Ever have unwanted thoughts that lead to feeling distressed? While unwanted thoughts and upsetting feelings can be a normal part of the human experience, there are some instances where these intrusive thoughts can become so distressing that a person engages in certain compulsive behaviors to try to eliminate them. This is known as obsessive compulsive disorder, or OCD.
OCD can start at any age and affects men, women, and children of all backgrounds, ethnicities, and races equally. It is estimated that one in 100 adults have the disorder within the United States.
What is Obsessive Compulsive Disorder?
Obsessive compulsive disorder consists of two key elements: the presence of obsessions and compulsions. The obsessions that a person with OCD has are thoughts that occur over and over that feel beyond manageable to the person experiencing them. The thoughts are intrusive to the individual and tend to feel out of control. Many times, people with OCD realize these thoughts are irrational but continue to have them anyways. Examples of obsessions that a person with OCD could experience include a preoccupation with staying clean, fear of contamination, unwanted sexual thoughts, religious-related obsessions, perfectionistic thoughts, and fear of losing control. While this is not an exhaustive list, these obsessions are more common for a person with OCD.
It is important to recognize that while the word obsession gets thrown around often in today’s culture, not just any unwanted thought is considered an obsession. In the causal sense of the word, obsession can mean a preoccupation with something, while an OCD obsession creates problems and internal tensions for the individual in their daily life.
The second component of obsessive compulsive disorder is the presence of compulsions. These compulsions are a response to the uncomfortable nature of obsessions and involve rituals or repetitive behaviors to help ease anxiety. The individual with OCD uses these compulsions with the intention to minimize the uncomfortable thoughts (obsessions) they are having. The important distinction to recognize with compulsions is that they are time-consuming, affect daily life functioning, and get in the way of activities the individual values. These behaviors are a response to the obsessions, a way to reduce the anxiety caused by the intrusive thoughts.
Like obsessions, not all repetitive behaviors are considered compulsions. An OCD compulsion occurs when the individual feels strongly driven to complete the behavior, which gets in the way of functioning normally throughout the day. It is important to be aware of the context around the behavior, recognize what the function is, and identify if the person completing it would rather not be doing it but feels compelled to do so. Some examples of OCD compulsions include washing hands, ordering or arranging, cleaning, checking, or repeating. While this is not an exhaustive list, it highlights many of the common compulsions found within obsessive compulsive disorder.
Symptoms Associated with Obsessive Compulsive Disorder
While OCD is mainly identified through the presence of obsessions and compulsions and their negative impact on daily life, there are some beliefs that can be present for a person with OCD. These dysfunctional beliefs can include:
- Having control over one’s thoughts
- Imperfection is unacceptable
- Over importance of thoughts
- Believing they can cause or are responsible for events outside of their control
- Intolerance for uncertainty
While having these thoughts do not necessarily mean an individual has OCD, they are examples of intrusive thoughts and belief systems that a person with OCD holds that can become detrimental to mental health and daily functioning.
Causes of Obsessive Compulsive Disorder
While research has established how chemicals and electrical impulses within the brain affect human behavior, there has been no recognition of a definitive cause for OCD. Some factors that are believed to contribute to OCD include:
- Genetic predisposition – 25% of individuals with OCD have an immediate family member who shares the same disorder
- Behavioral conditioning
- Environmental, such as traumatic brain injuries
- Severe trauma
A study completed by the National Institute of Health (NIH) identified that OCD may be associated with a mutation within the gene that transports serotonin in the brain, showing a likely chemical component to the disorder.
It is important to note that there has been no definitive cause identified for obsessive compulsive disorder and research is still underway. While no single identifiable cause has been found, it has been identified that the interplay between many factors play a role in the development and continuation of the disorder.
The most common and effective treatment for Obsessive Compulsive Disorder includes a combination of cognitive behavioral therapy and medication. Exposure and response prevention, or ERP, is a type of cognitive behavioral therapy considered most beneficial for individuals struggling with OCD. Combined with a specific medication called an SSRI or selective serotonin reuptake inhibitor, ERP is considered first line treatment for OCD.
Exposure and response prevention (ERP) is a type of therapy that is great for individuals with OCD because it focuses on confronting obsessions and resisting compulsions. With ERP, the person is put into an anxiety-triggering situation that would normally lead to acting out the compulsion. Supported by the therapist, the person is encouraged to tolerate the anxiety and uncomfortable feelings that arise.
The most common type of medications that are used to treat OCD include selective serotonin reuptake inhibitors, also known as SSRIs. SSRIs are a type of antidepressants used specifically in treating OCD and managing symptoms.
Other ways to help manage OCD symptoms and find relief include joining a support group, managing stress and anxiety, incorporating relaxation techniques and mindfulness into a daily routine, getting at least 7 hours of sleep each night, and eating a healthy diet.
Obsessive compulsive disorder can be a frustrating and debilitating disorder. Not only does it affect the individual, but it can have lasting impacts on those around them. Individuals may feel lonely and isolated because of the intrusive thoughts and time-consuming compulsions but it is important to recognize that support is available. With the right tools and support, it is possible to manage even the most intense and distressing symptoms of OCD.