OCD Definition

Recurrent, unwanted thoughts, ideas, or feelings are a symptom of obsessive-compulsive disorder (OCD). In order to get rid of the thoughts, they feel pressured to repeat an action. (compulsions). Repetitive behaviours like hand washing/cleaning, checking on things, and mental acts like counting or other activities may substantially hinder a person's daily activities and social interactions.

Even people without OCD frequently have disturbing thoughts or engage in repetitive actions. But these hardly ever get in the way of daily life. Patients with OCD experience intrusive, repetitive, and rigid thoughts and behaviours. When the behaviours are not followed, there is typically great suffering and a particular fear of terrible consequences. Although many OCD patients are aware of or assume that their obsessional thoughts are unfounded, some nonetheless could hold this belief. Even when they are aware that their intrusive thoughts or compulsive behaviours are unjustified, people with OCD find it difficult to let go of them.

The presence of obsessional thoughts and/or compulsions that are stressful, time-consuming (lasting more than an hour per day), and interfere with social or occupational functioning is required for the diagnosis of OCD. OCD affects 2-3% of the population in the US, with women being somewhat more likely to be affected than men among adults. OCD often begins in adolescence or early adulthood. OCD may be present in some persons even when they do not fully fit the criteria for the illness.

Obsessions

Obsessions are recurring, persistent desires or images that cause unpleasant emotions like fear, revulsion, or concern. Many OCD sufferers are aware that these excessive or unreasonable thoughts and activities are a product of their own imaginations. However, the distress brought on by these intrusive thoughts cannot be eliminated by logic or reasoning. The majority of OCD patients utilise compulsions to calm their uncomfortable obsessional thoughts or to disprove any perceived dangers. Additionally, individuals might try to ignore or conceal their obsessions, or they might try to focus on something else.

Examples of typical obsessional thought content:

• Anxiety about being contaminated by others or the environment.
• Unsettling sexual ideas or images.
• Strong anxiety about anything being lacking.
• Extreme anxiety about precision, symmetry, or order.
• Great anxiety about losing or tossing something valuable.
• Extremely religious, usually blasphemous, ideas or concerns.

Other examples include seemingly meaningless phrases, visuals, sounds, or musical compositions.

Compulsions

A person who experiences compulsions as a result of an obsession engages in repetitive behaviours or mental acts. An individual's obsession-related suffering is typically temporarily relieved or reduced by the behaviors, and they grow more eager to repeat the same behaviours in the future. Compulsions include either completely unconnected activities or responding in ways that are directly connected to an obsession (such as washing one's hands excessively out of fear of contamination). In the worst cases, a day could be filled with repetitive procedures that prevent you from carrying out your regular activities.

Compulsions examples:

• Excessive hand washing, taking shower, brushing teeth again and again, or toileting.
• Repeating cleaning of household things.
• Arranging things in a particular way.
• Repeatedly checking locks, appliances, doors, switches, etc.
• Constantly seeking approval or reassurance
• Rituals related to numbers, such as counting, repeating, excessively preferencing or avoiding certain numbers.
• Persons who have OCD may also stay away from specific persons, places, or circumstances that upset them and lead to obsessions and/or compulsions.

Avoiding these activities could make it much more difficult for them to function in life and could have a negative impact on other aspects of their mental or physical health.

Treatment

Effective OCD treatment frequently results in improvements in functioning and quality of life for patients. An individual may benefit from treatment if they want to function better at work and school, form and maintain relationships, and engage in leisure activities.

Cognitive Behavioral Therapy

The effective treatment cognitive-behavioral therapy (CBT) includes the technique of ERP (exposure and response prevention). During therapy sessions, patients are exposed to disturbing pictures or events connected to their obsessions. The initial effects of the treatment typically result in increased anxiety, even if it is customary to start with those that only induce mild or moderate symptoms. It is suggested that patients refrain from their regular compulsive habits (known as response prevention). By staying in a terrifying situation without anything horrible happening, patients learn that their fearful ideas are just that?thoughts. People gradually improve their ability to control their thoughts without using repetitive motions, which lowers their anxiety. Using evidence-based guidelines, therapists and patients typically collaborate to develop an exposure plan that gradually moves from low anxiety contexts to high anxiety situations. Both at home and in therapy sessions, exposures occur. CBT is the most successful therapy for treating many forms of OCD, however some OCD sufferers may not want to participate because of the initial fear it generates.

Medication

A family of medications called selective serotonin reuptake inhibitors (SSRIs), which are typically recommended to treat depression, can effectively cure OCD. SSRI dosages are usually greater for OCD treatment than for depression. Patients who do not respond well to one SSRI drug can respond well to a different one. It normally takes six to twelve weeks or more for the full amount of the maximum benefit to become visible. Patients with mild to severe OCD symptoms are frequently treated with either CBT or medication, depending on the patient's preferences, cognitive ability, and level of insight, as well as the existence or absence of co-occurring mental diseases. There might be more treatment choices available. The best treatment for OCD when symptoms are severe is a mix of CBT and SSRI.

Neurosurgical treatment

According to more recent research, gamma ventral capsulotomy, a surgical procedure, can be quite beneficial for patients who do not respond to traditional treatments and are badly afflicted, but it is underutilised due to historical prejudice and because of how intrusive it is. Data show that deep brain stimulation, which involves implanting a device in the brain, is beneficial. Deep brain stimulation does not permanently damage brain tissue, unlike a capsulotomy. Although there are less medical staff members and hospital systems able to provide DBS patients with the long-term help they need, the procedure is still highly invasive and challenging to manage.

How to Support a Loved One Struggling with OCD

It is encouraged that OCD patients ask their family, friends, or carers for help with exposure practise at home if they live with them. In actuality, having family and friends there is a clue that the treatment will be effective.

Self-care

Maintaining a healthy lifestyle can help you manage your OCD. Getting enough sleep, eating healthfully, exercising, and socialising can all be beneficial to one's overall mental health. Additionally, using simple relaxation techniques like massage, yoga, visualization, and meditation can ease stress (when not combined with exposure activities).

Body Dysmorphic Disorder

Body dysmorphic disorder patients are obsessed with perceived flaws in their appearance. While the apparent faults may not be noticeable or seem minor to others, the person with body dysmorphic disorder perceives them as unsightly or odd. It differs from the common worries that many individuals have about their appearance.

Additionally, repetitive actions or thoughts, such comparing one's looks to others or checking a mirror, are associated with body dysmorphic disorder. The obsessions may centre on a single body part or several, most frequently the skin, hair, or nose.

The obsessions and actions are time-consuming, undesired, and obtrusive (occurring, on average, three to eight hours per day). The person struggles to resist or control them and feels impelled to carry them out. Significant distress or difficulties are brought on by the concern with regular tasks like job or social contacts. This can involve staying home all day or avoiding certain social interactions entirely. High levels of worry, social anxiety, social avoidance, a gloomy mood, and low self-esteem are linked to body dysmorphic disorder.

Many people strive to correct their perceived flaws with cosmetic procedures like skin treatments or surgery, and they do it far too frequently. It's possible that those who suffer from body dysmorphic disorder are unaware that their concerns about their looks are misguided. Many persons who suffer from body dysmorphic disorder think that others target them or make fun of them because of their appearance.

An estimated 2% of persons are impacted by it. It typically begins before the age of 18 and affects both men and women. A cognitive behavioural treatment plan combined with medication, including selective serotonin reuptake inhibitors, is frequently used to treat body dysmorphic disorder.

Muscle dysmorphia, a type of body dysmorphic disorder that is more prevalent in men, is characterised by obsession with the thought that one's physique is inadequately large, heavy, or muscular. This type of illness affects people who appear to be normal-looking or even exceptionally muscular. Most people (but not all) overeat, exercise, or lift weights.

Trichotillomania (Hair-Pulling) Disorder

Trichotillomania, often known as the hair-pulling disorder, is characterised by recurrent hair pulling, most frequently from the scalp, brows, and eyelids. Although many people play with their hair or bite it, trichotillomania is not the same as these behaviours.

Significant anguish and functioning issues are brought on by hair pulling. The individual might avoid going to work, school, or other public places. Distress might entail a sense of helplessness, embarrassment, and shame. Different emotions, such as growing tension, may precede or follow hair pulling. It might be brought on by anxiety or boredom.

Trichotillomaniacs repeatedly try to lessen or stop pulling their hair out. An estimated 1%-2% of adults and teenagers in the general population are thought to experience trichotillomania in any given year, with females being substantially more likely to experience it. Usually, it starts right around puberty. It could appear and disappear over time, but if it is not treated, it usually persists. The most common kind of treatment is cognitive behaviour therapy (CBT), which includes the habit reversal therapy technique that can help patients better understand their triggers, increase awareness, break habitual patterns of pulling episodes, and help them take more control of their behaviour.

Excoriation (Skin-Picking) Disorder

The skin-picking illness known as dermatillomania, or excoriation disorder, is characterised by excessively frequent picking at one's own skin that results in lesions. Significant distress or issues arise as a result of the skin-picking behaviour at work, in social situations, or during other activities. It could make you feel out of control, embarrassed, and ashamed, and it might make you avoid social situations. Most people with excoriation disease have tried numerous times to reduce or stop skin picking.

Anxiety or boredom may be the causes of the behaviour. It could be a more instinctive behaviour or one that is preceded by growing tension and followed by a feeling of relief. It occasionally entails a need to strive to correct perceived "blemishes." Excoriation disorder in adults is substantially more frequent in women than in males, with a lifetime frequency of fewer than 2% in the general population. Adolescence is when it usually starts, and over time, it may come and go. The most common form of treatment for skin picking problem is cognitive behavioural therapy, which includes a method known as habit reversal therapy. This method can assist in identifying stressors and triggers, tolerating and reducing cravings, and substituting a less damaging behaviour for the original one. Obsessive-compulsive disorder or depression are common co-occurring psychiatric disorders in people with excoriation disorder.