Obsessive-Compulsive Disorder

Overview

Obsessive Compulsive Disorder (OCD) is a mental illness which prompts a person to have recurrent obsessive thoughts and carry out compulsive activity. An obsession is an unwanted and unpleasant thought, image or urge that repeatedly enters a person's mind, triggering feelings of unease or disgust. While there is no particular treatment for OCD, it could be managed by medicine and therapy, such as cognitive-behavioral therapy (CBT).

What is OCD?

OCD is typified by recurrent, bothersome thoughts known as obsessions and repetitive actions known as compulsions that are intended to lessen suffering or stop imagined harm. These ideas and actions can take up a lot of time, which can be quite distressing and interfere with day-to-day functioning.

Compulsions take the form of rituals like handwashing, checking locks, or counting, whereas obsessions frequently centre around themes like cleanliness, orderliness, or safety. Even though OCD sufferers are aware that their compulsions and obsessions are unreasonable, they yet feel anxious without fulfilling these perceived obligations.

Types of OCD

Contamination OCD: People who suffer from this kind are obsessed with germs or contamination. They might have obsessive cleaning or handwashing routines as a coping mechanism for their fear of getting contaminated by touching particular items or surfaces.

Checking OCD: This subtype is characterised by obsessions with damage or danger, which cause people to constantly check appliances, stoves, locks, and other items to make sure they're safe. These routines for verification might be time-consuming and disruptive to day-to-day activity.

Symmetry and Ordering OCD: People with this subtype are fixated on accuracy, symmetry, and order. When items are not precisely arranged or aligned, they could become upset and turn to obsessive habits like counting, symmetry-seeking, or organising to cope with their feelings of anxiousness.

Hoarding OCD: Often regarded as a subtype of OCD, hoarding disorder is typified by a recurrent inability to get rid of or part with belongings, regardless of their true value. Excessive clutter accumulation by people with hoarding OCD can cause severe anguish and functional impairment.

Pure-O OCD: Known as Purely Obsessional OCD, pure-O is characterised by intrusive, upsetting thoughts or images in the mind without any discernible compulsions. These obsessions, which can cause extreme anxiety and anguish, may revolve around taboo or violent subjects.

Symptoms of OCD

Many psychological symptoms are inherent to OCD, which can have a negative effect on a person's everyday functioning, interpersonal connections, and mental health.

These symptoms usually fall under two main groups: obsessions and compulsions.
Obsessions are recurrent intrusive thoughts, ideas, or urges that plague a person's mind. Some symptoms may also present themselves in the form of fears, like that of dirtiness, hurting oneself or others, making mistakes, or an obsessive need for symmetry and orderliness. These may trigger anxiety and unease in an individual.

On the other hand, compulsive activities or thoughts are those in which a person feels compelled to perform an action repeatedly due to an obsession or according to strict guidelines. Compulsions are frequently carried out to stop a dreaded circumstance or event from happening or to lessen the misery brought on by obsessions. Compulsions can take many different forms, such as compulsive hand washing or excessive cleaning, counting, double-checking, organizing objects in a certain way.

People with OCD can display a wide range of symptoms, ranging in intensity from minor to severe. These symptoms are subject to vary over time and may be impacted by environmental circumstances or stress. People with OCD frequently find it difficult to resist or control their obsessions and compulsions, even though they are aware that they are excessive or illogical.

Causes of OCD

Even though the exact root behind OCD hasn’t been fully identified, according to scientific research, its development may be influenced by a number of different neurological, genetic, environmental, and psychological variables.

Largely, we know that OCD tends to be genetically influenced since those who have a family history of the condition are more likely to have it themselves. Numerous genes that may be connected to OCD have been found through studies, however, the precise genetic pathways are still unknown.

People with OCD have also been shown to have abnormalities in the brain's orbitofrontal cortex, caudate nucleus, and anterior cingulate cortex, among other regions. Since these regions are involved in behavior, emotion regulation, and decision-making, it is possible that OCD symptoms are exacerbated by malfunction in these areas.

OCD risk may also be raised by environmental factors, such as traumatic childhood experiences, stressful life events, or major life transitions. In susceptible people, traumatic events can either precipitate the development of OCD symptoms or aggravate pre-existing ones.

Psychological factors, like anxiety and stress can also lead to OCD. Notably, this disorder may also persist, when aided by specific internal attitudes or beliefs in the mind, like the importance of maintaining order around.

Prevention of OCD

It is difficult to completely prevent OCD because of the specific interactions between genetic, neurological, environmental, and psychological factors. However, these preventive measures listed below may not guarantee immunity from OCD, they can contribute to overall mental well-being and potentially reduce the severity or frequency of symptoms.

Early intervention: It might be very important to identify and treat anxiety symptoms or obsessive-compulsive behaviours in children and adolescents. It is possible to control symptoms before they worsen by offering support and implementing suitable interventions, such as cognitive-behavioural therapy (CBT) or stress management approaches.

Healthy lifestyle: Promoting a well-rounded lifestyle that includes physical activity, enough sleep, and nourishing food helps enhance resilience and general mental health, which may help with OCD symptoms.

Stress management: By teaching people healthy coping skills for handling stress and anxiety, we can lessen the chance that people will turn to unhealthy coping processes that could exacerbate OCD symptoms.

Psychoeducation: Teaching people and their families about OCD, its symptoms, and the various treatment choices can aid in early detection and intervention, giving people the confidence to ask for assistance when they need it.

Refraining from substance misuse: Substance abuse can make OCD and other mental health disorders worse. Encouragement to abstain from or use drugs and alcohol sparingly can help lower the chance of symptoms getting worse.

Tests and Treatments for OCD

OCD diagnosis usually entails a thorough evaluation conducted by a mental health specialist, such as a psychologist or psychiatrist. The diagnostic procedure consists of multiple essential parts:

Clinical interview: A comprehensive interview is conducted by the mental health professional to learn about the patient's symptoms, including their intensity, duration, and effect on day-to-day functioning. They also ask about any associated suffering or impairment, as well as the existence of obsessions and compulsions.

Diagnostic criteria: The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria are used by the mental health professional to evaluate the patient's symptoms. An obsession, compulsion, or both must be present for the person to meet the criteria for OCD. These behaviours must be time-consuming, severely distressing, and interfere with daily functioning.

Differential diagnosis: The mental health practitioner looks at other mental health conditions such as anxiety disorders, depression, or body dysmorphic disorder as potential causes of the patient's symptoms. They also evaluate any substance abuse or medical issues that might be causing the symptoms.

Evaluation instruments: Standardised evaluation instruments, such as self-report surveys or rating scales, can be employed to enhance the clinical interview and offer more information about the type and intensity of the patient's symptoms.

To rule out medical illnesses that could mimic or exacerbate OCD symptoms, it may occasionally be necessary to collaborate with other healthcare experts, such as neurologists or primary care physicians. Following a comprehensive evaluation, the mental health specialist produces a diagnosis and a personalized treatment plan that may involve medication, psychotherapy, or a mix of both.
As per NHS, OCD could primarily be treated with:

1. Talking therapy, which is usually a type of therapy that helps an individual face their fears and obsessive thoughts without "correcting" them with compulsive acts.
2. Medicines, usually a type of antidepressant medicine that can help by altering the balancing chemicals in your brain.