Obsessive Compulsive Disorder Treatment
According to the World Health Organization (WHO), Obsessive-Compulsive Disorder, commonly known as OCD, is one of the top causes of a disability-related illness. OCD is also the fourth most prevalent mental illness overall, exceeded only by phobias, substance abuse, and clinical depression. The disorder can profoundly impact a person’s work and social life. In this article, we will explore the symptoms, types, causes, diagnosis, and treatment options for OCD.
What is OCD?
The presence of either an obsession, compulsion, or both separate OCD from other mental illnesses— obsessions go beyond normal everyday worries, and these excessive worries are persistent and unwanted. They can be anything from fear that a task isn’t completed to a fear of contamination from germs.
The person often knows their thoughts are unreasonable, but aren’t able to control them. They attempt to relieve the stress caused by these obsessions with compulsive behavior. Sometimes there is no logical connection between the obsession and compulsion. At other times they are connected, such as when a person obsessed with the fear of germs constantly washes their hands or repeatedly checks for locked doors. Like the obsessions, the person struggles to control compulsive behaviors while knowing they aren’t logical.
Symptoms and Types of OCD
OCD usually begins in childhood or during the teenage years and gradually worsens with age. Some sufferers may have obsessive thoughts without showing compulsive behavior. They may successfully hide their symptoms for fear of being ridiculed, but family members and close friends will spot the physical signs that accompany the thoughts.
Technically, the “types” of OCD are actually common symptom categories. They are based on similarities between the obsessive thoughts and compulsive actions taken to cope with them. The following are common categories of obsessive thoughts:
- Fear of contamination including germs, dirt, and bodily fluids.
- An obsession with order and symmetry.
- Perfectionism that includes a fear of losing things, exactness, and remembering things.
- Fear of losing control and harming oneself or others.
- Fear of something terrible happening.
- Fear of not completing something or things not being done “just right.”
These common obsessions are most often matched with excessive compulsions such as excessive handwashing, checking body parts, checking to see that nothing bad has happened, repeated routines, and spending an exorbitant amount of time arranging objects in a particular order.
Causes of OCD
Currently, we don’t know the exact cause of OCD. The disorder may be triggered by a combination of neurological, genetic, cognitive, behavioral, and environmental factors. Some research suggests a neurological basis, since neuroimaging shows differences in brain functions in OCD patients. We’ve seen some evidence in studies suggesting that OCD is a familial disorder caused by genetics.
We know there are no differences in occurrence between adult men and women. However,
childhood OCD is more common in boys than girls and symptoms tend to appear earlier. Rapid onset in childhood may be due to autoimmune causes such as a streptococcal infection. Some studies have linked rapid onset to pathogens such as bacteria associated with Lyme disease and the H1M1 flu virus. Traumatic Brain Injury (TBI) can also cause rapid onset in children and teens.
Behaviorally, we’ve seen people learn to associate a certain situation or object with fear. They use “rituals” to cope with this fear. Some of our patients begin this fear-avoidance cycle during and after a time of intense stress. Cognitively, we’ve had patients misinterpret unwelcome thoughts. For example, when caring for an infant, a new parent under great pressure may worry about harming the child, either accidentally or deliberately.
Diagnosis of OCD
Even though the disorder has biological roots, OCD can’t be detected with a blood test, x-ray, or other tests. As mental health professionals, we are trained to make a diagnosis through clinical interviews, judgment, and experience. Other family members and online resources can be a starting point, but are not a substitute for meeting with trained professionals.
OCD Treatment Options
There is no “cure” for OCD, and repetitive thoughts and behaviors are impossible to control alone. The first step for an OCD patient begins with their own doctor— we suggest an exam to rule out any physical causes. If none are present, the doctor will make a referral to a mental health specialist.
We consider the most appropriate treatments for every individual. For many, this includes combining talk therapy with medication. We may use cognitive-behavioral therapy (CBT) with the goal of replacing negative thoughts with productive thoughts. Exposure and response prevention (ERP) is a form of CBT. We expose patients to anxiety triggers a little at a time and then teach new responses to fears to replace repetitive rituals. We may also encourage group therapy with or without the involvement of family members.
