped.
The Vicious Cycle
of Obsessive Compulsive Disorder (OCD):
Obsessive and
Compulsive behaviour always cause distress and the person having OCD may try to
ignore or stop his obsessions because of the distress, but it does not work
that only increases his distress and anxiety. Ultimately, he or she feels
driven to perform compulsive acts to try to ease his stress. Despite efforts to
ignore or get rid of bothersome thoughts or urges but they keep coming back.
This leads to more ritualistic and distress behaviour.
What
affect Obsessive Compulsive Disorder?
Obsessive
Compulsive Disorder (OCD) can affect anyone, any person of any age there is no
specifications in it but commonly, the average age of recognizing OCD is 19
years. Moreover, about 50% of people with OCD begin to have symptoms in
childhood and adolescence but it is very rare for someone to develop OCD after
the age of 40.
Symptoms that are
present in individual having obsessive compulsive disorders:
Obsessive
Compulsive Disorder (OCD) patients frequently experience obsessive thoughts and
compulsive behaviours and their symptoms are written below:
·
A concept, image, or drive that
repeatedly enters your mind and causes feelings of dread, revulsion, or unease
is called an obsession.
·
A compulsion is a habitual behaviour
or mental act that you feel you must engage in to temporarily get rid of the
negative emotions triggered by the obsessive thinking.
Obsession
Symptoms:
Obsessions are
thoughts, fears, or worries that are normally unfounded but their happen often
and cause great anxiety. Reasoning does not help control the obsessions.
Moreover, obsessions often have themes to them, such as:
·
Fear of contamination or dirt.
·
Doubting and having difficulty
tolerating uncertainty.
·
Needing things orderly and
symmetrical.
· Aggressive or horrific thoughts about
losing control and harming yourself or others.
·
Unwanted thoughts, including
aggression, or sexual or religious subjects.
·
questioning your sexual desires or
orientation
·
intrusive images, words, or sounds
Examples of
obsession signs and symptoms include:
·
Fear of being contaminated by touching
objects others have touched.
·
Doubts that you've locked the door or
turned off the stove.
·
Intense stress when objects aren't
orderly or facing a certain way.
·
Images of driving your car into a
crowd of people.
·
Thoughts about shouting obscenities or
acting inappropriately in public
·
Unpleasant sexual images.
·
Avoidance of situations that can
trigger obsessions, such as shaking hands.
Compulsion
symptoms:
Compulsions
are repetitive, ritualized acts. They are normally meant to reduce anxiety that
is caused by the obsessions. As with obsessions, compulsions typically have
themes, such as:
·
Washing and cleaning.
·
Checking.
·
Counting.
·
Orderliness.
·
Following a strict routine.
·
Demanding reassurance.
Examples of compulsion signs and symptoms
include:
·
Hand-washing
until your skin becomes raw.
·
Checking doors repeatedly to make sure
they're locked.
·
Checking the stove repeatedly to make
sure it's off.
·
Counting in certain patterns.
·
Silently repeating a prayer, word or
phrase.
·
Arranging your canned goods to face
the same way.
“OCD is a health condition
like any other, so there's nothing to feel ashamed or embarrassed about. Having
OCD does not mean you're "mad" and it's not your fault you have it.”
What are the Causes of Obsessive Compulsive Disorder?
It is not clear
that what is the real cause of OCD? But
Genetics, brain abnormalities, and the environment are thought to plays an
important role. Normally, It appears to run in families. Several
different factors may play a role, including family history, life events,
differences in brain, personality traits, etc. Furthermore, some major causes
are written below.
Such as:
·
Changes in living situation, such as
moving, getting married or divorced, or starting a new school or job.
·
Death of a loved one or other
emotional trauma.
·
History of abuse.
·
Illness such as if you get the flu,
for example, you may start a cycle of obsessing about germs and washing
compulsively.
·
Low levels of serotonin, a natural
substance in the brain that maintains mental balance.
·
Over-activity in areas the brain.
·
Problems at work or school.
·
Problems with an important
relationship.
Risk and
Prognostic Factors:
There are three main and major risk and
prognostic factors of Obsessive compulsive disorder.
1. Temperamental
Factor
2. Environmental
Factor
3. Genetic
and Physiological Factor
Temperamental
Factors:
Greater internalizing of symptoms of OCD and
higher negative emotions and behaviors inhibition in childhood are possible
temperamental risk factors.
Environmental
Factors:
Physical and sexual abuse in childhood and
other stressful events that gives a trauma have been associated with an
increased risk for developing OCD.
Genetic and
Physiological factors:
When we talk about genetic and physiological
factor, familial transmission is due in this part and dysfunction in the
orbitofrontal cortex, anterior cingulate cortex, and striatum have been most
strongly implicated.
Prevalence:
When we talk about the prevalence of OCD, then
I would like to inform you that OCD is more common in males in childhood but on
the other hand, females are affected at the slightly higher rate than males in
adulthood.
How is OCD diagnosed?
There is no any kind of
specific test for Obsessive Compulsive Disorder. There is no blood test or
X-ray that can diagnose OCD. A
healthcare provider or psychologist makes the diagnosis after asking about symptoms
and medical and mental health history. Psychologist use criteria explained in
the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V) to
diagnose OCD.
The criteria given in it
include:
- Having obsessions, compulsions or both.
- The obsessions or compulsions take up a
lot of time (more than an hour per day).
- The obsessions or compulsions cause distress
or affect your participation in social activities, work responsibilities
or other life events.
- The symptoms aren’t caused by substances,
alcohol, medications or another medical condition.
- The symptoms aren’t explained by a
different mental health condition, such as generalized anxiety
disorder, eating disorder or body image disorder.
Criteria through DSM-V:
DSM explain us a criteria of OCD that is
important to meet while giving it as a diagnosis.
A. It had two parts:
1. Obsessions
2. Compulsions
Obsessions are defined by
· Recurrent and persistent through urges, or
images that are experienced, at some time during the disturbance, as intrusive
and unwanted, and that in most individuals cause marked anxiety and distress.
· The individual attempts to ignore and suppress
such thoughts, urges, or images, or to neutralize them with some other thought
or actions that is by performing a compulsion.
Compulsions are defined by:
· Repetitive behaviour for example, hand
washing, ordering, checking or mental acts and praying, counting, repeating
words silently that the individual feels driven to perform in responses to an
obsession or according to rules that must be applying rigidly.
· The behaviour and mental acts are aimed at
preventing or reducing anxiety or distress or preventing some dreaded events or
situations; however, these behaviours and mental acts are not connected in a
realistic way with what they are designed to neutralize or prevent, or are
clearly excessive.
B. The obsession and compulsions are time
consuming for example for more than one hour in a day or cause clinically
significant distress or impairment in social, occupational and other areas that
are important for functioning.
C. The obsessive-compulsive symptoms are not
attributable to the physiological effects of a substance for example, a drug of
abuse, a medication or any other medical condition.
D. The disturbance is not better explained in any
other mental disorder for example, excessive worries as in generalize anxiety
disorders, repetitive behaviour as in autism spectrum disorder, ritualized
eating behaviour as in eating disorders, preoccupation in having an illness as
in illness anxiety disorders, sexual urges or fantasies as in paraphilic
disorders.
These criteria must be present in paitent whom
we are giving the diagnosis of Obsessive compulsive disorder.
When to see a
Doctor?
There's a difference between being a perfectionist — someone who requires
flawless results or performance, for example — and
having OCD. OCD thoughts aren't simply excessive worries about
real problems in your life or liking to have things clean or arranged in a
specific way. It is important to see a Doctor, if your obsessions and
compulsions are affecting your quality of life, see your doctor or mental
health professional.
Suicide Risk:
Suicidal thoughts occur at some points in as many as about some
individual having OCD. Suicide attempts are also reported in up to one quarter
of individual with OCD, the presence of comorbid major depressive disorders
increase the risk of suicide in OCD.
Another cause of attempting suicide is their repeatative behavior and
sometimes when individual having OCD is aware from his disorder they feel
embarrass or ashamed while performing compulsive behavior because of obsessive
thoughts.
Treatment:
There is no sure
way to prevent obsessive compulsive disorder. However, getting treatment as
soon as possible may help prevent OCD from worsening and disrupting activities
and your daily routine. There are some effective treatments for OCD but that
cannot fully cure it but that can help to reduce the impact it has on your
life.
The three types
of treatment are:
1. Therapy
2. Medications
3. Exposure
and response prevention (EX/RP)
·
Therapy:
Therapy plays as
important role in the treatment of OCD the therapy that are generally use is Cognitive-behavioural
therapy (CBT). Cognitive-behavioural
therapy is a type of psychotherapy. You will talk to a therapist, who will help
you examine and understand your thoughts and emotions. Over several sessions,
CBT can help you stop negative habits, perhaps replacing them with healthier
ways to cope.
·
Medications:
Drugs called serotonin reuptake inhibitors
(SRIs), selective SRIs (SSRIs) and tricyclic antidepressants may help. They
increase levels of serotonin. Examples include clomipramine, fluoxetine,
fluvoxamine, paroxetine and sertraline and it is known as the most useful and
earliest treatment for individual having Obsessive compulsive disorder.
·
Exposure and response prevention
(EX/RP):
With this therapy, you do the thing that
causes anxiety. The healthcare provider then prevents you from responding with
a compulsion. For example, the provider may ask you to touch dirty objects but
then stop you from washing your hands.
Thankfully, the diagnosis of Obsessive compulsive disorder does
not limit someone’s potential in his daily life and other activities of life.
Many people having Obsessive-compulsive disorders successfully manage their
disorder and live normal, happy and successful life. Yes! It is hard to treat
but if someone is diagnosis with OCD so remember that there is a hope and hope
is everything we just have to recognize it and support our loved ones so they
can fight with it and can live a normal, happy, and successful life!
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