OCD

Everyone may experience obsessive thoughts from time to time, and many of us have particular quirks or preferences that might qualify as compulsions. It is common for someone to “cyber stalk” their ex-partner in an attempt to get emotional closure at the end of a relationship, for example. Many children and adults are fussy about the different types of foods on their plates, preferring them to not touch each other. Whilst these are common examples of obsessive thoughts and compulsions, these are not generally debilitating conditions.

OCD is diagnosed after a series of medical and psychiatric exams and is determined by how much the fears and obsessions interfere with day-to-day life. If the obsessive thoughts and compulsive routines take up more than one hour a day, cause emotional distress, or interfere with daily tasks, then a diagnosis of OCD is sure.

OCD does not always have both obsessions and compulsions, and the degrees of both can differ. Some people only experience a high degree of intrusive, fearful, illogical thoughts, but do not have ritualized actions. We would say this person has OCD primarily diagnosable by their obsessions. Another person might not have repetitive thoughts but can only function when they have carried out their routine actions. This is an example of OCD with mostly compulsive traits.

Obsessions

These are unwanted thoughts, fears, or images that recur at all times, especially when they are unwanted. They cause anxiety, fear, or disgust and cannot be reasoned away or controlled by logic. Health experts have identified some common themes amongst OCD patients, and a person may experience one of them or a combination of many.

Common obsessions within OCD are an obsession with cleanliness and a fear of germs and contamination, an obsession with safety for oneself and their loved ones, persistent doubts like wondering if the door was locked or the stove switched off, an obsessive need for order and symmetry, taboo thoughts having to do with sexuality, beliefs or religion, aggressive thoughts directed at self or loved ones, and aggressive or violent images flooding the brain.

These are disturbing to have to deal with, and there can be any amount of shame, fear, anxiety, and frustration involved with such thoughts. People who experience these types of obsessive thoughts might resort to substances, self-harm, or compulsive behaviors to channel their feelings.

Compulsions

A compulsion is a behavior that you perform repeatedly because you feel driven to it. These might be physical or mental acts and they are related to obsessive thoughts or fears. Usually, these actions provide only temporary relief from anxiety, and ultimately need to be performed repetitively. This can be disruptive, time-consuming, and in certain cases, physically harmful.

Common compulsions are washing, cleaning, tidying and arranging, performing safety checks (locking doors more than once, etc.), counting, touching, performing a structured routine of each of these actions, speaking to oneself constantly throughout the day to counter the thoughts, and being careful to avoid walking on cracks on the pavement.

OCD patients often construct highly personalized routines to cope with their obsessive thoughts. It is common for them to have morning, afternoon, and evening rituals. Failure to perform any part of their rituals results in them needing to repeat it until it is done correctly, and there is an associative fear of great harm happening if they fail to perform their tasks.

OCD can wax and wane in intensity over time. When our lives become stressful and demanding, OCD symptoms may worsen, and we may even develop new obsessions or compulsions. Devoting time to compulsive rituals often compounds the stress and anxiety we face, meaning that OCD becomes a severe condition to deal with.

In calmer seasons of life, OCD might not even be apparent. The rituals we perform during these times are familiar and comforting, and it can be empowering to feel as if we are in control of our lives simply by counting, tapping, or arranging things. It is only when we are prevented from performing any of our “checks”, or tidying sessions, that we begin to experience panic or fear.

A person may navigate their whole life being unaware of having OCD and coping perfectly well with their obsessions and compulsions. It can take one event, like losing the security of a job or relationship, or losing a loved one, for OCD symptoms to flare up and out of control. This is usually when people seek help, whether it is for themselves, or a loved one seeking help for someone they suspect of having OCD.

Connected Conditions

OCD often manifests itself alongside other conditions and mental health disorders. Most commonly, it is connected to depressive disorders, anger issues, and anxiety disorders, and frequently to body dysmorphia – a disorder where the patient believes that a part of their body is abnormal.

During diagnosis, the exams and tests must identify all underlying and connected disorders so that a treatment plan can be tailored for the patient. OCD by itself is often enough to cause impairment and greatly impact relationships, families, and careers. When it is connected to other conditions and disorders, it is almost certain to be debilitating.

Experts still do not know what causes OCD, but a combination of genetics, environment, and brain chemistry might be factors. Treatment for OCD consists of psychotherapy, medication, or a combination of the two. Because of the nature of OCD, and its tendency to be connected with other disorders, a treatment plan must often be tailor-made for the individual patient.

Therapy

Cognitive-behavioral therapy (CBT) is a common form of psychotherapy for OCD patients. The underlying emotion in most obsessive-compulsive behavior is anxiety and fear, and this is usually baseless and illogical, yet it prompts a real fear response. In cognitive-behavioral therapy, the patient is exposed to images or situations that they would normally avoid or control. They are instructed to forgo their usual coping behavior and face the fearful situation.

By allowing themselves to be exposed to a situation that they normally avoid or control, this time without their coping rituals, they begin to see that their fears are baseless. They begin to cope with the fears and are led gradually from low-anxiety exposure to high-anxiety exposure. Treatment is done in sessions with the therapist and continued at home. Patients sometimes avoid this type of therapy because they don’t feel as if they can face their fears, and might want to start with a different focus.

Medication

Medication for OCD is the same as medication for depression, which is selective serotonin reuptake inhibitors (SSRIs). It is usually a higher dosage that treats OCD, and patients who do not respond to one type of medication may respond positively to another. It can take between six and twelve weeks to see a difference, but the change is often dramatic and positive. It is recommended for severe cases of OCD that patients receive both CBT and SSRIs.

Next Steps

Whether you have been diagnosed with OCD, suspect you might have OCD, or whether you have a loved one with OCD and it is affecting you, it is always appropriate, and sometimes necessary, to seek outside help. Obtaining a medical diagnosis is a good place to start, but deciding on the best course of treatment may require a second opinion.

Many of us have never been part of a counseling session before, and the idea might be intimidating. In this case, it’s a good idea to write down every question you can think of regarding OCD, or any other disorder you want more information on. This is a great place to start when visiting a counselor for the first time.

Treatment is hardly ever a straightforward process. It might begin with consulting a medical professional, and counseling might be part of the entire journey for you. Contact our offices to set up an appointment with a counselor, and take the first step on your journey to emotional and mental wellness.