Obsessive-compulsive disorder, better known as OCD, is a common but often misunderstood disorder. In this lesson we’ll explore the obsessions and compulsions of OCD as well as causes and treatment.
Is the front door locked? Did I turn off the stove? I thought I unplugged the iron, but am I sure?Going back and rechecking to make sure we did something important such as locking the door to our home is common and natural. As the term ‘OCD’ has become more popular in our everyday language, many people try to relate to the symptoms of this disorder.
However, being thorough with our jobs or schoolwork, color-coding our wardrobes or even being exceptionally clean does not mean that we suffer from psychological disorder.Obsessive-compulsive disorder or OCD is one of the most common types of psychological disorder. OCD is most commonly defined by its symptoms. OCD sufferers experience recurrent, invasive thoughts or repetitive actions that are understood to be irrational and unnecessary. These recurring, invasive thoughts, called obsessions, and uncontrollable, repetitive actions, called compulsions, cause the person significant stress and disruption in their daily life.
Regardless of the name, not all people with OCD suffer from both obsessions and compulsions, even though it is most common together.OCD can take many forms. The following are only a few of the common types of OCD:
- Seeking cleanliness, orderliness or symmetry
- Performing repetitive acts that are thought to be protective, such as counting or praying
- Repeatedly checking, often for the purpose of safety
Disorders associated with gambling, drinking, overeating and Internet addiction are not considered part of obsessive-compulsive disorder. Although someone may describe themselves as a compulsive gambler, these activities are considered pleasurable.
The compulsions of an OCD sufferer often cause anxiety, guilt, grief, remorse and pain. In addition, people with OCD are aware that their thoughts and behaviors are irrational and cause them problems.It is important to understand how the obsessions and compulsions of OCD are different than those that we may consider normal.
Symptoms of OCD
Every person has experienced having a commercial jingle or a radio song stuck in their head. These thoughts can invade our heads and even become bothersome when they won’t go away and we find ourselves humming along. However, these brief fixations in our brains are nowhere near what is experienced by a sufferer of OCD. The force and frequency of OCD obsessions make it difficult to think of anything else.
These involuntary obsessions can take the form of thoughts, images, impulses or ideas and are often very disturbing in nature.
Often, those who suffer from obsessive thoughts also engage in repetitive behaviors. These behaviors, called compulsions, are performed in an attempt to forget about or find relief from the anxiety of obsessive thoughts. One common type of obsessive-compulsive disorder revolves around hand-washing and cleaning rituals. Those with this type of OCD often have uncontrollable and irrational fear of germs and sickness. The compulsive activity of cleaning provides a (very) temporary relief from the obsessive fear of germs. Unfortunately, the obsessive thoughts always return.
This pattern of obsessive thoughts and follow-up ritualistic compulsions take up more and more time in a person’s day. This can continue until the entire cycle of obsessions and compulsions causes serious problems in a person’s work, school and personal life.
What Causes Obsessive-Compulsive Disorder?
As with most mental disorders, it is unknown exactly what causes OCD. In fact, most experts believe that a combination of factors is nearly always at play with such complex mental issues. OCD is more common in people who have family who have suffered from OCD or similar disorders. This connection, called heritability, shows that the genetic component could account for around 50% of the chance of developing the disorder.
Often, antidepressant medications can help people with OCD. Because antidepressant medications affect the neurotransmitter serotonin, this has led scientists to look at related areas of the brains of OCD patients. PET scans of OCD patients show greater activity in regions of the brain that may be responsible for this disorder. When shown images related to their obsessions or compulsions, regions of the brain responsible for decision making show abnormally high levels of activity.
In addition, cognitive and behavioral psychologists have theorized about differences in the way OCD patients think and behave. We know that the areas of the brain involved in ‘shutting off’ attention are overactive in patients with OCD. Psychologists have found that sufferers of OCD don’t feel a sense of completion when finishing a task. Stated simply, they don’t know when to stop an activity, such as cleaning or washing. Some sufferers don’t trust their memories of completing a task, such as locking the door or turning off the stove.Psychologists have also found that OCD sufferers have difficulty with thought suppression.
Although they try to suppress their thoughts, it often has a reverse effect. This is a common problem for anyone trying to suppress a thought. For example, what is the first thing that happens when I tell you not to think about a white elephant?
Treatment of OCD
The treatment of OCD generally begins with medication, psychotherapy or both. Medications are rarely effective when used alone but can be very helpful in combination with talk therapy. Antidepressants are the most common class of medication used to treat OCD, and anti-anxiety medications are sometimes prescribed in conjunction with antidepressants. Currently, SRIs and SSRIs are the most common antidepressants used to treat OCD.
These antidepressants affect the neurotransmitter serotonin, which, as we learned, has a relation to this disorder.It is generally agreed that the most effective single treatment for OCD is cognitive-behavioral therapy. Cognitive-behavioral therapy is a type of talk therapy that focuses on the thoughts and behaviors. One new type of cognitive-behavioral therapy that has been proven to be very effective is exposure and response prevention, or ERP.
During ERP therapy, clients are exposed to something that triggers their obsession but are required to avoid performing compulsive behaviors. Someone with obsessions about germs or disease may be asked to shake hands with the therapist (without gloves) and not wash their hands in response. The therapist will then work with the client to find other ways to reduce anxiety. Eventually, the therapist and client may work up to touching public restroom doors without washing. With practice, this technique teaches the client that they have control over their thoughts and behaviors.
Obsessive-compulsive disorder, or OCD, is a common type of psychological disorder characterized by intrusive thoughts, called obsessions, and repetitive behaviors, called compulsions.
It is understood that OCD is a condition with some heritable, or genetic, component, and scientists have found specific differences in the brains of OCD sufferers. Psychologists are also studying differences in the way people with OCD think. It is believed that OCD sufferers have particular difficulty with thought suppression. Common treatments for OCD include medication and cognitive-behavioral therapy.
A particularly effective type of cognitive-behavioral therapy known as ERP involves exposure to the focus of an obsession.And remember, don’t think about the white elephant!
When this lesson is complete, you should be able to:
- Define obsessive-compulsive disorder as a psychological disorder
- Recognize the theories as to the conditions causes
- Describe the obsession and compulsions inherent in the disease
- Identify the possible treatments including ERP