Obsessive-Compulsive Disorder (OCD)

Approximately one in 50 American adults has Obsessive-Compulsive Disorder (OCD).

Obsessive-Compulsive Disorder is a psychiatric anxiety condition that affects 1 ouf ot 50 Americans each year according to a study by Gary Null, and author of Obsessive Compulsive Disorder.

It is characterized by repetitive behaviors, anxiety and difficulty coping with intruding thoughts (obsessions) and ritual behaviors (compulsions).

The symptoms of this condition can be time-consuming and exhausting for the individual, and can cause significant work and social distress (e.g., "Since I enjoy horror movies, I'm afraid that one day I might hurt someone.")

Obsessive-Compulsive Disorder Symptoms

The following information is taken taken from the Diagnostic and Statistical Manual 4th Edition (DSM-IV) and the Center for Addiction and Mental Health (CAMH), and some of it is taken ad verbatim:

The symptoms are broken down to two categories: obsessions and compulsions.

Obsessions

• Recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress.

• The thoughts, impulses, or images are not simply excessive worries about real-life problems.

• The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action.

• The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion).

According to CAMH, there are six major common obsessions in OCD. These are: contamination, doubting, ordering, religious, aggressive, and sexual.

For example, victims of OCD will have a fear of shaking hands for fear or germs (contamination) or excessive fear of having blasphemous thoughts (religious).

Compulsions

• Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly.

• The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.

Other Symptoms

• At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable.

• The obsessions or compulsions cause marked distress, are time consuming (tkae more than 1 hour a day), or significantly interfere with the person's normal routine, occupational (or academic) functioning, or usual social activities or relationships.

• The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical conditions.

A ccording to CAMH, there are six major common compulsions in OCD. These are: cleaning/washing, ordering, checking, and hoarding.

For example, recurrent thoughts of getting into a car accident can result in a paralyzing anxiety that keeps the person from going to work; or the thoughts of germs might make an individual become extremely afraid of coming in touch with other people.

So What Causes OCD?

The exact nature of OCD or why it happens is still unknown.

Some recent studies indicate abnormalities with serotonin levels in the brain.

Serotonin is a neurotransmitter that is thought to regulate anxiety, sleep, appetite, and sex. Recent research suggests that OCD sufferers might have abnormally low levels of serotonin since they seem to benefit from serotonin-reuptake inhibitors (SSRIs) antidepressants such as Prozac or Celexa.

Treatment

Some of the most widely used treatments for OCID include Exposure and Response Prevention (ERP) and Cognitive Behavioral Therapy (CBT):

Exposure and Response Prevention (ERP)

“Exposure”: This is the process that involves partial or gradual expose to a real or imagined situation that triggers the anxiety.

Treatment generally starts with cues or situations that cause mild anxiety, and as the patient improves, he or she is gradually exposed to stronger anxiety provoking cues.

“Response prevention”: In this stage, patients learn better ways to control or resist the compulsion to perform ritualistic behaviors.

Cognitive Therapy (CT)

In cognitive therapy (often used with ERP), patients focus on the thoughts that cause unbearable distress and anxiety.

When they participate in these tasks, they learn to pay closer attention to the thoughts and feelings that trigger these emotions. From there on, they learn to find healthier ways to cope with obsessive thoughts.

Special Note

Medications to treat OCD can help but are seldom effective on their own. Survivors of OCD also benefit from extensive group therapy and support groups.

Support Groups

OcdTribe - Support group for people with OCD. Includes a directory of therapists.

dailystrength - Popular support groups for people with OCD. It also includes an ask a therapist service.

Ocdonline - Overview by Dr. Steven Phillipson, PhD on treatment for OCD.

Mdjunction - A comprehensive site with online support groups for physical and mental health conditions, including OCD.

Anxieties - Self-help website with information on OCD and includes four seven on overcoming obsessions.

OCD Foundation - An international not-for-profit organization of individuals with OCD and related conditions. Includes a research fund & scholarships.

Related Topics

Please visit the following links:

• Social Phobia

• Bipolar

• Mental Health: It All Starts In You




Citations

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association, 1994

Eva M Cybulska. "Obsessive Compulsive disorder, the brain and electroconvulsive therapy". British Journal of Hospital Medicine, 2006; 67(2):77-82

Hyman, B. M., & Pedrick, C. The OCD workbook: Your guide to breaking free from obsessive–compulsive disorder (2nd ed.). Oakland, CA: New Harbinger, pp. 2005, 125-126.

Moritz S, Jelinek L, Klinge R, Naber D. Fight fire with fireflies! Association Splitting: a novel cognitive technique to reduce obsessive thoughts. Behavioural and Cognitive Psychotherapy, 2007; 35, 631-635




Updated: May 5, 2012

Article created: April 24, 2011




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