Obsessive Compulsive Disorder
Obsessive-Compulsive Disorder, more commonly known as OCD, is a common, chronic, and long-lasting disorder and is characterized by way of persistent, undesired thought processes (obsessions) and/or repeating actions (compulsions). Obsession, in this case, is highly unpleasant as the individual is compelled to repeat certain behaviors again and again.The condition, most of the time, is anxiety-related and the thoughts are unwanted and intrusive. Sufferers often understand that these thoughts are irrational, but by performing compulsive behavior, they believe they will be cured or will be relieved.
Recurring actions such as hand washing (to avoid catching germs), counting numbers, checking things over, or cleaning are frequently carried out with the anticipation of avoiding compulsive thoughts or making them disappear altogether. This is to avoid their obsession turning into reality.
OCD is a common mental condition that affects 2.5 million adults or 1.2% of the U.S. population. (NIMH: Obsessive-Compulsive Disorder) The onset of the condition is, typically, in early adult life but it can occur in childhood. Women are more likely to be affected than men. And, men often suffer from symptoms earlier than women.
The symptoms of this disorder can vary tremendously. A sufferer may engage in obsessive thinking and behavior for a short time each day, whilst another might not be able to live a normal life because the condition is so disruptive.
Diagnosis is often made once the compulsions and obsessions are taking up excessive amounts of time when they are causing stress to the sufferer, and when they disrupt everyday lives.
If Obsessive Compulsive Disorder is not treated properly, its symptoms could grow worse. Without help, half of OCD sufferers still have the condition 30 or more years later.
Treatment is available for this disorder and, for some, it will result in a 100% cure. For others, treatment can enable them to take control of their lives, as the seriousness of their symptoms will be reduced. 80% of sufferers respond to treatment.
Psychotherapy has been proven to have a good success rate in treating OCD. Specifically, this involves cognitive behavioral therapy, which works through sufferers being exposed to and responding to their OCD. The treatment can work alongside medication, such as antidepressants.
Treatment is available for this disorder and, for some, it will result in a 100% cure. For others, treatment can enable them to take control of their lives, as the seriousness of their symptoms will be reduced. 80% of sufferers respond to treatment.
Psychotherapy has been proven to have a good success rate in treating OCD. Specifically, this involves cognitive behavioral therapy, which works through sufferers being exposed to and responding to their OCD. The treatment can work alongside medication, such as antidepressants.
OCD: Symptoms and Types
American Psychiatric Association defines Obsessive Compulsive Disorder (OCD) as –
a disorder in which people 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. [ Ref. APA article ]
- Checking
- Contamination
- Hoarding [ Read also: Hoarding Disorder ]
- Intrusive Thoughts
- Oven knobs, appliances, lights, candles (to prevent fire)
- Taps (to prevent flood)
- Locks, windows, alarms (to prevent burglary)
- Letters (to prevent anything inappropriate from being written)
- Purses or wallets (to prevent losing important cards or money)
- Symptoms of illnesses (to prevent contracting them)
- People (to prevent anything from happening to them)
- Reading words (to prevent missing something vital)
- Shaking hands with people (to avoid their germs)
- The use of public toilets or telephones
- Touching door handles
- Waiting in the doctor’s surgery
- Eating out in a public place
- Crowds
- Touching staircase banisters (handrails)
- Hospitals
Intrusive Thoughts are the fourth type of OCD. These are intrusive and often repugnant to the sufferer and can be of a sexual or violent nature. Examples might be:
- Relationship thoughts (worries over sexuality, faithfulness)
- Sexual thoughts (worries of becoming a pedophile, or being attracted to a member of one’s family)
- Magical thoughts (believing a thought can make an event happen such as a car crash, or treading on cracks will create a catastrophic event).
- Violent thoughts (murder, obsession with knives, poisoning, etc).
Obsessions and Compulsions
Obsessions can take the form of fears, worries, impulses, and uncontrollable thoughts. They tend to be repetitive, intrusive, and unwanted. These thoughts can disrupt everyday life. Sufferers understand that the thoughts are their own, and not introduced by some external force, yet are unable to stop them.
Common obsessions include worrying about contamination, contracting high-profile illnesses like AIDS, worrying about symmetry in objects, harming oneself, unwanted thoughts about sex or violence, and worrying that if the repetitions are not carried out, something terrible might occur.
Compulsions are the rituals used to help keep the obsessions at bay. The sufferer will repeat these in a very rigid way, believing that by doing so, the obsessions will disappear, but in fact, the cycle can worsen. Compulsions are carried out with a sense of responsibility by the OCD sufferer.
Common compulsions include washing hands or the body, cleaning the house, aligning items to make them neat, counting to a certain number or saying a sentence or phrase, checking locks or light switches in fear of break-ins or electricity failure, etc.
Treatment for obsessions and compulsions is available through a verbal program of Cognitive Behavioral Therapy. This will include Exposure and Response Prevention (ERP). It is available with or without medication.
Read also: OCD Myths and Facts
What causes OCD to get worse
The severity of OCD can vary from person to person. Unfortunately, for some people, their OCD can worsen over time.This is often seen in people who have had the disorder for a long time. If a person doesn't get the right treatment for their OCD, their symptoms may worsen. As the OCD progresses, it can become more severe and debilitating.
What causes OCD to get worse? OCD can worsen for a variety of reasons. Some of the most common factors that cause OCD to get worse include stress, anxiety, trauma, and life changes. Other possible causes include changes in brain chemistry, hormones, or certain medications. Sometimes, it may simply be the result of the natural progression of the disorder.
For some, it may be something that triggers their anxiety, such as seeing a messy room or thinking about germs. Another possibility is that the person's OCD triggers change over time. For example, a person with OCD who is obsessed with germs may find that their triggers change from hand-washing to cleaning the house. As their triggers change, their OCD may become worse.
The factors that cause OCD to get worse include:
- Lack of treatment - OCD can get worse if it goes untreated. When OCD isn’t managed, it can start to take over your life and cause a lot of distress.
- Stress - If you're under a lot of stress, it can make your OCD symptoms worse. Things like work stress, family stress, job loss, relationship problems, or any other type of stress can trigger OCD symptoms or make them worse.
- Traumatic events - Trauma or other stressful life events can trigger OCD symptoms, or make existing symptoms worse.
- Life changes - For some people, stressful life events such as divorce, the death of a loved one, or a major life change, such as a new job or a new baby, can trigger an increase in OCD behaviors and thoughts.
- Certain medications - Some medications can cause or worsen OCD symptoms. This includes some antidepressants, anti-anxiety medications, and others.
- Change in medication - If you're taking medication for OCD and there are changes in your dosage or the type of medication you're taking, it can make your symptoms worse.
- Hormonal changes - Women with OCD may find that their symptoms get worse during pregnancy or menopause. Certain changes that occur during adolescence or young adulthood can also contribute to the development or worsening of OCD.
- Substance abuse - Using drugs or alcohol can worsen OCD symptoms.
- Sleep deprivation - Not getting enough sleep can make OCD symptoms worse. This is because when you're tired, you're more likely to be anxious and have difficulty concentrating.
- Poor diet - Poor nutrition can lead to anxiety and mood swings, which can further exacerbate OCD symptoms.
- Uncongenial environment - There are also a number of environmental factors that can make OCD symptoms worse. These can include things like noise pollution, bright lights, and chaotic surroundings.
If you're struggling with OCD, it's important to identify your triggers, so you can be aware of them and try to avoid them if possible. If you can't avoid them, you can work on coping strategies to lessen the impact they have on your OCD. This might mean talking to your boss about work stress, talking to a therapist about family stress, or taking a break from social media if it's causing you anxiety.
If you’re not sure what’s causing your OCD to get worse, it’s always a good idea to talk to your doctor or a mental health professional. They can help you identify possible triggers and develop a plan to manage your symptoms.
The low mood of morbid depression will prevent everyday tasks from being performed and the mood cannot be lifted, making it different from simply ‘feeling down’. Isolation is a key factor in depression, with the sufferer not wanting to socialize and cutting themselves off from contact, and even family and friends may lose touch with the person affected. Symptoms of depression are:
OCD occurring in pregnancy is known as pre-natal or antenatal OCD. When it occurs after the birth itself, it is known as post-natal OCD or postpartum OCD.
This mental condition is more frequent during or after pregnancy because of the increased feelings of safety and responsibility a mother experiences for her growing baby. Pregnancy is a time when guidelines are issued about safety and so an increased awareness develops in the mothers' minds. Coupled with this are the increased amounts of stress and anxiety that pregnancy and birth naturally cause.
The obsession in this form of OCD will focus on the idea of harming the unborn or newborn baby accidentally or purposefully and it is an extremely common condition.
Obsessions in pre-natal or post-natal OCD (Postpartum OCD) might include:
The compulsions will still exist, but they will not be seen by others because they are mental compulsions. Sufferers of Pure O may constantly ask for reassurance from loved ones and avoid places (so a mental form of the compulsion remains). It is often difficult for family members to realize that the sufferer has a form of OCD.
Sufferers are typically more secretive about this form of the condition because their imagination fears that they do not want to confront or externalize. If they talk about these thoughts, which are like nightmares and are completely abhorrent to them, they believe something terrible will happen and it is usually to loved ones or people who are vulnerable.
Pure O sufferers will find themselves inwardly challenging their accusations, questioning themselves constantly (‘Do I not care?’, ‘Do I want these horrible thoughts?’, ‘Do I give in?’). Rather than outwardly challenging their thoughts, everything is internalized and the person will suffer in silence because they feel too vulnerable to do anything to stop the cycle.
Pure O, however, can be treated in the same way as other types of OCD, through Cognitive Behavioral Therapy (CBT). It is more difficult for the sufferer to open up about Pure O because of its secretive nature. The first step is understanding that the intrusive thoughts are involuntary, not deliberate so that the guilt of these thoughts is minimized. The next step is to seek professional help and begin the treatment of CBT.
This anxiety disorder results in the person examining themselves in front of a mirror and comparing themselves, unfavorably, to others. It is very common for us to all have moments where we have a loss of self-confidence because of the way we look, but a sufferer of BDD will not be able to mentally get over the ‘flaw’ or defect and their feelings will intensify to the point of anxiety, depression, or sometimes even to thoughts of suicide.
A BDD sufferer may become irrationally concerned about a very minor flaw (usually on or around the face, such as redness, scars, or hair thinning), or they may worry incessantly about a defect that is entirely imagined.
There are similarities in this disorder to that of OCD and some sufferers have both. Symptoms include checking their appearance, seeking reassurance about it, repeated grooming, or avoiding mirrors altogether.
BDD sufferers will tend to pick the skin around the area, use camouflage, or even seek surgery to correct the flaw.
People with this condition are troubled by social situations and often have relationship problems. The condition is usually concealed by the sufferer, who is highly embarrassed by it.
Causes of BDD are as yet unproven, but experts believe that psychological factors may be to blame, such as being teased or having something pointed out or sexual abuse. An abnormality in the chemical serotonin in the brain may also be a contributing factor.
It is a type of self-injury and people with CSP may also have BDD. They will typically be in their teens or slightly older, as with many OCD disorders.
Symptoms include scratching and picking at healthy skin, gouging the area, possibly making it bleed, or picking excessively at a mild lesion. Sometimes the skin will be damaged to the extent of bruising or even permanent disfigurement.
These actions take place to ease the anxiety of the sufferer, generally during the evening, and they are in response to a certain event or situation. The person will feel an urge to pick up and heightened tension. A person with CSP will often be unaware of what they are doing.
The face is the most common target, and sufferers will use their fingernails or perhaps tweezers or pins to alleviate the problem. They will be uncomfortable in social situations, feeling the need to camouflage the damaged area with clothing or make-up.
Cognitive Behavioural Therapy may be used as a treatment, but increasingly Habit Reversal Training (HRT) is viewed as the more effective treatment of CSP. HRT works in making the sufferer much more aware of the triggers (i.e. the situations) that lead to their skin picking.
Other methods of quitting can include tying up the hands or wearing mittens until the urge to pick passes, keeping the skin clear and clean, and trying to stay busy, to avoid having the time to pick the skin.
Gender is a factor in the condition; it affects females much more than males and will present itself from adolescence onward (the peak age is between 9 and 13). Millions of people are thought to suffer from TTM but the condition may be difficult to spot, as well as the age group will typically mean that secrecy can be particularly well employed, and many cases therefore remain unreported.
Symptoms of TTM do vary, but the most common is the repeated pulling out of hair from the head, eyebrows, eyelashes, or any other areas. This is usually done with the fingers. Another symptom is the sucking of hair, leading occasionally to its ingestion.
Before hair pulling, people with TTM will experience tension and an urge to carry out the pulling. They will feel relief at the act itself.
Sufferers will attempt to camouflage the hair loss with hats, scarves, and perhaps with false eyelashes. They will avoid socializing, for fear of their secrets being exposed. The condition may therefore prevent sufferers from having intimate relationships.
Habit Reversal Training (HRT) is the most suitable treatment for this condition because it forces sufferers to confront their habit and have an awareness of what they are doing, and when they are doing it.
Once sufferers understand what the situations are that result in hair pulling, they can apply alternative behavior to such situations.
Some people ‘obsess’ about sports or about collecting objects and mistake this normal behavior for OCD, when the obsessions of the real condition are, by contrast, wholly negative and can leave the sufferer feeling repugnant and scared.
Addiction in non-sufferers may of course lead to its disorder, known as Impulse Control Disorder (for compulsive gamblers, sexaholics, shopaholics, etc). But the difference is that the addiction began as something positive, that the person lost control over. OCD begins as negative, intrusive thoughts.
Obsessive Compulsive Personality Disorder (OCPD) is very different from OCD. OCPD is personality-driven, while OCD is anxiety-driven. A person with OCPD may have similar traits, such as the desire to clean, be a perfectionist, or have control issues, but they do not see this as negative. They are perfectly content to act this way and may criticize others for not doing so. It is the positive thought process that differentiates the person from an OCD sufferer, whose own obsessions and thoughts are unhappy ones, and who cannot control these, or the compulsions that follow. (See also: Personality Disorders)
Schizophrenia is a condition that many sufferers of OCD believe they will inherit. They fear the loss of control that schizophrenia brings. However, the two illnesses are not linked and a sufferer of OCD is no more likely to develop schizophrenia or other mental condition than anyone else.
Genetics may be a factor, as evidence suggests that OCD can run in certain families, although nothing specific in terms of inherited genes has been proven to have a relationship with OCD. But a sufferer of the condition is much more likely to have another member of their family suffer from it (as much as four times more likely) than someone who does not have it.
Infections such as those causing streptococcal bacteria may be related to the onset of OCD, particularly in children and young adults. The link may be between the brain reacting with antibodies to cause the condition.
The Brain – Sufferers of OCD seem to have an increase in blood flow and brain activity in the areas that control emotion.
Adverse Events – an event of violence or bereavement might be a trigger for OCD for those who have one of the above factors (like affected genes). The event itself can result in OCD that relates to it. Stress is another factor that can exacerbate the condition.
The most effective treatment of OCD is believed to be Cognitive Behavioral Therapy (CBT). For many people, CBT alone can improve or cure their condition. They become their own therapist, by understanding their thoughts and subsequent behavior, and what the triggers are.
Because research into OCD is ongoing, many practitioners are unaware of the symptoms and the different elements of the condition. Therefore, sufferers should become aware of their symptoms (or look for those in loved ones) so that they can explain them and ask to be referred to a specialist. Sufferers should be open and honest about their condition, as they may be feeling depressed or have thoughts of suicide.
Medication that often helps, when used with CBT, is in the form of Selective Serotonin Reuptake Inhibitors (SSRI). These are thought to help to ease the anxiety and take the edge off OCD.
Self-help for OCD tends to follow the CBT method, with the person affected by the disorder gradually coming to terms with it and understanding the thoughts, impulses, and subsequent compulsions and there is a wealth of self-help information available.
Identifying OCD in children or teenagers early enough will lead to more effective treatment. Early intervention is proven to be the best way to treat the disorder. The isolation OCD creates in sufferers is a difficult hurdle to overcome.
Occasionally, the sufferer will refuse to seek help, wishing to keep their thoughts and feelings private. In this case, family members and partners could show them educational advice and leaflets. A doctor may also ask family members about the compulsions of the sufferer.
OCD and Depression
OCD and depression are intrinsically linked, with 3 in 4 people suffering from OCD having depression as well. The stress of having to perform compulsions, based on repugnant, unwanted obsessions, means that depression is often an inevitable companion of OCD.The low mood of morbid depression will prevent everyday tasks from being performed and the mood cannot be lifted, making it different from simply ‘feeling down’. Isolation is a key factor in depression, with the sufferer not wanting to socialize and cutting themselves off from contact, and even family and friends may lose touch with the person affected. Symptoms of depression are:
- Lack of interest in activities, or the world around them
- Low mood
- Low attention and concentration levels
- Pessimism, or even suicidal thoughts
- Low energy level
- Lack of interest in sexual desire
- Feeling guilty or ashamed
- Gaining or losing weight
- Feeling hopeless about everything
- Lack of sleep
OCD in Pregnancy (This can happen during or post-pregnancy): Postpartum OCD
Between 2 and 4% of all new mothers are thought to suffer from this condition. OCD can occur during pregnancy, or afterwards, or it may have existed already and grown worse in pregnancy.OCD occurring in pregnancy is known as pre-natal or antenatal OCD. When it occurs after the birth itself, it is known as post-natal OCD or postpartum OCD.
This mental condition is more frequent during or after pregnancy because of the increased feelings of safety and responsibility a mother experiences for her growing baby. Pregnancy is a time when guidelines are issued about safety and so an increased awareness develops in the mothers' minds. Coupled with this are the increased amounts of stress and anxiety that pregnancy and birth naturally cause.
The obsession in this form of OCD will focus on the idea of harming the unborn or newborn baby accidentally or purposefully and it is an extremely common condition.
Obsessions in pre-natal or post-natal OCD (Postpartum OCD) might include:
- fear of harming the baby accidentally
- fear of stabbing the baby
- fear of drowning the baby
- fear of harming the fetus because of diet
- frequent washing of clothes, sterilizing equipment
- avoiding changing nappies for fear of sexually abusing the baby
- avoiding feeding the baby for fear of poisoning it
- keeping the baby away from visitors, to avoid contamination
- avoiding certain foods when pregnant, for fear of harming the fetus
You may also like to read: Postpartum Depression and Postpartum Psychosis
Pure OCD (Pure O)
Pure O is the type of OCD that differs from others in that, it features no outwardly visible compulsions but occurs purely in the mind of the sufferer in the form of anxious, guilt-ridden obsessions. The thoughts are extremely unwanted and troublesome and can be violent or religious, for example.The compulsions will still exist, but they will not be seen by others because they are mental compulsions. Sufferers of Pure O may constantly ask for reassurance from loved ones and avoid places (so a mental form of the compulsion remains). It is often difficult for family members to realize that the sufferer has a form of OCD.
Sufferers are typically more secretive about this form of the condition because their imagination fears that they do not want to confront or externalize. If they talk about these thoughts, which are like nightmares and are completely abhorrent to them, they believe something terrible will happen and it is usually to loved ones or people who are vulnerable.
Pure O sufferers will find themselves inwardly challenging their accusations, questioning themselves constantly (‘Do I not care?’, ‘Do I want these horrible thoughts?’, ‘Do I give in?’). Rather than outwardly challenging their thoughts, everything is internalized and the person will suffer in silence because they feel too vulnerable to do anything to stop the cycle.
Pure O, however, can be treated in the same way as other types of OCD, through Cognitive Behavioral Therapy (CBT). It is more difficult for the sufferer to open up about Pure O because of its secretive nature. The first step is understanding that the intrusive thoughts are involuntary, not deliberate so that the guilt of these thoughts is minimized. The next step is to seek professional help and begin the treatment of CBT.
Body Dysmorphic Disorder (BDD)
Body Dysmorphic Disorder (BDD), also known as ‘imagined ugliness’ disorder, is a condition that affects a person’s perception of their physical appearance. They become obsessed with a flaw (either imagined or a slight defect) in the way that they look.This anxiety disorder results in the person examining themselves in front of a mirror and comparing themselves, unfavorably, to others. It is very common for us to all have moments where we have a loss of self-confidence because of the way we look, but a sufferer of BDD will not be able to mentally get over the ‘flaw’ or defect and their feelings will intensify to the point of anxiety, depression, or sometimes even to thoughts of suicide.
A BDD sufferer may become irrationally concerned about a very minor flaw (usually on or around the face, such as redness, scars, or hair thinning), or they may worry incessantly about a defect that is entirely imagined.
There are similarities in this disorder to that of OCD and some sufferers have both. Symptoms include checking their appearance, seeking reassurance about it, repeated grooming, or avoiding mirrors altogether.
BDD sufferers will tend to pick the skin around the area, use camouflage, or even seek surgery to correct the flaw.
People with this condition are troubled by social situations and often have relationship problems. The condition is usually concealed by the sufferer, who is highly embarrassed by it.
Causes of BDD are as yet unproven, but experts believe that psychological factors may be to blame, such as being teased or having something pointed out or sexual abuse. An abnormality in the chemical serotonin in the brain may also be a contributing factor.
Compulsive skin picking
Compulsive Skin Picking (CSP) can be one of the compulsions of Body Dysmorphic Disorder (BDD) and is part of the OCD family. It involves the sufferer picking continually at their skin, the result of which can inflict permanent damage.It is a type of self-injury and people with CSP may also have BDD. They will typically be in their teens or slightly older, as with many OCD disorders.
Symptoms include scratching and picking at healthy skin, gouging the area, possibly making it bleed, or picking excessively at a mild lesion. Sometimes the skin will be damaged to the extent of bruising or even permanent disfigurement.
These actions take place to ease the anxiety of the sufferer, generally during the evening, and they are in response to a certain event or situation. The person will feel an urge to pick up and heightened tension. A person with CSP will often be unaware of what they are doing.
The face is the most common target, and sufferers will use their fingernails or perhaps tweezers or pins to alleviate the problem. They will be uncomfortable in social situations, feeling the need to camouflage the damaged area with clothing or make-up.
Cognitive Behavioural Therapy may be used as a treatment, but increasingly Habit Reversal Training (HRT) is viewed as the more effective treatment of CSP. HRT works in making the sufferer much more aware of the triggers (i.e. the situations) that lead to their skin picking.
Other methods of quitting can include tying up the hands or wearing mittens until the urge to pick passes, keeping the skin clear and clean, and trying to stay busy, to avoid having the time to pick the skin.
Trichotillomania (Hair Pulling Disorder)
Trichotillomania (TTM) is a psychological condition which, although not directly linked to OCD, bears similarities with Compulsive Skin Picking as it is characterized by uncontrollable, often unconscious urges. TTM is essentially an Impulse Control Disorder.Gender is a factor in the condition; it affects females much more than males and will present itself from adolescence onward (the peak age is between 9 and 13). Millions of people are thought to suffer from TTM but the condition may be difficult to spot, as well as the age group will typically mean that secrecy can be particularly well employed, and many cases therefore remain unreported.
Symptoms of TTM do vary, but the most common is the repeated pulling out of hair from the head, eyebrows, eyelashes, or any other areas. This is usually done with the fingers. Another symptom is the sucking of hair, leading occasionally to its ingestion.
Before hair pulling, people with TTM will experience tension and an urge to carry out the pulling. They will feel relief at the act itself.
Sufferers will attempt to camouflage the hair loss with hats, scarves, and perhaps with false eyelashes. They will avoid socializing, for fear of their secrets being exposed. The condition may therefore prevent sufferers from having intimate relationships.
Habit Reversal Training (HRT) is the most suitable treatment for this condition because it forces sufferers to confront their habit and have an awareness of what they are doing, and when they are doing it.
Once sufferers understand what the situations are that result in hair pulling, they can apply alternative behavior to such situations.
Tourette syndrome (TS)
Tourette syndrome (TS) is a neurological condition, which involves rapid movements (or tics) which are involuntary.
TS is considered to be an inherited disorder that generally begins in childhood and half of all sufferers will exhibit the disorder into adulthood.
It has a relationship with OCD and Attention Deficit Hyperactivity Disorder (ADHD). There is also thought to be a link between learning difficulties and sleep disorders.
As well as being an inherited condition (with a 50% chance of the gene passing through pregnancy), 3 to 4 times more males suffer from TS than females.
Tics will occur (either in a motor or vocal way) with the increase of stress and they may not occur when the person is busy or relaxed. Sufferers will attempt to hold the tic inside until they are alone when it will need to be expressed.
The tic is an involuntary urge. It can vary from a facial expression to the jerking of limbs, throat clearing, and touching. Vocal swearing only affects about 10% of people with TS and this is known as Coprolalia.
The relationship between TS and OCD can be distinguished by the repetition of urges. Motor tics need to be performed to gain some relief, which is similar to the obsession and compulsion characteristics of OCD.
Treatment of OCD with tics tends to differ from that of OCD without tics, with the use of anti-obsessional medication and neuroleptic treatment, although studies in this area are limited.
Studies do show that streptococcal and viral infections in childhood have been factors for sufferers with OCD and the conditions of TS and OCD may be linked to an antigen through the motor components of the conditions. Further research is needed in this area.
TS is considered to be an inherited disorder that generally begins in childhood and half of all sufferers will exhibit the disorder into adulthood.
It has a relationship with OCD and Attention Deficit Hyperactivity Disorder (ADHD). There is also thought to be a link between learning difficulties and sleep disorders.
As well as being an inherited condition (with a 50% chance of the gene passing through pregnancy), 3 to 4 times more males suffer from TS than females.
Tics will occur (either in a motor or vocal way) with the increase of stress and they may not occur when the person is busy or relaxed. Sufferers will attempt to hold the tic inside until they are alone when it will need to be expressed.
The tic is an involuntary urge. It can vary from a facial expression to the jerking of limbs, throat clearing, and touching. Vocal swearing only affects about 10% of people with TS and this is known as Coprolalia.
The relationship between TS and OCD can be distinguished by the repetition of urges. Motor tics need to be performed to gain some relief, which is similar to the obsession and compulsion characteristics of OCD.
Treatment of OCD with tics tends to differ from that of OCD without tics, with the use of anti-obsessional medication and neuroleptic treatment, although studies in this area are limited.
Studies do show that streptococcal and viral infections in childhood have been factors for sufferers with OCD and the conditions of TS and OCD may be linked to an antigen through the motor components of the conditions. Further research is needed in this area.
What isn’t classed as OCD
With the growth of OCD, there has been an increase in the number of misuses of the word, for behavior that does not relate to the condition. Social networking has had an impact on the trend for people to label themselves as OCD, but their behavior might only last for a moment or two. Genuine OCD can last for hours at a time and be utterly disruptive.Some people ‘obsess’ about sports or about collecting objects and mistake this normal behavior for OCD, when the obsessions of the real condition are, by contrast, wholly negative and can leave the sufferer feeling repugnant and scared.
Addiction in non-sufferers may of course lead to its disorder, known as Impulse Control Disorder (for compulsive gamblers, sexaholics, shopaholics, etc). But the difference is that the addiction began as something positive, that the person lost control over. OCD begins as negative, intrusive thoughts.
Obsessive Compulsive Personality Disorder (OCPD) is very different from OCD. OCPD is personality-driven, while OCD is anxiety-driven. A person with OCPD may have similar traits, such as the desire to clean, be a perfectionist, or have control issues, but they do not see this as negative. They are perfectly content to act this way and may criticize others for not doing so. It is the positive thought process that differentiates the person from an OCD sufferer, whose own obsessions and thoughts are unhappy ones, and who cannot control these, or the compulsions that follow. (See also: Personality Disorders)
Schizophrenia is a condition that many sufferers of OCD believe they will inherit. They fear the loss of control that schizophrenia brings. However, the two illnesses are not linked and a sufferer of OCD is no more likely to develop schizophrenia or other mental condition than anyone else.
OCD Causes
There are several theories about the causes of OCD.Genetics may be a factor, as evidence suggests that OCD can run in certain families, although nothing specific in terms of inherited genes has been proven to have a relationship with OCD. But a sufferer of the condition is much more likely to have another member of their family suffer from it (as much as four times more likely) than someone who does not have it.
Infections such as those causing streptococcal bacteria may be related to the onset of OCD, particularly in children and young adults. The link may be between the brain reacting with antibodies to cause the condition.
The Brain – Sufferers of OCD seem to have an increase in blood flow and brain activity in the areas that control emotion.
Adverse Events – an event of violence or bereavement might be a trigger for OCD for those who have one of the above factors (like affected genes). The event itself can result in OCD that relates to it. Stress is another factor that can exacerbate the condition.
While there is still a debate raging about how and why OCD develops, some aspects of the disorder are becoming more understood by mental health professionals. The most credible theories involve both biological and environmental factors.
Biological Causes and Factors
The human brain is an extremely complex piece of biological machinery. Billions of nerve cells must communicate with one another for your body to work properly. This communication takes place via electric signals, which pass from one cell to another with the help of chemicals called neurotransmitters. One of these neurotransmitters is called Serotonin, and people with low levels of it tend to develop OCD.
Biological Causes and Factors
The human brain is an extremely complex piece of biological machinery. Billions of nerve cells must communicate with one another for your body to work properly. This communication takes place via electric signals, which pass from one cell to another with the help of chemicals called neurotransmitters. One of these neurotransmitters is called Serotonin, and people with low levels of it tend to develop OCD.
Additional research showed that these lower levels of Serotonin can be passed to children when the parents have low levels themselves. This adds to the biological influence of OCD development, adding a heredity factor to it.
This imbalance also shares a link with brain development. Pathways the brain uses for judgment and planning and the area that filters messages for body movement are both affected. In this sense, low Serotonin levels impact both the communication and development of the brain.
Another theory has to do with a certain illness. There is a link between bacterial infection and OCD development in children. The Streptococcus bacteria, when left untreated and allowed to reoccur can cause children to develop OCD and other mental disorders.
Environmental Causes and Factors
Stress from the environment can have a huge impact on mental health. When people have a predisposition towards OCD biologically, certain environmental triggers can aggravate the disorder and lead to worsening symptoms. Examples of these triggers are:
Biological and Environmental Influences
These theories link certain factors to OCD, but they are not proven to cause them. This means that just because someone has low Serotonin levels, they will not automatically have OCD. For the most part, there has to be both a biological and environmental factor for the condition to develop.
This imbalance also shares a link with brain development. Pathways the brain uses for judgment and planning and the area that filters messages for body movement are both affected. In this sense, low Serotonin levels impact both the communication and development of the brain.
Another theory has to do with a certain illness. There is a link between bacterial infection and OCD development in children. The Streptococcus bacteria, when left untreated and allowed to reoccur can cause children to develop OCD and other mental disorders.
Environmental Causes and Factors
Stress from the environment can have a huge impact on mental health. When people have a predisposition towards OCD biologically, certain environmental triggers can aggravate the disorder and lead to worsening symptoms. Examples of these triggers are:
- Mental or physical abuse
- Unstable or changing living conditions
- Sickness
- Loss of a loved one
- Changes or stress at work or home
- Relationship problems or stress
Biological and Environmental Influences
These theories link certain factors to OCD, but they are not proven to cause them. This means that just because someone has low Serotonin levels, they will not automatically have OCD. For the most part, there has to be both a biological and environmental factor for the condition to develop.
For example, someone may have had an untreated Streptococcus infection as a child experienced abuse, and ended up having OCD. Even so, someone who experiences both biological and environmental factors may never have the condition. It means that the chances of developing it are greater.
Can OCD be prevented?
If we have a decent idea about what causes obsessive thoughts, logic dictates that we should be able to prevent them from happening. Unfortunately, mental disorders are complicated and can not be prevented.
However, early intervention can reduce the amount of time a person suffers from the symptoms. Proper treatment can also help make the symptoms manageable. A combination of therapy and medication is often used successfully to help people live productive and happy lives.
OCD Treatment
Treatment is crucial for OCD; left untapped it may flourish and become all-consuming.
The most effective treatment of OCD is believed to be Cognitive Behavioral Therapy (CBT). For many people, CBT alone can improve or cure their condition. They become their own therapist, by understanding their thoughts and subsequent behavior, and what the triggers are.
Because research into OCD is ongoing, many practitioners are unaware of the symptoms and the different elements of the condition. Therefore, sufferers should become aware of their symptoms (or look for those in loved ones) so that they can explain them and ask to be referred to a specialist. Sufferers should be open and honest about their condition, as they may be feeling depressed or have thoughts of suicide.
Medication that often helps, when used with CBT, is in the form of Selective Serotonin Reuptake Inhibitors (SSRI). These are thought to help to ease the anxiety and take the edge off OCD.
Self-help for OCD tends to follow the CBT method, with the person affected by the disorder gradually coming to terms with it and understanding the thoughts, impulses, and subsequent compulsions and there is a wealth of self-help information available.
Saturation or Thought Stopping: This method of therapy encourages an individual to think about one obsessive thought they have complained about over and over for a certain period and a certain number of days. Studies show that when a person does nothing except concentrate on one particular thought that scares them, after an allotted period the fear will lose its strength.
Hypnotherapy can also work for OCD sufferers, by unconsciously changing their thoughts and allowing them to see what is real and what is not.
Ketamine Therapy For OCD: Ketamine is a drug that is typically used as an anesthetic. Recent research has shown that ketamine may be effective in treating OCD, even in people who have not responded to other treatments. (You may read also: Ketamine Therapy: A Promising New Treatment for Anxiety)
Ketamine Therapy For OCD: Ketamine is a drug that is typically used as an anesthetic. Recent research has shown that ketamine may be effective in treating OCD, even in people who have not responded to other treatments. (You may read also: Ketamine Therapy: A Promising New Treatment for Anxiety)
Can OCD be cured?
There is no conclusive answer as to whether the disorder can be cured or not. Nonetheless, there are reports of people who have overcome the disease and live normal lives. Some experts believe that although patients may have recovered from the disorder, it may still lie dormant in the psyche just waiting for a trigger. Hence, the best answer to the question is that there is no complete cure for OCD, but it can be managed through proper treatment.
How to get over OCD?
There are usually three options for OCD treatment: cognitive behavioral therapy, the use of medication to inhibit serotonin, and both at once. Cognitive behavioral therapy (CBT) is deemed the most effective way to manage the disorder. This involves the aid of a trained specialist who helps patients get over their obsession and control their compulsive actions.
Cognitive therapy stems from the idea that certain actions are always caused by specific thought patterns. With the help of a therapist, the patient can have a better understanding of how his or her thoughts work.
Obsessive thoughts, by themselves, are not problematic. However, the compulsive actions that result from these thoughts can be harmful and embarrassing. Through behavioral therapy, the therapist can help the patient change his or her behavior especially when obsessive thoughts become intrusive.
The merging of both cognitive and behavioral therapy can help people with OCD overcome the disorder by understanding their thought patterns and consciously changing the way they act in response to those thoughts.
For example, if a patient has a fear of getting contaminated with germs, the therapist can expose him or her to contaminated objects but prevent him or her from doing the same compulsive action. Through repetition, the patient will gradually understand that no extreme harm can come from touching dirty objects and thus overcome the disorder in due time.
Can OCD be cured through CBT? It may help manage the problem by changing the behavior of patients towards obsessive thoughts, but it may not necessarily put a stop to those thoughts.
What to do about obsessive thoughts?
Obsession is the main cause of compulsion. Hence, the best way to control the abnormal action is by suppressing or reducing the tendency of having obsessive thoughts. This can be done through the use of SSRI antidepressants. The medication helps reduce the production of serotonin, which is generally observed to reduce obsession. However, the effect cannot be seen right away. It may take about 2-4 weeks before any positive results can be seen.
It is important to report any side effects to the doctor who has prescribed the medication. There are instances when patients report physical side effects like headaches and diarrhea. There are also cases of suicidal tendencies, anxiety, restlessness, and addiction in a few patients. Therefore, it is crucial to report any unwanted side effects that may occur while taking the medicine.
Things to consider
While undergoing CBT, SSRI medication, or both, the patient needs to get sufficient sleep, regular exercise, and nutritious meals. While they may not necessarily treat the disease, these things do help in making the treatments more effective. In addition, enough rest can help calm the nerves and reduce anxiety attacks. A balanced diet is also helpful in keeping the body strong, especially during the intake of medication.
Final word
OCD: is there a cure? There is a possibility of managing the disease to the point of stopping any compulsive action. However, obsessive thoughts may still be triggered after therapy and medication. The best way to combat the disorder is to seek professional help to ensure that OCD is managed properly.
Advice for family members, relatives, and partners in supporting someone who has OCD
Finding out about the condition of OCD is very important for families and carers of loved ones. Practical support as well as emotional care is crucial and therefore knowledge of OCD is a very useful tool.Identifying OCD in children or teenagers early enough will lead to more effective treatment. Early intervention is proven to be the best way to treat the disorder. The isolation OCD creates in sufferers is a difficult hurdle to overcome.
Occasionally, the sufferer will refuse to seek help, wishing to keep their thoughts and feelings private. In this case, family members and partners could show them educational advice and leaflets. A doctor may also ask family members about the compulsions of the sufferer.
Sometimes families may take part in the rituals, believing that it helps, when it actually reinforces the condition. Tackling OCD as a ‘team’ is crucial. For children, it is often useful to externalize the disorder, by calling it a bully and drawing pictures of it. Schools may need to know about OCD.
Colluding with the disorder is not recommended, and sometimes a light-hearted response might work, such as ‘let’s leave OCD outside today’. Providing clean towels, clothes, etc that the sufferer wants is only prolonging the OCD.
Reassurance is often sought, but family members should try to encourage the sufferer to question their motives for wanting reassurance. In other words, to sow the seeds of Cognitive Behavioral Therapy.
Tacking OCD together is the best course of action for families. On good days, it will be possible to keep the disorder at bay, and on bad days, it is important to just cope, in the best way that families can.
Colluding with the disorder is not recommended, and sometimes a light-hearted response might work, such as ‘let’s leave OCD outside today’. Providing clean towels, clothes, etc that the sufferer wants is only prolonging the OCD.
Reassurance is often sought, but family members should try to encourage the sufferer to question their motives for wanting reassurance. In other words, to sow the seeds of Cognitive Behavioral Therapy.
Tacking OCD together is the best course of action for families. On good days, it will be possible to keep the disorder at bay, and on bad days, it is important to just cope, in the best way that families can.
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