Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by uncontrollable, unwanted thoughts and repetitive, ritualized behaviors you feel compelled to perform. It’s normal, on occasion, to go back and double-check that the iron is unplugged or your car is locked. But if you suffer from obsessive-compulsive disorder (OCD), obsessive thoughts and compulsive behaviors become so consuming they interfere with your daily life. You probably recognize that your obsessive thoughts and compulsive behaviors are irrational—but even so, you feel unable to resist them and break free.
UNDERSTANDING OCD OBSESSIONS AND COMPULSIONS
OBSESSIONS – are involuntary thoughts, images, or impulses that occur over and over again in your mind. You don’t want to have these ideas, but you can’t stop them. Unfortunately, these obsessive thoughts are often disturbing and distracting.
COMPULSIONS – are behaviors or rituals that you feel driven to act out again and again. Usually, compulsions are performed in an attempt to make obsessions go away.
RISK FACTORS
Genetics :Twin and family studies have shown that people with first-degree relatives (such as a parent, sibling, or child) who have OCD are at a higher risk for developing OCD themselves.
Brain Structure and Functioning : Imaging studies have shown differences in the frontal cortex and subcortical structures of the brain in patients with OCD.
Environment: People who have experienced abuse (physical or sexual) in childhood or other trauma are at an increased risk for developing OCD.
Infection: In some cases, children may develop OCD or OCD symptoms following a streptococcal infection—this is called Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS).
MOST COMMON CATAGORIES
1.Washers : are afraid of contamination. They usually have cleaning or hand-washing compulsions.
2.Checkers : repeatedly check things (oven turned off, door locked, etc.) that they associate with harm or danger.
3.Doubters and Sinners : are afraid that if everything isn’t perfect or done just right something terrible will happen, or they will be punished.
4.Counters and Arrangers : are obsessed with order and symmetry. They may have superstitions about certain numbers, colors, or arrangements.
5.Hoaders : fear that something bad will happen if they throw anything away. They compulsively hoard things that they don’t need or use.
SIGNS AND SYMPTOMS
People with OCD may have symptoms of obsessions, compulsions, or both. These symptoms can interfere with all aspects of life, such as work, school, and personal relationships.
OBSESSIONS – are repeated thoughts, urges, or mental images that cause anxiety. Common symptoms include:
⚫Fear of germs or contamination
⚫Unwanted forbidden or taboo thoughts involving sex, religion, and harm
⚫Aggressive thoughts towards others or self
⚫Having things symmetrical or in a perfect order
COMPULSIONS – are repetitive behaviors that a person with OCD feels the urge to do in response to an obsessive thought. Common compulsions include:
- Excessive cleaning and/or handwashing
- Ordering and arranging things in a particular, precise way.
- Repeatedly checking on things, such as repeatedly checking to see if the door is locked or that the oven is off
- Compulsive counting
TIC DISORDER : Some individuals with OCD also have a tic disorder. Motor tics are sudden, brief, repetitive movements, such as eye blinking and other eye movements, facial grimacing, shoulder shrugging, and head or shoulder jerking. Common vocal tics include repetitive throat-clearing, sniffing, or grunting sounds.
TREATMENT AND THERAPY
1.PSYCHOTHERAPY : A type of psychotherapy called cognitive behavior therapy is especially useful for treating OCD. It teaches a person different ways of thinking, behaving, and reacting to situations that help him or her feel less anxious or fearful without having obsessive thoughts or acting compulsively. One type of therapy called exposure and response prevention is especially helpful in reducing compulsive behaviors in OCD.
2.MEDICATION : Antidepressants are sometimes used in conjunction with CBT for the treatment of obsessive-compulsive disorder. However, medication alone is rarely effective in relieving the symptoms of OCD. Mostly SSRIs are used like Fluoxetine, Fluvoxamine and Paroxetine.
3.FAMILY THERAPY : Because OCD often causes problems in family life and social adjustment, family therapy is often advised. Family therapy promotes understanding of the disorder and can help reduce family conflicts. It can also motivate family members and teach them how to help their loved one.
4.GROUP THERAPY : Group therapy is another helpful obsessive-compulsive disorder treatment. Through interaction with fellow OCD sufferers, group therapy provides support and encouragement and decreases feelings of isolation.
FIVE STEPS FOR CONQUERING OBSESSIVE THOUGHTS (5 R Approach)
1.RELABEL : Recognize that the intrusive obsessive thoughts and urges are the result of OCD. For example, train yourself to say, “I don’t think or feel that my hands are dirty. I’m having an obsession that my hands are dirty.” Or, “I don’t feel that I have the need to wash my hands. I’m having a compulsive urge to perform the compulsion of washing my hands.”
2.REATTRIBUTE : Realize that the intensity and intrusiveness of the thought or urge is caused by OCD; it is probably related to a biochemical imbalance in the brain. Tell yourself, “It’s not me—it’s my OCD,” to remind you that OCD thoughts and urges are not meaningful, but are false messages from the brain.
3.REFOCUS : Work around the OCD thoughts by focusing your attention on something else, at least for a few minutes. Do another behavior. Say to yourself, “I’m experiencing a symptom of OCD. I need to do another behavior.”
4.REVALUE : Do not take the OCD thought at face value. It is not significant in itself. Tell yourself, “That’s just my stupid obsession. It has no meaning. That’s just my brain. There’s no need to pay attention to it.”
5.REMEMBER : You can’t make the thought go away, but neither do you need to pay attention to it. You can learn to go on to the next behavior.
Note : I have made a course titled “Obsessive Compulsive Disorder : A Disorder That Cannot Be Ignored” that is published online on Unacademy, India’s largest online education platform.
Dr.Tasaduk Hussain Itoo is Medical Doctor at Acharya Shri Chander College of Medical Sciences and Hospital Jammu /Social Activist /Educator at Unacademy, India’s largest online education platform and can be mailed at drtasadukitoo@gmail.com
