We often hear people say obsessive-compulsive disorder in our daily life, but what exactly is obsessive-compulsive disorder?Obsessive-compulsive disorder (OCD) is a mental health condition, in which people have persistent or repetitive thoughts (obsessions) that are distressing, leading to the person’s behavior (compulsions) to neutralize or suppress the thoughts. OCD can affect daily functioning and can be very debilitating. The thoughts and obsessions are persistent and recurrent, and cannot just get rid of them. Some people with OCD are aware that the obsessions are irrational, but cannot stop the thoughts nor the compulsions. The anxiety caused by these obsessive-compulsive thoughts can only be alleviated by repeating the behavior all the time. Behavioural aspects can range from mild to severe, such as washing hands, sweeping the floor, cleaning up files, or even an obsessive thought like someone getting too close to me might stain me. They can only keep on repeating to relieve anxiety, and these symptoms of OCD can seriously affect work, relationships, daily life, etc. Obsessive compulsive disorder occurs mostly in adolescence or early adulthood (before the age of twenty-five) and occurs equally in men and women, accounting for roughly 2-3%of the population.
There are two main symptoms of obsessive-compulsive disorder, obsessive thinking and compulsive behavior:
Obsessions:
Obsessions can be thoughts, images or urges that are distressing. Examples include the need to keep things symmetrical, fear of contamination or poor hygiene, unsure whether the door is locked or the stove has been turned off, etc. Even if they know rationally that they are unreasonable, they still cannot stop such thoughts. These thoughts can create anxiety, and in order to relieve such anxiety, people with OCD have obsessive-compulsive behaviors.
Compulsive behavior:
Compulsions are behaviors that are performed to temporarily reduce anxiety and distress in response to their obsession. Some people carryout the compulsive behavior in the belief that it will stop bad things from happening. Common examples include washing hands, checking, counting, cleaning, arranging items, repeating etc. These behaviors may affect their normal life.They spend several hours a day doing these repetitive and compulsive behaviors, causing great trouble to their lives, interpersonal and social relationships.
There is no single cause for OCD, and some theories that have been thought to be risk factors include: family history of obsessive compulsive disorder, co-existing mental health disorders, history of trauma, biological factors, as well as environmental factors.
Treatment options for obsessive compulsive disorders include medication and psychotherapy, or a combination of both. Types of therapy used for OCD include cognitive behavior therapy (CBT) and exposure and response prevention (ERP). CBT aims to help people learn to change their thoughts and behaviors, identify problematic thoughts, etc. CBT is often used for other mental health conditions like anxiety and depression. ERP involves exposure to their obsessions, followed by response prevention (the patient is prevented from carrying out the compulsive behavior). For example, preventing excessive hand washing compulsive behavior, etc.
Some patients with OCD may require a combination of therapy and medication. This will require seeing both psychiatrists for medication, and therapists for the psychotherapy. Family therapy can also assist, where families and patients face OCD together to understand the symptoms of OCD tor educe family conflict.
References:
Stein, D. J., Fineberg, N. A., Bienvenu, O. J., Denys, D.,Lochner, C., Nestadt, G., ... & Phillips, K. A. (2010). Should OCD be classified as an anxiety disorder in DSM-V ?. Depression and anxiety, 27(6),495-506.
Pertusa, A., Fullana, M. A., Singh, S., Alonso, P., Menchón,J. M., & Mataix-Cols, D. (2008). Compulsive hoarding: OCD symptom, distinct clinical syndrome, or both?. American Journal of Psychiatry, 165(10),1289-1298.
