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Obsessive Compulsive Disorder (OCD)
What is Obsessive Compulsive Disorder?
Typically an individual with OCD will be plagued by recurring distressing thoughts, fears or images (obsessions) that are difficult to control. The anxiety produced by these thoughts leads to an urgent need to perform certain rituals or routines (compulsions). The compulsive rituals are performed in an attempt to stop the obsessive thoughts.
Although the ritual may temporarily alleviate anxiety, the person must perform the ritual repeatedly to prevent the obsessive thought returning. This OCD cycle can progress to the point of taking up many hours in a day and significantly interfering with daily activities and quality of life.
People with OCD may be aware that their obsessions and compulsions are senseless or unrealistic, but they cannot stop them.
Causes of Obsessive Compulsive Disorder
Although the exact cause of OCD is not fully understood, studies have shown that a combination of biological and environmental factors may contribute to the condition.
From a biological perspective, many researchers have reported that OCD is linked to increased activity in areas of the brain related to controlling feelings and actions. Others have also proposed a link between OCD and insufficient levels of serotonin (a neurotransmitter that plays a role in regulation of mood, aggression, impulse control, sleep, appetite, body temperature and pain).
Research also suggests that environmental stressors can trigger (or worsen) OCD in people who are susceptible to developing the condition. These environmental factors include:
- Abuse
- Changes in living situation
- Illness
- Death of a loved one
- Work or school related changes or problems
- Relationship concerns
Symptoms of Obsessive Compulsive Disorder
The symptoms of OCD vary widely depending on the individual.
Examples of “obsessions” include:
- Fear of dirt or contamination by germs
- Fear of causing harm to others
- Fear of making a mistake
- Fear of being embarrassed or behaving in a socially unacceptable manner
- Fear of thinking evil or sinful thoughts.
- Need for order, symmetry or exactness
- Excessive doubt and the need for constant reassurance
Examples of “compulsions” include:
- Repeatedly bathing, showering or washing hands
- Refusing to shake hands or touch doorknobs
- Repeatedly checking things, such as locks or stoves
- Constant counting (mentally or aloud) while performing routine tasks
- Constantly arranging things in a certain way
- Eating foods in a specific order
- Being stuck on words, images or thoughts (sometimes disturbing) that won’t go away
- Repeating specific words, phrases or prayers
- Needing to perform tasks a certain number of times
- Collecting or hoarding items with no apparent value
Individuals with OCD are more likely to also develop chronic hair pulling (trichotillomania), muscle or vocal disorder, or an eating disorder like anorexia or bulimia. They are also predisposed to developing other mood problems like depression or generalized anxiety disorder.
Management of Obsessive Compulsive Disorder
Think Psychological Services will customise a therapy plan that best suits your situation. The therapy plan will be based on your specific circumstances and seeks to improve your daily quality of life.
Typical management strategies for OCD include behavioural intervention such as:
- Cognitive Behavioural Therapy (CBT) – The most effective therapy for obsessive-compulsive disorder is often CBT.
- Exposure and response prevention (ERP) – ERP is a therapy that involves identifying the situations that cause you anxiety and then gradually builds confidence to face these situations.
At Think Psychological Services we use a combination of CBT and ERP. Patients create a hierarchy of situations that cause distress and when they participate in exposure tasks, they are asked to pay particular attention to thoughts and feelings related to those situations. Over time, you will learn to deal with the anxiety without relying on your anxiety-relieving compulsions (the actions you usually take to help you cope with the situation).
Although this sounds frightening, people with OCD find that when they confront their anxiety without their compulsion, the anxiety can disappear completely.