“Obsessive compulsive disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over” – The National Institute of Mental Health.           

OCD is a disorder in which individuals have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do something repetitively (compulsions). The repetitive behaviors, such as hand washing, checking on things or cleaning can significantly interfere with a person’s daily activities and social interactions. 


OCD is an illness that confines individuals into vicious circles of repetitive thoughts and behaviors (obsessions) which they cannot control. These thoughts lead to nervousness or anxiety which compels them to perform certain rituals or routines immediately (compulsions). The rituals or routines are executed in order to prevent or stop the obsessive thoughts. Although the anxiety is subsided once the ritual has been performed, it has to be repeated again, if the thoughts crop up again, which makes it into a vicious cycle. This ritual and the repetitive aspect of it can take up a lot of time and can be quite distressing for the individual as it interferes with their daily life. These individuals may be aware that these obsessions and compulsions are unrealistic, but they have no control over it and are unable to stop. 

Examples of Obsessions:·

  • Fear of contamination or dirt.      
  • Needing things orderly and symmetrical.   
  • Aggressive or horrific thoughts about harming yourself or others.      
  • Unwanted thoughts, including aggression, or sexual or religious subjects. 

Examples of Compulsions:·

  • Washing and cleaning.     
  • Checking.
  • Counting.       
  • Orderliness.       
  • Following a strict routine.    
  • Demanding reassurances.  

OCD is a disorder that affects adults, adolescents and children around the world. Most people are diagnosed by about age 19, typically with an earlier age of onset in boys than in girls, but onset after age 35 does happen.    


CAUSES OF OCD:

1.     Genetics 

Studies have indicated that people with first degree relatives (parent, sibling or child) who have OCD are at a higher risk for developing OCD themselves. The risk seems to be higher when the first degree relative developed OCD in childhood or in the teenage years. 

2.     Brain structure and functioning 

The brain contains billions of neurons that communicate and work together for the brain to function at an optimum level. Chemicals called Neurotransmitters are through which neurons communicate. It was believed that low levels of a neurotransmitter called Serotonin played a pivotal role in the development of OCD. Now, however scientists are of the opinion that OCD is caused from the problems in the pathways of the brain that are connected to areas dealing with judgment and planning with another area that filters messages involving body movements. Studies have also indicated a link between an infection called Streptococcus and OCD. If this infection is recurrent and untreated it may lead to OCD and other disorders in children. 

3.     Environment 

The environment that we live in plays a huge part in our physical and mental being as well. People who have experienced abuse in any form in childhood, changes in their living situation, any illness or trauma, death of a loved one, work or school related changes or problems and relationship problems or concerns are at an increased risk for developing OCD. 

TREATMENT OF OCD: 

 Seeking treatment can help bring symptoms under control so that they don’t interrupt and come in the way of your day-to-day life. It could also be a possibility that some individuals may require treatment for the rest of their lives.  

Psychotherapy 

"Cognitive Behavior Therapy (CBT) is a time-sensitive, structured, present-oriented psychotherapy directed toward solving current problems and teaching clients skills to modify dysfunctional thinking and behavior". Cognitive behavioral therapy (CBT) is a productive treatment for OCD. The crux of CBT is to teach individuals with OCD to confront their fears and reduce anxiety without performing the ritual behaviors and reducing the exaggerated or catastrophic thinking that occurs in OCD. Exposure and Response Prevention (ERP), is a type of CBT therapy which exposes the individual to the feared object or obsession, such as dirt, and having the individual learn healthy ways to cope with their anxiety.  

Medication

Pharmacological interventions can help in controlling the obsessions and compulsions that come with OCD. The first line of treatment is antidepressants. Antidepressants approved by the Food and Drug Administration (FDA) to treat OCD include:·       

  • Clomipramine for adults and children 10 years and older.  
  • Fluoxetine for adults and children 7 years and older.
  • Fluvoxamine for adults and children 8 years and older.     
  • Paroxetine for adults only.       
  • Sertraline for adults and children 7 years and older.

RELATED CONDITIONS: 

Other conditions which have common features with OCD occur frequently in family members of OCD patients. Body Dysmorphic Disorder (preoccupation with imagined ugliness), Hypochondriasis (preoccupation with physical illness), Trichotillomania (hair pulling), Excoriation (skin picking), Nail biting (onychophagia) eating disorders like binge eating, neurological disorders like Tourette’s Syndrome.