Obsessive Compulsive Disorder

October 26, 2021Mental healthADHDAnxietyPsychiatric ConditionStress2

Obsessive-compulsive disorder (OCD) is a disorder in which individuals have repeating, undesirable contemplations, thoughts or sensations that make him feel to do something  over and over.The repetitive behaviors, such as hand washing, checking on things or cleaning, can significantly interfere with a person’s daily activities and social interactions.This disorder features a pattern of unwanted thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions).
You may try to ignore or stop your obsessions, but that only increases your distress and anxiety. Ultimately, you feel driven to perform compulsive acts to try to ease your stress. 
OCD often centers around certain themes — for example, an excessive fear of getting contaminated by germs. To ease your contamination fears, you may compulsively wash your hands until they’re sore and chapped.
Approximately 2% of the population have OCD. About half of the time, the symptoms appear during childhood or adolescence, and this rarely happens after the age of 40.

Types –

OCD can affect different people in different ways. It may involve:
•  Concern with checking
A person with OCD may feel the need to check repeatedly for problems. This might include:
▪︎repeatedly checking communication, such as e-mails, for fear of having made a mistake or offending the recipient
▪︎checking taps, alarms, door locks, house lights, and appliances to prevent leaks, damage, or fire, for example
▪︎confirming the authenticity of memories
▪︎checking their body for signs of illness

•  Fears of contamination
Some people with OCD feel a continual, overwhelming need to wash. They may fear that objects that they touch are contaminated.
This can lead to:
▪︎avoiding crowds for fear of contracting germs
▪︎repeatedly cleaning the bathroom, kitchen, and other rooms
▪︎excessive toothbrushing or handwashing

•  Hoarding
This involves a person feeling unable to throw away used or useless possessions.

•  Intrusive thoughts
This involves feeling unable to prevent repetitious unwanted thoughts These may involve violence, including suicide or harming others.The thoughts can cause intense distress, but the person is unlikely to act in a way that reflects this violence.

•  Symmetry and orderliness
A person with this type of OCD may feel that they need to arrange objects in a certain order to avoid discomfort or harm.They may repeatedly rearrange the books on a shelf, for example.

Symptoms –

Obsessions.
While everyone worries, in people with OCD, worries and anxiety can take over, making it hard to carry out everyday tasks.
Common topics of this anxiety include:
• Harm, including a fear of being responsible for a catastrophic event
• Contamination, by bodily fluids, germs, dirt, and other substances
• Religious or superstitious beliefs, such as a concern about offending God or stepping on cracks in the sidewalk
• Losing control, such as the fear of acting on an urge to self-harm or hurt others
• Unwanted sexual thoughts, including thoughts about inappropriate activities
• Perfectionism, which may involve the fear of losing things or an intense focus on exactness or remembering things.

Compulsions.
Not every repetitious behavior is a compulsion.For a person with OCD, however, the need to perform repetitious behavior is intense, it occurs frequently, and it is time-consuming. The behavior may take on a ritualistic aspect.
Some examples include:
• monitoring the body for symptoms
• washing and cleaning, including handwashing
• repeating routine activities, such as getting up from a chair
• Counting things over and over again
• Ordering things in a particular or symmetrical way
• Repeated checking (such as checking that the door is locked or that the oven is off)

OCD in Children
The first signs of OCD oftenappear in adolescence, but they sometimes emerge in childhood.

Symptoms including children, with OCD include:
• difficulty completing schoolwork
• low self-esteem
• trouble forming or maintaining friendships and other relationships
• disrupted routines
• physical illness, due to stress
When OCD begins in childhood, it may be more common in males than females. By adulthood, however, it affects males and females at equal rates.

Causes –
The exact cause of OCD is unknown, but there exists few factors that are believed to play a role.
•  Family history
  Research has shown that if you, a parent, or a sibling have OCD, there is a 25% chance that another immediate family member will also have it.
•  Genetics
Although a single “OCD gene” has not been identified, OCD may be related to particular groups of genes.
•  Biological factors
One theory is that OCD comes from a breakdown in the circuit in the brain that filters or “censors” the many thoughts, ideas, and impulses that we have each day. As a result, you may experience obsessions and/or compulsions. The breakdown of this system may be related to serotonin abnormalities.​
•  Stress
Stress from unemployment, relationship difficulties, problems at school, illness, or childbirth can be strong triggers for symptoms of OCD.

Risk Factors –
OCD often occurs with other conditions, including:
• social anxiety disorder
• attention deficit hyperactivity disorder (ADHD)
• major depressive disorder
• Tourette syndrome
• eating disorders

Complications –
Long-term complications of obsessive compulsive disorder have to do with the type of obsessions or compulsions.
• Excessive time spent engaging in ritualistic behaviors
• Difficulty attending work, school or social activities
• Health issues, such as contact dermatitis from frequent hand-washing
• Overall poor quality of life
• Troubled relationships
• Suicidal thoughts and behavior

Diagnosis –
Steps to help diagnose obsessive-compulsive disorder may include:
•  Psychological evaluation.
This includes discussing your thoughts, feelings, symptoms and behavior patterns to determine if you have obsessions or compulsive behaviors that interfere with your quality of life. With your permission, this may include talking to your family or friends.
•  Diagnostic criteria for OCD.
Your doctor may use criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
•  Physical exam.
This may be done to help rule out other problems that could be causing your symptoms and to check for any related complications.

Treatment –

Medication
There are a variety of medications that are effective in reducing the frequency and severity of OCD symptoms. Many of the medications that are effective in treating OCD are –
•  Clomipramine (Anafranil) for adults and children 10 years and older
• Sertraline (Zoloft) for adults and children 6 years and older
•  Fluoxetine (Prozac) for adults and children 7 years and older
•  Paroxetine (Paxil, Pexeva) for adults only
•  Fluvoxamine for adults and children 8 years and older
All of above medications affect levels of serotonin.
Psychotherapy
Psychological therapies are also highly effective treatments for reducing the frequency and intensity of Obsessive compulsive disorder symptoms. Effective psychological treatments for OCD emphasize changes in behavior and/or thoughts.
When appropriate, psychotherapy can be done alone or combined with medication. The two main types of psychological therapies for OCD includes –
•  cognitive behaviorial therapy (CBT) 
•  exposure and response prevention (ERP) therapy.

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• Brahmi Churna
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• Saraswatarhishta
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