OCD is described as recurring obsessions or compulsions that severe enough to time consuming or cause marked distress or significant impairment. People with this disorder recognise that their reactions are irrational or disproportionate.
An obsession is a recurrent and intrusive thought, feeling, idea or sensation (sexual image, thought of killing someone). A compulsion is a conscious, standerdised, recurrent pattern of behaviour, such as counting, checking or avoiding. Obsessions increase anxiety, whereas carrying out a compulsion, anxiety is decreased. A person with OCD generally experiences both the obsession and the compulsion as ego-dystonic. Obsessions are often time consuming and interfere significantly with people’s normal routine, occupational functioning, usual social activities or relationships with friends and family members.
Causes or Etiology - There are several factors responsible for OCD. They are-
Biological Factors- in biological factors, neurotransmitters, genetic and other biological data are the causes of OCD.
Neurotransmitters- many clinical drug trials that have been conducted, support the hypothesis that a dysregulation of serotonin is involved in the symptom formation of OCD. Clinical studies said that CSF concentrations of serotonin metabolities can be seen in OCD.
Brain-imaging Studies- various functional brain –imaging studies, Eg-PET scan have shown increased activity (metabolism and blood flow) in the frontal lobe, basal ganglia of the patients with OCD. MRI studies have found bilaterally decreased size of caudates in patients with OCD.
Genetics- studies have shown that the disorder in twins have consistently found a significantly higher concordance rate for monozygotic twins than for dizygotic twins. Family studies of these patients have shown that 35% of the first-degree relatives of OCD patients are also affected with the same disorder.
Other biological data- a higher than usual incidence of non specific EEG abnormalities occurs in patients with OCD. Sleep EEG studies have found abnormalities are slow in OCD.
Behavioural Factors- according to learning theorists, obsessions are conditioned stimuli. Compulsions are established in a different way. When a person discovers that a certain action reduces anxiety attached to an obsessive thought, he or she develops active avoidance strategies in the form of compulsions or ritualistic behaviours to control the anxiety.
Psychological Factors- there are several factors of OCD as psychological factors. Such as-
Personality Factors- OCD differs from obsessive compulsive personality disorder. Most people with OCD do not have premorbid compulsive symptoms and such personality traits are neither necessary nor sufficient for the development of OCD. Only about 15-35% of OCD patients have had premorbid obsessional traits.
Psychodynamic Factors- Sigmund Freud said about there are major psychological defence mechanisms that determine the form and the quality of obsessive compulsive symptoms.
Symptoms or Clinical Features- there are few symptoms of OCD. They are-
- In obsessions, recurrent and persistent thoughts, impulses or images that are experienced.
- The thoughts, impulses or images are not simply excessive worries about real life problems.
- The person attempts to ignore or supress such thoughts, impulses or images.
- The person recognises that the obsessional thoughts, impulses or images are a product of his/her own mind
- In compulsions, repetitive behaviours such as- handwashing, ordering, checking, counting or mental acts.
- The behaviours or mental acts are aimed at preventing or reducing distress or preventing some situations.
Obsessive-compulsive disorder treatment may not result in a cure, but it can help bring symptoms under control so that they don't rule your daily life. Some people need treatment for the rest of their lives.
The two main treatments for OCD are psychotherapy and medications. Often, treatment is most effective with a combination of these.
Cognitive behavioral therapy (CBT), a type of psychotherapy, is effective for many people with OCD. Exposure and response prevention (ERP), a type of CBT therapy, involves gradually exposing you to a feared object or obsession, such as dirt, and having you learn healthy ways to cope with your anxiety. ERP takes effort and practice, but you may enjoy a better quality of life once you learn to manage your obsessions and compulsions.
Therapy may take place in individual, family or group sessions.
In Exposure and response prevention technique, the main goal of the therapy is to cut the association between compulsion and release of anxiety followed by psycho- education. In this technique, patients are instructed to tolerate the anxiety, which is the product of obsession. It is believed that, if one can forcefully tolerate the anxiety, it will be decreased after some time. But, the whole process should be done under supervision of trained psychologist. The therapist will initial make a hierarchy, which will guide whole process like where to start. This hierarchy to be created with the co-operation of the client/ patient. The compulsion, which creates the least anxiety, the therapy will start from there. In the ongoing sessions, patient will discuss his/her discomforts, stress, negative thoughts etc with the therapist and the therapist will guide him/her accordingly.
Certain psychiatric medications can help control the obsessions and compulsions of OCD. Most commonly, antidepressants are tried first.
However, your doctor may prescribe other antidepressants and psychiatric medications.
If you need any kind of help feel free to consult Psychologist or Counselor by booking an appointment at My Fit Brain.