What is OCD?

Obsessive-compulsive disorder (OCD) is characterized by repeated and persistent intrusive thoughts, impulses or images that cause an individual to feel compelled to repetitive behaviours or thought processes. Obsessive thoughts do not necessarily result in obsessive behaviours. However, obsessive-compulsive behaviour is a means to help alleviate the anxiety caused by an obsessive-compulsive concept.

 

Although obsessive-compulsive disorder is common, it can cause serious physical and mental distress. In addition to increased anxiety in everyday life, the inability to control thoughts and impulses causes the individual to feel conflicted. Though most patients are well-aware that their behaviour is strange, only about 75-90% of people with OCD gain such insight.

 

Examples of obsessional symptoms:

  • Cleanliness, such as repeated and excessive hand washing
  • Double checking door locks, stoves, etc.
  • Always entering a doorway with the same foot
  • Walking with feet parallel to the curb
  • Arranging items in a certain way
  • Unconsciously repeating the same words many times
  • Constantly reliving an experience or memory in the mind
  • Recurrent worries, such as hypochondria etc.

 

How to understand OCD:

The specific cause of obsessive-compulsive disorder is not clear but is known to be related to an individual's cognition, cognitive deficits, or other psychological complications. In additional to physiological, psychological, genetic, environmental or other external factors, personality and childhood events may also lead to obsessive-compulsive disorder. Repeated ideas and behaviours emerge as means to alleviate certain fear or anxiety.

 

Men and women are equally likely to develop OCD though men may develop the disease at an earlier age. In the general population, its prevalence is around 2%.

 

Obsessive-compulsive disorder can be misdiagnosed as anxiety, depression, or other psychological disorders. As with any psychological problems, it is important to seek a professional psychologist or psychiatrist for formal diagnosis and treatment.

 

How to deal with OCD:

 

  • Exposure therapy (ERP) — includes both imaginary and real-life exposure, which modifies individual cognition through progressive induction training to eliminate the chain reaction of fear and anxiety.

 

Example:
Imaginary exposure – ask an individual with an obsessive-compulsive cleaning habit (washing hands repeatedly) to imagine that their hands are dirty, but they are not allowed to wash them

 

Physical exposure - literally exposing the individual's hands to dirt and preventing them from washing their hands. When the compulsive behavior (hand washing) is prevented, the individual will undoubtedly experience pain and anxiety. Repeated exposure exercises may help individuals realize that the things they are anxious about are not going to happen and thus decrease feelings of unease and associated OCD behaviours.

 

  • Aversion therapy  Avoiding bad habits through aversive conditioning by combining the goal of abstinence with "punishment".

 

Example: Use a rubber band strapped around the wrist to inflict temporary pain in effort to help reduce the number of instances of an obsessive-compulsive behaviour.

 

  • Medical treatment:
    There are many different medications used for the treatment of obsessive-compulsive disorder such as: fluoxetine, sertraline, paroxetine, clomipramine (TCA), HCL (SNRIs), mirtazapine (NaSSA) and other SSRI drugs. Please follow a medical professional’s advice and treatment plan; do not alter dosage or change medication without consulting a medical professional.

 

  • Physical therapy:

    Deep brain stimulation (DBS), electroconvulsive therapy, and surgery are used in severe cases when psychotherapy and medication are ineffective. Combination therapy is when psychotherapy and medication are used together.

 

How to effectively manage Obsessive-Compulsive Disorder?

At the personal level
  • Establish a positive mindset: When anxious, give yourself positive feedback: “This is normal; I have done very well” or “Don't worry too much about it, let it be.”

  • Learn to relax: Complete mindfulness exercises such as breathing exercises or meditation.

  • Shift your focus: Find a variety of hobbies and activities to do.

  • Persistence: any of the above, in addition to treatments such as exposure therapy, requires self-encouragement and persistence

 

Family and friends
  • Do not judge, question, or pressure the individual

  • Be patient and respectful

  • Provide encouragement and company during medical appointments and treatment

  • Encourage patients not to give up treatment, value every small improvement, and provide emotional and personal support.