Understanding Obsessive Compulsive Disorder (OCD): Treatment, Challenges and More
OCD, or Obsessive Compulsive Disorder, is a lifelong condition driven by obsessive thought patterns that culminate in repetitive compulsive behaviors. A common misconception is that people who are obsessed with being clean and organized have OCD. This is not the case. A person with OCD cannot stop themselves from exhibiting compulsive behavior even when they know it is causing them harm.
If you are concerned whether you or someone you love has OCD, seek professional help at the earliest. The sooner you start OCD treatment, the better the chances of managing symptoms. To learn more about Obsessive Compulsive Disorder and the different types of OCD, download the Estenarh app now.
What is OCD & OCD Behavior
OCD is a type of mental disorder that is marked by repetitive obsessive thoughts and compulsive behaviors. What differentiates OCD thought patterns from regular thoughts is that they are unwanted and cause fear and anxiety. These unwelcome patterns can also present themselves as mental images and urges that cause significant distress. The resulting compulsive behavior is a way of coping with the thought pattern and can become a ritualistic practice.
OCD commonly gets mistaken for OCPD or Obsessive Compulsive Personality Disorder. A person who has OCPD is usually preoccupied with being organized, having control and perfectionism. They tend to reject the notion that their behavior is wrong or their actions excessive. More often than not, OCD sufferers are aware of their condition. However, not all OCD types are the same.
There are instances of patients who only struggle with obsessive thoughts or compulsive behaviors and not both.
Obsessions vs Compulsions - What are they?
In OCD, obsessions are debilitating thoughts that keep playing over and over again in the patient’s head. Sometimes, even if the patient is aware that they won’t act on dangerous thought patterns involving harming themselves or others, or doing something inappropriate, they still worry that they might act on them.
Compulsions or compulsive behavior in OCD is often linked to an obsessive thought, although there are cases where the compulsive behavior is more of a ritual that stems from a belief. This could look like knocking on the doorframe a specific number of times whenever they leave the house because they believe that not doing so would put them in danger. When compulsive behavior is related to obsessive thought, the result is a mental or physical reaction to the thought. For instance, if you have obsessive thoughts about germs on your hand making you sick, the compulsive behavior would look like washing your hands repeatedly to the point of damaging your skin. These behaviors can really consume a significant amount of time and leave OCD sufferers with a diminished quality of life.
OCD has so many different expressions. There are symptomatic nuances under obsessions and compulsions that differentiate them further. There is no cure for OCD, just ways to manage its intensity better. This is why it is important to start treatment of Obsessive Compulsive Disorder as early as possible.
OCD Symptoms & Types
OCD presents itself in countless forms but is often broken down into five main categories. The symptoms vary depending on the OCD category.
5 Main Types of OCD
- Checking
- Contamination
- Symmetry and order
- Intrusive thoughts
- Hoarding
OCD Symptoms Related to Checking
Obsessive Thought Patterns:
These are usually related to fears and worries about causing damage or harm to self, others, or property. For instance, burning the house down because the stove is on, forgetting your wallet, leaving the front door unlocked, sending a poorly worded email or text message, or new driving routes, among others.
Compulsive Behaviors:
The compulsive behavior that stems from the above thoughts is excessive checking. Some of these fears or worries are common, and we have all probably double-checked door locks and whether we have our phones and wallets before leaving the house. But for a person with OCD, these checks can take hours. It could look like never being able to leave the house on time, endlessly re-reading texts or emails, and just being frozen in a cycle of compulsive actions.
OCD Symptoms Related to Contamination
Obsessive Thought Patterns:
The fear of germs, dirt, or other perceived contaminants causing harm to self or others is the obsessive thought behind Contamination OCD. Worries include having to shake hands, the use of public toilets, touching door knobs/handles, handling physical money, or even visiting the hospital and other crowded places.
Compulsive Behaviors:
The behavioral implications of Contamination OCD include compulsive cleaning and disinfection of self and belongings. This could look like bathing multiple times a day, overwashing hands, and spending hours and hours cleaning and disinfecting the house. It can also lead to spending exorbitant amounts on cleaning products. In some extreme cases, fear of contaminants can even result in the person refusing to leave their home.
OCD Symptoms Related to Symmetry and Order
Obsessive Thought Patterns:
There is an element of perfectionism that drives the thought patterns in this scenario, where the person finds themselves obsessed with achieving symmetry and order in everything. It stems from the worry of causing discomfort or harm through disorder.
Compulsive Behaviors:
OCD sufferers under this category spend hours organizing things and getting them to look perfectly aligned. This type of compulsive behavior often takes up a lot of time and leaves patients feeling drained or exhausted. They may prioritize restoring/creating order over regular responsibilities like going to a meeting on time or running errands. Any disruption to their well-ordered space can cause significant distress.
OCD Symptoms Related to Intrusive Thoughts
Obsessive Thought Patterns:
Here, thought patterns are often violent, taboo, or socially unacceptable and leave the OCD sufferer feeling deeply distressed, disgusted, and worried about acting on the thought. Committing violent or sexual acts against loved ones, driving into traffic, or even having blasphemous thoughts on religion are some examples of intrusive thoughts. This is different from fantasizing or imagining scenarios. Here, the thoughts are completely unwanted, and the OCD sufferer has no intention of acting on it but continually worries about acting on it.
Compulsive Behaviors:
This type of OCD results in behaviors like seeking reassurance from loved ones, excessive showering in an attempt to cleanse their thoughts, or even repeating prayers. Individuals with this condition often try to avoid situations that they believe will trigger intrusive thoughts.
OCD Symptoms Related to Hoarding
Obsessive Thought Patterns:
OCD hoarders are afraid of accidentally throwing something of value and importance. They also tend to attach sentimental value to items, reinforcing their belief that they cannot throw them away. There are also aspects of ‘magical thinking’ involved. This is when a person believes that certain objects may possess supernatural powers - for example, perceiving an object as one that brings good luck. Other thoughts that drive hoarding include fears of scarcity or running out of something, or fear of contamination - which prevents them from touching objects that feel dirty to them.
Compulsive Behaviors:
A person with this type of OCD tends to stockpile large quantities of items that may appear irrational or unnecessary. They tend to keep rechecking whether they have accidentally thrown away something they should not have. This results in them living with large amounts of trash and seriously affects their general well-being.
What Causes OCD
While researchers are still unable to pinpoint the exact cause of OCD, they believe that there are certain factors that play a part in its development. These include:
Childhood Trauma
Some studies indicate the possible connection between early abuse and neglect in children and OCD.
Genetics
It was found that the likelihood of an individual developing OCD was higher if their parent or sibling had OCD as a child or teenager.
PANDAS Syndrome
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections - or PANDAS, are a set of conditions that can afflict those who had strep infections as a child. OCD has been identified as one of those conditions.
Brain Changes
There are clear differences in the brain structures of people with and without OCD - especially in the frontal cortex and subcortical brain structures. It is probably why OCD is also associated with other neurological conditions that impact similar regions of the brain. This includes epilepsy, Tourette’s syndrome, and Parkinson’s disease.
Though it is not uncommon to observe signs of OCD in smaller children, this condition typically presents in early adulthood with the average age of onset recorded as 19. Once you cross the age of 40, the chances of developing OCD are slim.
Other Disorders Related to OCD
OCD sufferers often struggle with other disorders depending on the category their obsessive thoughts or compulsions fall under. Body dysmorphia, compulsive picking of skin, hypochondria, pulling out hair or trichotillomania, and olfactory reference syndrome are some of the conditions to look out for.
A person with OCD often also suffers from depression, anxiety, or eating disorders, given the nature of their condition.
OCD follows a wave-like pattern, with some periods having aggravated symptoms and others where the symptoms are less debilitating. While there is no cure or prevention for OCD, treatment helps manage it.
Managing OCD: Therapy & Treatment Protocols
The recommended treatment for OCD involves a combination of psychotherapy and medication. Psychotherapy, also known as talk therapy, offers different strategies to help individuals manage their condition. These include:
Exposure and Response Prevention (ERP)
Here therapists expose patients to their fears and help them resist the urge to respond compulsively. This reinforces the truth that nothing bad will happen if they don’t act on their compulsions and helps the patient recognize that their thoughts are not reality.
Cognitive Behavioral Therapy (CBT)
After being examined, a patient is taken on an inward journey to understand their thought patterns and emotions. Eventually, they are able to replace the thoughts that are harming them with healthier ways of thinking and new coping mechanisms that are less disruptive to daily life.
Acceptance and Commitment Therapy (ACT)
This form of psychotherapy focuses on helping individuals accept that their thoughts are only thoughts and not reality. This helps them break free from the obsession driving their behavior and lead a more relaxed life.
OCD medication usually includes SRIs or Serotonin Reuptake Inhibitors and antidepressants. These can take up to 12 weeks to make a noticeable difference. It is important to consult a licensed medical practitioner before taking any medication for OCD.
Do not be discouraged if you or a loved one has OCD. With time, patience, and the right support system, it is possible to regain a life that is fulfilling and free from crippling anxiety. Download the Esternarh app to access helpful resources on OCD and how to live with it. The app also allows you to easily schedule an online consultation with our highly qualified mental health professionals from the convenience of your home.
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