Obsessive Compulsive Disorder

Obsessive Compulsive Disorder (OCD)

What is it?

Obsessive Compulsive Disorder (OCD) is a common anxiety disorder that individuals often carry from childhood into their adult life.

According to the American Psychiatric Association, a diagnosis of OCD requires evidence of obsessive behaviour or compulsions that endure for more than one hour and cause major distress and impair work, social interaction or other important functions.

A person suffering from OCD can identify with persistent, intrusive, senseless thoughts and impulses (obsessions) and repetitive, intentional behaviours (compulsions). 

To keep themselves safe and find relief, they feel compelled to carry out some compulsive act, for example, checking that the doors are locked, counting, repeating words or checking that someone they love is safe.

Why does it happen?

Research suggests that genetics (what an individual inherited from their parents) and the environment a person grew up in, may contribute to OCD (Nestadt et al, 2010). In order to feel secure, the younger mind develops inflexible beliefs about safety and these beliefs can only be updated in therapy when a person learns to rely on realistic and tested memories of safety (Apergis-Schoute et al., 2017).

What are the symptoms?

1.    Cleaning: spending a lot of time washing or cleaning (sometimes for hours) to avoid contamination from germs, viruses, dirt or chemicals.

2.    Repetition: of names, phrases or behaviours to reduce anxiety, or avoid bad luck,

3.    Checking.  Compulsive drive to reduce physical or emotional risk, for example, by leaving a door unlocked, the gas stove switched on or retracing steps to ensure that no damage was done.

4.    Ordering: and arranging things to have a sense of control and reduce discomfort.  For example, books or clothes are arranged in a certain order and any deviation causes distress.

5.    Mental compulsions: to counteract intrusive obsessive thoughts, such as using phrases to reduce anxiety or prevent a dreaded future event.

6.  Obsessive thoughts: that are unwanted, persistent and out of control.

How is it treated?

The primary treatment interventions include:

1.    Psychotherapy, which helps a person to understand the nature of OCD and find new ways of dealing with the associated anxiety.  One of the most effective methods is Cognitive Behavioural Therapy (CBT) where you will begin to understand what belief systems are triggering your thoughts that result in unwanted behaviours.  Graded exposure to the declared anxiety means overcoming the least resistant anxiety and working gradually upwards to neutralise the strongest trigger for the condition.

2.    Medication prescribed and described by your doctor, to treat the symptoms but not the underlying cause.

3.    Other treatments that may help include Hypnosis, BWRT, and NLP.

Related problems

Some features of OCD occur within family members, for example, body dysmorphic disorder (preoccupation with imagined ugliness), hypochondriasis (preoccupation with physical illness), trichotillomania (hair pulling), some eating disorders such as binge eating disorder, and neurologically based disorders such as Tourette’s syndrome. (APA.2020).

 

References:

American Psychiatric Association https://www.psychiatry.org/patients-families/ocd/what-is-obsessive-compulsive-disorder

Apergis-Schoute AM, Gillan CM, Fineberg NA, Fernandez-Egea E, Sahakian BJ, Robbins TW (2017) Neural basis of impaired safety signaling in obsessive compulsive disorder. PNAS 114:3216–3221

Health Service Executive (2020) https://www2.hse.ie/

International Journal of Neuropsychopharmacology (2018) mapping compulsive in the DSM-five obsessive-compulsive and related disorders: cognitive domains, neural circuitry, and treatment.  doi:10.1093/ijnp/pyx088

Nestadt, G, Grados, M & Samuels, J.F. (2010) Genetics of Obsessive-Compulsive Disorder, The Psychiatric Clinics of North America. doi: 10.1016/j.psc.2009.11 

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