Obsessive compulsive disorder is a potentially debilitating anxiety disorder that could persist throughout a person’s entire life, the patient with OCD actually is sort of trapped in this pattern of repetitive thoughts and then behaviors that are senseless. the person knows they’re senseless, yet they can’t find a way to adequately stop.
OCD also exists as a spectrum it can range from mild to moderate to severe, if severe people with OCD can actually have their entire lives destroyed, they have no capacity to go to work, no capacity to go to school and an inability to even carry out the basic activities of daily living.
How common is OCD in the population?
for many years people thought OCD was relatively rare psychiatric disorder but what we come to find out more recently, is that there’s a lot of people suffering with these repetitive thoughts and behaviors, but they were very reluctant to seek treatment. so in the 1980s there was a study that came out that showed approximately 2% of the u.s. population suffers from OCD and that makes it actually more common than other psychiatric disorders such as schizophrenia, bipolar disorder and panic disorder so it’s actually quite common it just goes undiagnosed and unrecognized and the people who are suffering with OCD tend not to come forward to seek help.
Key Features Of OCD
OCD can occur in people of all ethnic groups, and it’s one of the few psychiatric disorders where we see men and women being equally affected. so the key features of OCD, there’s two main features that are common in OCD. those would be obsessions and compulsions.
so obsessions are unwanted ideas or impulses that continuously come up in a person’s mind, some of the common persistent fear our harm that may come to someone’s loved ones, contamination such as feeling like you’re dirty or feeling like you’re contaminated in some way and excessive need to do things correctly or perfectly.
so the example I like to use is the fear of contamination because it’s an easy one that I think everyone can understand, so you may feel as though your hands are dirty and you may need to wash them excessively. so if I’m worried I’m going to get contaminated or I think I’m contaminated then I my obsession is the thought of contamination or thought that my hands are dirty and my compulsion for my compensatory behavior that helps me reduce the anxiety is to wash my hands excessively. so the thoughts tend to be intrusive, they’re unpleasant and they cause a high degree of anxiety.
we see people doing the compulsions to sort of deal with the anxiety because the compulsion leads to some relief from the feeling of anxiety, and the compulsion would be a response to the obsession for people with OCD. so they developed these repetitive behaviors that actually reduce their anxiety and they’re called compulsions.
The most common ones are checking and washing, an example of checking would be like, “I can’t remember if I left the stove on! I have to check it X number of times to make sure that it’s actually off or I can’t remember if I locked my car doors, I have to click the button x number of times before I’m convinced it’s perfectly locked.
the behaviors are actually used to ward off harm to self or others, so basically these patients have these behaviors because they think that by doing them they’re somehow going to help ward off harm to themselves or others, it doesn’t really make sense, the relief from the anxiety that the person receives from the compulsions is short-lived, it’s temporary and therefore they actually have to keep performing these compulsions over and over again in order to continue to reduce their anxiety.
How Do We Treat OCD ?
So there’s a couple of different things we can do, obviously psychotherapy medication or some combination of both is the most appropriate choice. the most effective psychotherapy for OCD is actually CBT or cognitive behavioral therapy, more specifically what works well with these patients is exposure and response prevention therapy, so it’s a form of CBT in this case the patient would be exposed to situations that make them anxious.
So we could take that example of the person who fears contamination. you might force the person to dirty their hands and then the therapist would prevent the person from doing the compulsion which would be washing, and that would thereby interrupt this pattern of behavior, and if you do that long enough and work at it long enough eventually it should be extinguished.
There are many medications for OCD , they all have few side effects, that relatively well tolerated. so our first choice to go along is the therapy of course, it generally takes somewhere between one to three weeks to start seeing some benefits from these things and treatment should be continued for a minimal several months and it could even last up to a year depending on your severity.