Obsessive-Compulsive Disorder (OCD)

Obsessive-compulsive disorder (OCD) is a mental disorder in which people experience unwanted and repeated thoughts, feelings, images, or sensations (obsessions) and engage in behaviours or mental acts (compulsions) in response. Often a person with OCD carries out the compulsions to temporarily eliminate or reduce the impact of obsessions, and not performing them causes distress.

• While OCD and OCPD (Obsessive Compulsive Personality Disorder) share feature such as a strong preoccupation with details and rules in some areas of one’s life, they differ in important ways.
• People with OCPD experience their thoughts and behaviour as rational and purposeful and they do not have unwanted thoughts that compel them to create routines or rituals, as do those with OCD.
• Symptoms of OCD often change over time and in response to anxiety-provoking circumstances, while for those with OCPD, their symptoms are stable across time.

DISCLAIMER: This information is for educational purposes only and not to be used for self-diagnosis. If you or a loved one can relate to a number of features listed below, then please do use our therapist directory to find a psychiatrist, psychologist or therapist that is right for you to receive a professional diagnosis.

What are the primary symptoms/signs of the condition?

• The problem can go along with other conditions, including anxiety disorders, depression, and eating disorders. It typically first appears in childhood, adolescence, or early adulthood.
• Diagnostic criteria for the obsessive-compulsive disorder include the presence of obsessions, compulsions, or both, where:
  • Obsessions are recurring thoughts, urges, or images that are experienced as intrusive and unwanted and, for most people, cause anxiety or distress. The individual tries to ignore them, suppress them, or neutralize them with a different thought or action.
  • The compulsions are carried out to reduce the anxiety and distress experienced by the obsessions. Excessive obsessions are also made in order to prevent a feared situation or event from taking place.  However, the acts are not really connected to the outcomes.
•  These obsessions or compulsions take up more than one hour a day or cause clinically significant distress or impairment for the individual. 
• For a diagnosis of OCD, they must not be better explained by the effects of a substance or by another mental disorder or medical condition.
• The specific details of obsessions can vary widely: They may include thoughts about contamination, a desire for order, or taboo thoughts related to sex, religion, and harm to oneself or others.
• In response to their obsessions, most people with OCD resort to compulsions, which may include behaviours such as washing; rearranging or counting objects; seeking reassurance; or checking (to see if an oven is turned off or a door is locked, for example). 
  • They can also include mental acts that are not outwardly observable. Compulsions may temporarily relieve feelings that stem from an obsession, including anxiety, distress, or the sense that something is not right.

• People with OCD may also avoid people, places, or things that may trigger obsessions and compulsions. They also often have unusual beliefs that can include a heightened sense of responsibility, inability to handle uncertainty, perfectionism, or an exaggerated view of the significance of troubling thoughts.
• Individuals with OCD vary in their degree of insight into the condition. Someone with good insight may recognize that the OCD-related beliefs (that performing a compulsion will prevent a terrible event, for example) are not actually true; someone with poorer insight may think such beliefs are true or are likely to be true.
• The severity of symptoms may vary over time, but the disorder can persist for years or decades if it is not treated. If left untreated, it can limit one’s ability to function at work, school, or home.
• People with OCD frequently also experience another form of mental illness – such as an anxiety disorder (such as generalized anxiety disorder or panic disorder), depressive or bipolar disorder, tic disorder etc. Those with OCD may also experience a range of other conditions, including related disorders such as body dysmorphic disorder, trichotillomania, and excoriation disorder.

Please Note: This information is for educational purposes only and not to be used for self-diagnosis. If you or a loved one can relate to a number of features listed below, then please do use our therapist directory to find a psychiatrist, psychologist or therapist that is right for you to receive a professional diagnosis.

What factors can be contributing causes? 

• While the causes of obsessive-compulsive disorder are not fully understood, there are both genetic and environmental risk factors. People who have a parent, sibling, or child with OCD are at greater risk of having it themselves, and studies with twins confirm the role of genetic influence in the development of the disorder. Childhood physical or sexual abuse and other traumatic events are associated with greater risk.
• In some children, a streptococcal infection (Streptococcal infections are any type of infection caused by the group of bacteria Streptococcus. There are many different types of Streptococci and infections vary in severity from mild throat infections to pneumonia) precedes the sudden development or worsening of OCD symptoms. 

What is the recommended treatment?

• Obsessive-compulsive disorder is typically treated with psychotherapy, medication, or both at the same time.
• Research-backed forms of therapy for treating OCD include Cognitive Behavioral Therapy (CBT), which is used to treat a range of disorders, and a specific type of CBT called Exposure and Response Prevention (ERP). 
• In ERP, a person with OCD, initially guided by a therapist, is exposed to thoughts, things, or situations that produce anxiety or lead to obsessions and compulsions and, in doing so, learns to not engage in habitual compulsions. This approach aims to gradually reduce the anxiety prompted by such thoughts and encounters so that the individual can better manage OCD symptoms.
• Medications called serotonin reuptake inhibitors (SRIs) and selective serotonin reuptake inhibitors (SSRIs) are also used to treat OCD. These include the older antidepressant clomipramine and more recently developed drugs such as fluoxetine, fluvoxamine, and sertraline. 
• SSRIs are thought to work by increasing the amount of the neurotransmitter serotonin in the brain, and they are commonly prescribed for other conditions, including depressive and anxiety disorders. They may take as long as 12 weeks to produce an improvement in symptoms when used to treat OCD.

• A general practitioner (GP) or psychologist can usually diagnose the condition by asking questions about a person’s medical history and symptoms.
• The GP/psychologist will also inquire about a patient’s physical health to ensure that the obsessive-compulsive behavior is not caused as a result of an underlying medical condition, or by factors such as drug or alcohol use.
• The GP/psychologist will check the symptoms that the patient presents with against the standard criteria for the condition before making a diagnosis.

• OCD is estimated to affect more than 2.3% of people at some point in their lives
• An estimated three quarters of adults with OCD are diagnosed, at some point in their lives, with an anxiety disorder (such as generalized anxiety disorder or panic disorder); more than half are diagnosed with a depressive or bipolar disorder; and up to 30% have a tic disorder.

If you are experiencing any of these signs, here are some activities you can do at home until you are able to consult a professional.

• • Exercise
  • Engage in creative outlets such as writing, painting, or music
  • Keep a gratitude journal
  • Talk to a family member or friend about how you are feeling
  • Practice Mindfulness
  • Practice Yoga
  • Engage in a well-balanced diet
  • Maintain a good sleep schedule 
  • Recognise what you can and can’t handle