Obsessive-Compulsive Disorder can be described as a type of anxiety disorder, although it has distinct differences from normal anxiety and stress. In addition to adults, children and teens may also have OCD. About 1-3% of people are thought to have this disorder.
Even though OCD has variations, most cases of OCD involve obsessions with doing particular tasks or routines (compulsions) usually in a specific way. People that have OCD may realize that their actions are not rational, however, they find relief from anxiety and intrusive thoughts by behaving in their certain way.
People who do not suffer from OCD may find that there are advantages that accompany the disorder, such as keeping a clean, organized room, but to people with the disorder, the thoughts and feelings are more of a curse than a gift. Whereas everyday worries and stresses normally fade away in a matter of days, sufferers of OCD may be extensively haunted by distressing, anxious thoughts.
A person must have either obsessions or compulsions (or both) to be diagnosed with OCD. The Quick Reference to the diagnostic criteria from DSM-IV-TR (2000) states several characteristics of obsessions and compulsions:
- Recurrent and persistent thoughts, impulses, or images that are experienced as intrusive and inappropriate and that cause marked anxiety or distress.
- The thoughts, impulses, or images are not simply excessive worries about real-life problems.
- The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action.
- The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind, and are not based in reality.
- Repetitive behaviours or mental acts that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly.
- The behaviours or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviours or mental acts are not actually connected to the issue, or they are excessive.
A few simple examples of obsessive compulsions are:
- Touching objects a certain number of times before or after using them,
- Touching every pole/shaft/pillar that is passed while walking by,
- Locking/unlocking doors a certain number of times before carrying on with normal activity,
- Washing hands at specific times of the day or after doing a certain activity,
- Keeping a room or area clean and organized in a very specific fashion.
It is important to realize that their are more serious cases of OCD that can have a major impact on someone's life (socially, emotionally, and physically).
The cause of OCD has two theories - either it is a psychological disorder or it has a neurological origin.
In the psychological sense, it can start from a very insignificant act and lead to the full-fledged disorder. For instance, a person that is about to eat dinner might normally wash their hands, however, one day he/she might wonder if they washed their hands long enough or in the correct way. This slightly distressing thought can make the person consider rewashing their hands. Once this behavior takes place, it is negatively reinforced by the relief of stress - and the more times that it happens, the more ritualistic the acts will become.
On the other hand, the disorder could be neurological. In this case, it is commonly believed that there is some kind of abnormality in the neurotransmitter, serotonin. However, researchers realize that this could be an effect of the disorder, rather than the cause. A biological cause is supported by patients' responses of a certain antidepressant that allows for more serotonin to be available to more nerve cells as well as several genetic studies and discoveries. It has also been shown that brain activity differs in people that have OCD (compared to those that do note). This suggests that people with OCD have impaired (or at least alternate) brain functionality.
First-line treatment for OCD is available in several flavors: behavioral therapy, cognitive therapy, and medication.
One of the most effective behavioral treatments is known as ERP (Exposure and Ritual/Response Prevention). This technique exposes the person to the stimulating situation (such as locking a door or using an object) and then prevents the ritual/response from taking place (such as unlocking/relocking a door or touching an object a certain number of times). Although it is intense for the first few sessions, sufferers from OCD tend to experience a significant drop in anxiety. This kind of treatment can be repeated with more intense exposure as the person progresses psychologically.
Medications are also available for OCD. Doctors may prescribe certain serotonin-related antidepressants to reduce levels of anxiety and compelling thoughts.
When first-line treatment fails, people with OCD may consider major treatment options (which can include surgical operations).