Obsessive-Compulsive Disorder: Symptoms, Risk Factors, and Treatment
Article
Obsessive-compulsive disorder (OCD) is a psychological problem characterized by reoccurring unwanted thoughts and fear (obsessions) that urge a person to do something repeatedly (compulsions). This is a long-term disorder that is now becoming common among people of all ages.
Signs and Symptoms of OCD:
The symptoms of obsessive-compulsive disorders include either obsessions or compulsions and sometimes both. These symptoms impair one’s life functioning and therefore almost all aspects of life such as school, work, social, and personal relationships.
Obsessions in OCD mean recurrent and persistent unwanted thoughts, mental images, or impulses that produce distressing feelings such as stress and anxiety. Common obsessions include:
- Persistent fear of germs or getting contaminated by touching objects
- Unwanted and uncontrollable thoughts related to religion, sex, or harm
- Horrific thoughts about harming others or oneself
- Always need things arranged symmetrically or in a perfect order
Compulsions refer to the repeated purposeful behavior or mental acts that an individual with OCD feels compelled to perform to reduce anxiety related to obsessive thoughts. Examples of symptoms of compulsions include:
- Excessive bathing, hand washing, and cleaning
- Repeatedly arranging things in an orderly manner
- Unconsciously checking on things such as checking to see if the switch is off or door is locked over and over again
- Following a strict schedule
However, all these habits don’t count as compulsions as everyone double-checks the switches and locks. But Individuals suffering from obsessive-compulsive disorder generally:
- Can’t manage their thoughts and actions, even though they are recognized as recurrent and excessive
- Spend at least 60 minutes every day on these mental actions
- Don’t get happy when performing these thoughts but may experience only brief relief from anxiety and other distressing thoughts
- Struggle to perform daily functions due to these behaviors and thoughts
Some patients with OCD also get diagnosed with a tic disorder. Motor tics are sudden, involuntary, and repetitious movements of the body caused by spasm-like contractions of muscles such as eye blinking, shoulder shrugging, nose twitching, facial grimacing, and head jerking. Whereas vocal tics involve the sounds uttered unintentionally, for example, coughing, sniffing, throat clearing, and grunting.
The symptoms of OCD may change over time. People experiencing OCD try to help themselves by either avoiding events that trigger their obsessions or using drugs to relieve themselves. Most people are well aware that their actions do not make any sense but some may not realize that their actions are abnormal.
The symptoms of OCD among students are typically recognized by the parents and their teachers. However, the adults that think they have OCD should talk to their doctor immediately because untreated OCD can badly affect your lifestyle.
Risk Factors of OCD:
Obsessive-compulsive disorder is now becoming a common disorder affecting children, teenagers, and adults all over the world. Most people are diagnosed at the age of 19 but some older than 35 years of age are also diagnosed with this mental health illness.
Although the actual causes of OCD are yet unknown, its risk factors include:
Genetics:
Family studies have shown that an individual whose first-degree relative, for example, a parent, child, or sibling has OCD is at higher risk of developing this mental illness. This risk is even higher if that first-degree relative developed OCD in childhood or adolescence. More research is required to explore the connection between OCD and genetics that may help improve the diagnosis and treatment strategies for OCD.
Brain Structure and Functioning:
According to imaging studies, there is a difference in the structure of the frontal cortex and subcortical structures of the brain of patients suffering from OCD. The symptoms of OCD and abnormalities in certain areas of the brain are also found correlated, however, the connection is yet not clear. Identifying and understanding the real causes of OCD can help determine specific methods to treat OCD.
Environment:
The environment can also play a role in the development of OCD as studies have found an association between childhood trauma and symptoms of OCD. But still, more research is required in this area.
In some cases, children have been reported to develop symptoms of obsessive-compulsive disorder after getting a streptococcal infection. This condition is termed Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS).
Treatment and Therapies of OCD:
The typical treatment of OCD includes medications, psychotherapy (talk therapy), or sometimes both. Most OCD patients respond well to the treatment strategies but some patients continue to experience symptoms.
Some people with the obsessive-compulsive disorder also develop other mental health problems such as anxiety, depression, and body dysmorphic disorder (BDD), a mental health problem in which a person is upset about their body appearance. Keeping in view these mental health problems the treatment for OCD should be decided.
Medications:
First-line treatment of symptoms of obsessive-compulsive disorder is serotonin reuptake inhibitors (SRIs) which include selective serotonin reuptake inhibitors (SSRIs).
Compared to depression, for the treatment of OCD higher doses of serotonin reuptake inhibitors are required. This may take 8 to 12 weeks until SRIs start working, however, some patients show rapid improvement.
If these medications fail to improve symptoms, some patients are treated with antipsychotic medications. According to research, antipsychotic medications can help manage symptoms of patients suffering from both OCD and tic disorder but more research is required regarding the effectiveness of these medicines to treat OCD.
Before starting the prescribed medication, make sure to:
- Talk to the pharmacist or healthcare provider and understand the health benefits and risks of prescribed medication.
- Don’t stop the medication suddenly and without consulting your doctor. This is because suddenly stopping the medication may cause rebound symptoms of OCD. Other life-threatening withdrawal effects may also occur.
- Talk to a specialist in case of any side effects. Ask them to change your dose or prescribe a different medication.
Some other medicines are also used to improve the symptoms of OCD but more research is required before a conclusion.
Psychotherapy:
This is the second treatment option for managing the symptoms of OCD among adults and children. Research suggests that psychotherapy such as cognitive-behavioral therapy (CBT) and other therapies (habit reversal training) can be also used to treat OCD besides using medications. A new type of CBT called Exposure and Response Prevention (EX/RP) is also effective for treating compulsive symptoms in OCD, even in patients who don’t respond well to medications.
As with other mental health problems, OCD patients are also treated with medications, psychotherapy, or a combination of both. In some patients, Exposure and Response Prevention is considered a treatment option especially when medications do not prove effective.
Other Treatment Options:
Other treatment options include Transcranial Magnetic Stimulation (TMS) approved by Food and Drug Administration, in 2018. TMS is now used as an adjunct in the treatment of symptoms of OCD in adults.
Finding help:
If you are experiencing symptoms of OCD for some time, it is time to seek professional help. Many mental health clinics offer online counseling sessions and virtual counseling that can help you manage the situation. In virtual counseling, your counselor monitors your activities regularly and helps you to be accountable through an online virtual system. This is an easily accessible service for everyone that ensures fast recovery.
The bottom line:
OCD is a long-term mental health condition that is becoming common in people of every age group. Symptoms of OCD include obsessions and compulsions caused due to some family history, environment, or structural changes in the brain. Anyone who experiences any symptoms of OCD should immediately talk to the doctor and get treatment. The best treatment strategy for OCD includes medications and counseling.
All information in this article is written based on the publication of The National Institute of Mental Health, a U.S based federal agency that researches mental disorders. The experts of NIMH provide information on mental health problems and the latest mental health research.
