Obsessive-Compulsive Disorder (OCD) – Symptoms, Causes & Treatment

What is OCD?

OCD, or obsessive-compulsive disorder, is a chronic and long-lasting disorder that makes a person do repetitive behaviour (compulsion). The disorder can interfere with our daily activities, which can lead to unwanted distress.

The person will have the urge to repeat a particular action repeatedly. And if they try to ignore or stop the particular action, it can lead them to distress. Additionally, they may think that not completing their ritualistic behaviour can lead to major consequences for themselves or their loved ones. These actions can impact all aspects of life, like school, work and relationships.

The most common repetitive behaviours include hand washing, cleaning and checking on things. In most cases, OCD centres around themes like getting contaminated by germs, asking for reassurance, checking if the doors are locked and repeating words in your head.

People with OCD will know that their obsessional thoughts are not real, and some may believe that their thoughts are realistic. According to NCBI, about 0.6% of Indians are affected with obsessive disorder. However, further research is required as the epidemiological aspect of OCD in India is limited.

Symptoms of OCD

Obsession symptoms

OCD usually involves both compulsion and obsession. However, some people may have only obsession or compulsion symptoms. People will not realise that they have an obsession and compulsion are unreasonably high. They might tend to realise when excess time is required or wasted, which can interfere with their daily routine.

Some of the common symptoms of obsession are

• Difficulty in tolerating uncertainty
• Arranging things orderly and symmetrically
• Fear of contamination
• Horrifying thoughts about losing control
• Harming self or others
• Unwanted thoughts
• Aggression

Some of the common examples of obsession thoughts are

• Doubts about locking the door or turning off the stove.
• Illusion of driving the car into a crowd of people.
• Thoughts of inappropriate acts in public.
• Unpleasant sexual images.
• Try to avoid situations like shaking hands to avoid contamination.
• Intense, stressful behaviour when things are not appropriately arranged.
• Fear of contamination when touching objects others have touched.

Compulsion symptoms

The compulsion of repetitive behaviours or mental acts will help people with OCD reduce their anxiety. Additionally, by doing these activities, they think that something bad can be prevented without happening. However, engaging in compulsive behaviour does not bring pleasure and only temporarily relieves anxiety.

In most cases, the compulsion behaviour is not realistic and can be fixed. Some of the common symptoms include

• Checking frequently
• Counting
• Following a routine or ritual
• Demanding reassurance
• Stacking things in order
• Often washing or cleaning

Some of the common examples include

• Checking doors repeatedly to see if it is locked
• Counting in certain patterns.
• Whispering certain words, numbers and phrases
• Arranged things in a certain way
• Hand washing until their skin becomes raw

Diagnosis of OCD

The diagnosis of OCD can sometimes challenging. In most cases, the symptoms of OCD can resemble other disorders like anxiety disorder, personality disorder and other mental health conditions. Additionally, it is possible for a person to have both OCD and other mental health disorders. Some of the common diagnostic methods are

Psychological evaluation

A physical examination will include discussing a person’s feelings, symptoms, behaviour and thoughts. This will help determine whether the person has an obsession or compulsive behaviour that can interfere with their daily life. The test will also include talking to the affected person’s friends and family.

Physical exam

A physical exam can help rule out options which can cause the same symptoms as OCD.

Risk factors of OCD

OCD is a common disorder and can affect anyone. In most cases, people are diagnosed with OCD at the age of 19.  

Genetics

First-degree relatives like sibling and parents who are affected with OCD can pass their disorder to their children or younger siblings. Additionally, the risk is higher if the person develops their OCD as a child or a teen. However, further research is required to explain the connection between genetics and OCD.

Brain Structure and Functioning

During the imaging studies, people with OCD had different brain structures like frontal cortex and subcortical structures. There is research that supports there is a connection between OCD symptoms and brain abnormalities. However, the connection is not clear and further research is required.

Environment

Environment plays a major role in people getting affected with OCD. Children with childhood trauma have an increased risk of developing OCD later in their life.

Treatments and Therapies for OCD

OCD can be treated with medication and therapy.

Medication

OCD symptoms can be reduced with medication like serotonin reuptake inhibitors (SRIs) and selective serotonin reuptake inhibitors (SSRIs). The medication will be prescribed in higher dosages and can take up to 8-12 weeks to start working. In some cases, people can experience rapid improvement in a short span of time.

If the SRIs and SSRIs do not work, then antipsychotic medication will be prescribed. However, research has shown that people with OCD and tic disorder respond well to antipsychotic medication.

Psychotherapy

Psychotherapy is an effective treatment for both adults and children affected with OCD. Cognitive behavioural therapy and habit reversal training can be effective among other therapies.

Exposure and response prevention is a therapy that makes people spend in a situation that can trigger a compulsion behaviour. For example, touching dirty objects and preventing them from washing their hands or reducing the number of times to wash their hands.

Like the other treatment, OCD treatment can be personalised. Some people might require a therapy, and some will only require medication, whereas others will require a combination of both.

Complications of OCD

Some of the common complications associated with OCD are

• Troubled relationships
• Excessive time wasting due to engaging in ritualistic behaviour
• Difficulty in attending school and work
• Poor quality of life
• Health issues like contact dermatitis due to excessive hand washing
• Suicidal thoughts

Lifestyle and home remedies

OCD symptoms can be reduced with the help of a professional. However, with certain lifestyle changes and home remedies, OCD symptoms can be controlled.

Coordinate with your mental health professional and learn techniques and skills to manage and reduce the symptoms. It is also important to practise those regularly.

Medication can help with the symptoms. Do not skip your medication even if you feel well and your symptoms are in control. If you stop or pause your medication, the OCD symptoms can relapse.

Pay attention to your symptoms. Your symptoms can get triggered due to certain actions. Discuss this with your healthcare professional, and they might help you. Do not hesitate to consult your doctor if you see any changes in symptoms.

Prevention of OCD

OCD cannot be prevented. However, early diagnosis and treatment will help with the symptoms. Medication and therapy can help reduce the symptoms and improves the quality of life.

When to consult your doctor?

OCD symptoms can be similar to other symptoms. Consult your doctor if you have symptoms like

• Repetitive and ritualistic behaviour
• Checking things often
• Whispering words, phrases and numbers
• Counting
• Hand washing or cleaning things often, even if they are not dirty.

Conclusion

OCD is a common mental health condition and can affect anyone. It is common among children and adults. In regard to mental health conditions, early diagnosis and treatment are required to reduce and manage your symptoms.

OCD can reduce the quality of life of a person. So treatment can aim to improve the quality of life and also reduces your obsession and compulsion.

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