Obsessive Compulsive Disorder (OCD) is a form of an anxiety disorder wherein an individual has recurring, negative, and intrusive thoughts, images or impulses called Obsessions that lead to anxiety. As a way of coping with these obsessions, the individual performs repetitive behavior or mental acts called Compulsions. The diagnosis requires a presence of obsessions and/or compulsions that are time consuming, that cause major distress, and impair aspects of functioning such as work and social behaviour. But what it is not however, is a ‘cute’, ‘trendy’, or ‘funny’ way to describe oneself or others who do things a certain way. We often use the term “OCD” to describe each other’s personalities as a joke, however such stereotypes may trivialize another person’s suffering. It’s one thing to be aware and know these terms and another to use them incorrectly. Moreover, English language provides us with a wide range of options to choose from like fastidious, orderly, persnickety, Type A, uptight, perfectionist, obsessive, and more to describe someone who is overparticular about the way they do things but do not suffer from a mental health condition. Let’s take this as an opportunity to learn, unlearn, and relearn about OCD and become informed, sensitive individuals.
COMMON MISCONCEPTIONS SURROUNDING OCD
- ‘We are all a little bit OCD sometimes’- OCD is not a character trait or personality quirk, it is a very real mental health condition that affects millions of individuals. ‘No Neha, you’re not OCD because you like your room neat and clean.’
- ‘OCD is not that big of a deal, people need to ‘relax’/‘chill’- It is in fact a serious anxiety disorder that affects millions of people. People with OCD face severe, often debilitating anxiety over a number of things called ‘obsessions’ and to overcome the anxiety, they use rituals or ‘compulsions’. ‘No Jai, you asking them to relax will not help them deal with their anxiety.’
- ‘OCD is just about washing hands, being neat and clean’- Triggers related to cleanliness make up only a small part of the range of OCD triggers. Obsessions and compulsions can be related to a wide variety of things including losing control, infidelity, harming self or others, religion, sexuality and much more. ‘No Rhea, OCD is not just limited to obsessions about cleanliness.’
THE OCD CYCLE
- The recurrent, unwanted, negative thoughts which are called Obsessions act as a trigger.
- These triggers lead to Anxiety.
- Anxiety can be felt in the following forms:
- Heart palpitations
- Restlessness
- Headache
- Stomach uneasiness
- Weakness in limbs
- Trembling
- Sweating, etc
- At the peak of anxiety, the individual tends to perform an act, behaviour or ritual for relief called Compulsions.
- Compulsions provide temporary relief.
- However, this cycle may repeat itself from 1-2 times a day/week to 20 or more times a day resulting in hours of an individual’s daily life being spent in gaining momentary relief through compulsive behaviors only to turn to stage one of Obsessions later causing significant distress in regular functioning.
SOME COMMON OBSESSIONS
- Fear of being contaminated, dirty, or catching germs
- Fear of acting on impulse to harm self or others
- Fear of falling sick or having a disease
- Concerns about evenness or exactness
- Forbidden or perverse sexual thoughts or images
- Superstitious ideas about numbers, colours or patterns
- Negative thoughts related to God or religion
SOME COMMON COMPULSIONS
- Excessive washing or cleaning
- Repeated checking that no harm is done to self or others
- Rereading, rewriting, repeating activities or movements
- Counting while performing tasks to end on a ‘safe’ number
- Telling, asking or confessing for reassurance
- Repeated doctor visits, testing (Doctor shopping)
CAUSES OF OCD
The exact causes of OCD have not been identified yet, however it is commonly believed to have a neurobiological basis. The condition may be triggered by a combination of neurological, genetic, behavioural, cognitive, or environmental factors. The risk factors include family history, stressful life events, or even other mental health problems.
ONSET OF OCD
Although symptoms of OCD can begin at almost any age, it usually begins before the age of 25 and research suggests that there are two distinct periods when OCD symptoms are most likely to appear.
- Early-onset OCD: This is when the symptoms start manifesting during late childhood or early adolescence.
- Late-onset OCD: This is when the symptoms begin to manifest in early adulthood.
PREVALENCE OF OCD
One in every 167 individuals (approximately 0.6% of the population) in their lifetime are diagnosed with OCD in India. Numbers show that more males struggle with OCD than females.
Globally, 2 to 3 out of every 100 individuals (approximately 2-3% of the population) have OCD in their lifetime. It affects men and women equally.
TREATMENT OF OCD
The two main treatment options for OCD are Psychotherapy and Medications. Often the treatment is more effective with a combination of both. The most effective therapeutic treatments include:
- Cognitive Behavior Therapy (CBT)
- Exposure and Response Prevention
- Imaginal Exposure
- Habit Reversal Training
- and/or Medication
OCD treatment may not result in 100% cure but it can help bring symptoms under control so that they do not disrupt an individual’s daily life. Awareness, recognition, and acknowledging OCD as a mental health condition is already half the work done and can aid in effective treatment progress!
Author,
Sanjana Karnik,
Clinical and Research Intern, PsychLine.in
REFERENCES
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
Reddy, Y. J., Rao, N. P., & Khanna, S. (2010). An overview of Indian research in obsessive compulsive disorder. Indian Journal of Psychiatry, 52 (1), S200- S209. doi: 10.4103/0019-5545.69233
Leckman, J. F., Grice, D. E., Boardman, J., Zhang, H., Vitale, A., Bondi, C., … & Goodman, W. K. (1997). Symptoms of obsessive-compulsive disorder. American Journal of Psychiatry, 154(7), 911-917. https://doi.org/10.1176/ajp.154.7.911