Understanding obsessive-compulsive disorder
Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. In this article, consultant clinical psychologist Dr Jaime Jonsson explains the symptoms of OCD and how patients can manage them.
What is obsessive-compulsive disorder?
OCD is characterised by uncontrollable and involuntary thoughts (obsessions) that elevate anxiety, and in response, the actions (compulsions) that soothe the anxiety.
OCD, like many mental illnesses, does not have a cut-and-dry cause. Certain factors regarding brain chemistry and structure, as well as family history and genetics, can make individuals more likely to develop it. Additionally, significant influences on the development of OCD that aren’t biological are environment and past trauma. Mothers can sometimes develop OCD upon the birth of their child, as they become increasingly anxious about the condition and fragility of their baby.
It is important to note that the obsessions and compulsions of a patient with OCD are not indicative of their true thoughts, feelings, and personality, which is why many patients find the condition so distressing and will not want to act out their compulsions. There is a lot of stigma surrounding OCD, which leads to patients having a difficult time with work, social settings and relationships, and it can even lead to the deterioration of their physical health.
What are the behaviours associated with OCD?
Examples of obsessions can include:
- Needing symmetry and balance and fearing the consequences of asymmetry
- Fear of germs and contamination
- Aggressive and violent thoughts towards the self and others, and fearing causing harm to others
- Intrusive thoughts and visualisations, of a sexual, violent, or religious nature.
Examples of compulsions include:
- Rituals like turning the lights on and off over and over, detailed arranging of things in particular ways, colour sorting and repetitive counting, excessive washing of the hands, and interacting with items in a specific order and manner.
- Correcting thoughts, such as counting repetitively or to a specific number, repeating a phrase or word often.
- Checking over and over, like if appliances are off, if the door is locked, or if an item is where is should be.
- Needing reassurance from others that everything is in order and alright.
How is OCD treated?
Before treatment for OCD can be initiated, a patient can get diagnosed through a psychological evaluation. While a diagnosis isn’t strictly necessary to live with OCD, it can be helpful in order to get accommodations for the condition and to access supportive resources. OCD can also be confused with other anxiety disorders, depression, and schizophrenia, so having a professional to sort through the symptoms of the patient to diagnose them correctly can ensure the patient can alleviate their distress sooner.
OCD cannot be “cured” in the way other illnesses can be, but treatment can reign in the symptoms so that they stop influencing the patient’s life. Depending on the severity of the OCD, a patient may need ongoing, long-term, or intensive treatment.
Treatments for OCD focus on two approaches: medicine and therapy. Often, they are used in combination.
Medications that can used in the treatment of OCD are antidepressants (SSRIs) to regulate the brain chemicals and neurotransmitters.
Therapy typically involves cognitive behavioural therapy (CBT), which helps patients identify and challenge their obsessive thought patterns, and may include exposure therapy to equip patients with the tools and confidence to resist compulsions and face them head-on, so that they can feel more secure and have more rational thinking.