OCD stands for obsessive-compulsive disorder
People with obsessive-compulsive disorder (OCD) have obsessions and/or compulsions. Obsessions are unwanted thoughts, ideas, or feelings that are repetitive in nature. In response to which there are repetitive habits like washing hands, checking, or praying which make it hard for a person to do their daily tasks.
OCD is marked by repetitive, disturbing thoughts and rigid, ritualized behaviours. People with OCD know their obsessions are irrational, but some may still believe they are true(due to poor insight.
What is the difference between obsessions and compulsions?
Obsessions are thoughts, images or urges keep coming back over and over again and which are hard to resist for the patient. Obsessive thoughts are unwanted and bothersome. People who have obsessions often try to get rid of anxiety by avoiding or hiding their obsessions.
Compulsions are repeated actions or thoughts that a person keep doing in response to their obsessions to relieve stress or stop a feared event from happening. Some common compulsions include repeatedly washing hands, doing ritual checks, praying, and doing superstitious or counting in your head.
Few examples of obsessions:
- Repetitive thoughts that hands are dirty, it can also apply to bedsheets, lines or clothes
- sexual thoughts which are disturbing for the patient
- Worry about saying or doing something which is offensive.
- desire for symmetry, balance, or accuracy
- doubt that door is open/car is not locked properly/gas stove is still running
Few examples of compulsions:
- excessive hand washing, showering, brushing teeth, or taking long time bathing
- Cleaning the house for hours together and not getting satisfied
- Putting things in a certain order or symmetry
- Repeatedly checking locks/doors/stove
- Counting while doing task or praying in head repeatedly
You can have one or the other without the other, but it's more common to have both simultaneously.
It is not clear if the symptoms come from a core problem in the brain or if they come from a pattern of obsessive and compulsive behaviour that is then reflected in the brain. Because both biological and environmental factors are likely to play a role in developing OCD, it's hard to say who is more likely to get it and what their symptoms will be once they do.
What causes OCD?
The disease can run in families because of strong genetic predisposition. The causes of OCD in the environment may not be known. Stressful life events can cause OCD in people who already have it or make an illness worse. Adverse events in early childhood, strong family history of OCD can be the contributing factor as a cause.
What is the treatment available for OCD?
ERP (exposure and response prevention) therapy
ERP therapy is one of the gold standard treatment for OCD where a patient is exposed gradually to their fears related to their obsessions and they are trained to cope with their anxiety and prevent them from doing the compulsions
ERP shows people how to resist their compulsions by gradually exposing them to their obsessions that make them want to act on them. By using ERP, people can learn to deal with things that make them anxious without doing compulsions.
Cognitive Behaviour Therapy
CBT is helpful when there is associated anxiety and depression along with OCD. In most of the cases of OCD, symptoms of anxiety and depression are present. CBT helps patients to identify irrational thoughts and work on them.
Medication
Selective serotonin reuptake inhibitors (SSRIs) are preferred in treatment of OCD. Clomipramine, which belongs to group tricyclic antidepressant has shown very good results in treating OCD patients. The dose of an SSRI used to treat OCD is usually higher than the dose used to treat depression.
The tricyclic antidepressant (TCA) clomipramine was traditionally the first drug used to treat OCD. SSRIs have become more popular in the past few years because they have less side effects as compared to TCAs.
