INTRODUCTION

Obsessive-compulsive disorder(OCD) is a mental and long-lasting disorder. According to the World Health Organization, OCD is one of the top 20 causes of illness-related disability, worldwide, for individuals between 15 and 44 years of age. Along with treatment for OCD, one can live a happy life.

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What is OCD?

OCD is a chronic disorder in which a person has recurrent thoughts and uncontrollable behavior which urges them to do a certain behavior time and again. Sometimes people with OCD tend to become a liability during an emergency situation. OCD consists of both obsession and compulsion.

What is the difference between Obsession and Compulsion?

Obsession is obsessive thoughts, impulses, and ideas which disrupt one’s life. Compulsions are the urge which occurs in response to an obsession.

By repetitive thoughts and ideas, one faces anxiety and when they respond with compulsions they feel safer and relief which is short-lived. Although, if one is disrupted during compulsion they feel petrified whether they might hurt their loved ones as they stopped doing their ritual.

Prevalence of OCD

OCD is that the condition affects as many as 12 in every 1,000 people (1.2% of the population) from young children to adults, regardless of gender, social, or cultural background. Reports say that the 12-month prevalence of OCD is also 1.2%, with a similar prevalence internationally of between 1.1%—1.8%.

Gender

OCD occurs to both men and women correspondingly. childhood-onset is present more in males and in the late twenties in women.

Facts about OCD

1. According to the World Health Organization, anxiety disorders, like OCD, are more prevalent in developed countries than in developing countries
2. There has been no identification of even a single OCD gene
3. OCD can not be diagnosed with medical equipment like an X-ray

Symptoms of OCD

1. Fear of germs or contamination.
2. aggressive
3. having things in perfect order
4. taboo thoughts involving sex or religion
5. compulsive counting
6. excessive cleaning
7. repeatedly checking

 

Types of OCD

1. Contamination and washing

This obsession is mainly focused on the fear of contamination through diseases/ illness or fear of dirt, germs, being physically unclean and it even extends towards animals, insects, or any sort of liquid. These kinds of people generally avoid public places like washrooms and tend to refrain themselves.

The fear of contamination makes them feel uncomfortable and disgust so they fight that feeling through compulsion by washing repeatedly until they feel some kind of relief.

2. Accidental harm and checking compulsion

People who fall under this category tend to recheck repeatedly in fear of being negligent and hurting themselves or others. Example: Rechecking if they have closed the door, turned off the stove, etc.

This is the fear of uncertainty and doubt. They continuously reassure themselves to feel a certain kind of relief.

3. Symmetry obsession with counting and arranging

Being a perfectionist comes along with OCD patients. These people tend to engage themselves in compulsive behavior by repetitively arranging and organizing objects. The patients experience discomfort when things are not aligned or perfect according to them. They tend to rearrange and organize until they feel better. This may be caused due to fear. Example: ” if I don’t arrange the pens, my brother will fall from his bike while coming back from college”

4. Taboo thoughts and mental rituals

This obsession is characterized by intrusive thoughts and impulses especially about religion, sex, or violent nature. This group of people is often known as “purely obsessional”. These people tend to overthink either being a rapist or physically hurting somebody but they have never because they know their thoughts are dangerous and they suppress that feeling by mental rituals. They constantly argue with themselves on morality, neutralize their thoughts, and get reassured by their loved ones. People dealing with this obsession already know their triggers so they refrain from such places.

Causes and risks for OCD

1. Drug-induced OCD

Atypical antipsychotics such as olanzapine (Zyprexa) have been proven to induce de-novo OCD in patients.

2. 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. There is no one single gene component found yet but scientists believe certain genes may have played a part.

3. Brain structure and functioning

A hinder functioning with the transmission of certain brain chemicals, such as serotonin and norepinephrine may contribute to OCD.

4. Environmental factors

It has been noticed that stressful events like trauma, physical abuse, and stress can play a part in development. Children may develop OCD or OCD symptoms following a streptococcal infection—this is called Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)

5. Pregnancy and the postpartum period

Hormones can trigger symptoms and symptoms get worse with pregnancy

 

THEORIES OF OCD

1. Cognitive-behavioral theory

Almost everybody experiences some unexpected thoughts on a daily basis but people dealing with OCD, it makes them vulnerable. It is a vicious cycle of thoughts haunting them. People with OCD know that their thoughts are dangerous and they want to be in control but one gets trapped in these dangerous thoughts and it’s nearly impossible for them to concentrate or shift their focus on anything else. Even though they have a feeling of hurting somebody there has not been even a single case as such because they compel themselves to suppress those feelings.

2. Psychodynamic Theory

Psychodynamic theories of OCD state that obsessions and compulsions are signs of the unconscious conflict that you might be trying to suppress, resolve, or cope with. These thoughts are in conflict on a daily basis with one’s morality as its related to one’s odd wishes regarding religion, sex, and violence which are not socially accepted. They try to suppress their feelings by focusing on other things that end up becoming a mental ritual. They don’t stop until they feel secure and relieved.

Preventions:

There are no preventions to OCD but one can seek help before it gets worse.

Treatments:

The most beneficial type of treatments are medication and therapies in OCD

1. Psychotherapy

Cognitive behavior therapy helps in the change in one’s thought process. The psychologist creates a situation and helps the patients suppress those feelings and take control over them.

2. Relaxation

It helps in the relaxation of the mind by doing activities like meditation and yoga.

3. Medication

Psychiatric drugs called selective serotonin helps OCD people take control over obsession and compulsions. It usually takes 2 to 4 months before it is effective. If still there are signs of symptoms, doctors might give antipsychotic drugs like aripiprazole. The most common psychiatric drugs are Citalopram, fluoxetine, paroxetine, and sertraline.

4. Neuromodulation

● In rare cases when both medication and therapy do not work, the doctors might recommend devices that change electrical activity in certain areas of the brain.

● Deep brain stimulations use electrodes that are implanted in the head.

5. TMS (Transcranial Magnetic stimulation)

It is a non-invasive device that is held above the head to induce the magnetic field. It is FDA approved for OCD treatment, it stimulates nerve cells.

When to seek professional help?

Professionals suggest that as soon as the symptoms start to interfere in one’s day to day life one needs to seek professional help.

When to get emergency help?

When one’s obsession and compulsions take more than an hour of time on a daily basis

Where should one get help?

● The International OCD Foundation (IOCDF)

● The Association for Behavioral and Cognitive Therapies

● The Anxiety Disorders Association of America

● SAMHSA’s National Helpline