OCD

Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by debilitating, uncontrollable, reoccurring thoughts or reactions. Obsessive thinking triggers the urge to repeat certain behaviors or compulsions in sequential order. 

In order to regain a sense of control in their lives, individuals attempt to control feelings through behaviors. Simple rituals are put in place to help feel more secure. Eventually these types of rituals and habits unnecessarily complicates daily function. Examples of OCD behavior may include:

✅ repeatedly checking on others
✅ repeating words or phrases
✅ counting objects repeatedly
✅ rearranging objects for symmetry
✅ tapping fingers or feet
✅ excessive cleaning
✅ repetitive checking
✅ seeking reassurances
✅ Impulsive decisions
✅ excessive hand washing

Causes of Obsessive-Compulsive Disorder

While there is no exact cause for the onset of OCD, there are a few hypotheses researchers are working to prove. While the root cause has not yet been pinpointed, here are the factors that are suspected to make individuals more susceptible to OCD and others that have been ruled out:

💡 brain chemistry                                         ❌ parenting 
💡 family mental history                               ❌ common life stressors 
💡 learned behaviors                                     ❌ chronic illnesses 
💡 traumatic event                                         ❌ vaccines 
💡 stressful environments                             ❌ immunizations
💡 need to control fearful thoughts            ❌ cleanliness standard
💡 low serotonin levels

💡 brain chemistry
💡 family mental history
💡 learned behaviors
💡 traumatic event
💡 stressful environments
💡 need to control fearful thoughts
💡 low serotonin levels
❌ parenting 
❌ common life stressors 
❌ chronic illnesses 
❌ vaccines 
❌ immunizations
❌ cleanliness standard

Misconceptions About Obsessive-Compulsive Disorder

Stigmas surrounding OCD are too commonly heard within our society. Many use terms or claim themselves to “be OCD” or call their friend “OCD” because of personal preferences for cleanliness or organization. One may also use these phrases or terms to describe behaviors, emotions, or thoughts. OCD specifically is not a joke when it is an everyday life experience. 

It is also common for the media to portray behaviors of OCD as debilabiting behaviors influencing the individual functioning of everyday routines emphasizing the inability to live a life with the diagnosis. OCD rituals are commonly assumed as behaviors of sequential counting aloud or visual routines. Rituals are more likely to be completed mentally, solely being heard in the mind of the experiencer. The silence of rituals can cause dangers in the diagnosing and remission process as suicidality and homicidality may be present mentally, though undetected behaviorally. This is far from the truth and a dramatized description of the disorder, though it is not uncommon for cases to be extreme, it is still common for individuals to still function and live an active life.  

Here is a list of false symptoms and assumptions that are commonly mistaken as OCD:

🚫 a quirk
🚫 unrealistic fears
🚫 a choice
🚫 just hand washing
🚫 not serious
🚫 a joke
🚫 being over clean
🚫 untreatable
🚫 an adjective

🚫 a quirk
🚫 unrealistic fears                        
🚫 a choice
🚫 just hand washing
🚫 not serious                                  
🚫 a joke
🚫 being over clean
🚫 untreatable
🚫 an adjective

Signs and Symptoms of Obsessive-Compulsive Disorder

It is critical to remember while there are always behavioral signs to a disorder, it does not conclude one has the diagnosis. Seeking support from a provider, such as a psychiatrist or psychologist can assist in assessing symptoms and initiating treatment. Since OCD can be caused by a magnitude of environmental factors, it is critical to still consider the biological effects on development, specifically with low serotonin levels. Consulting with a psychiatrist or psychologist will address the concerns of serotonin levels through assessment testing scales and measurements.

Some common obsessions and compulsions of OCD are as follows:

Obsessions:                                                       Compulsions:

🚩 fear of germs and contamination         🚩 excessive checking of things 
🚩 fear of losing control                                 🚩 checking safety of loved ones
🚩 fear of harming yourself or others         🚩 counting, tapping, repeating words
🚩 fear of losing items                                    🚩 excessive washing or cleaning
🚩 excessive focus on religion                      🚩ordering or arranging things
🚩 intrusive sexual thoughts                         🚩 praying excessively 
🚩 order and symmetry                                 🚩 accumulating items
🚩 superstitions

Obsessions:                                                      
🚩 fear of germs and contamination
🚩 fear of losing control 
🚩 fear of harming yourself or others  
🚩 fear of losing items 
🚩 excessive focus on religion
🚩 intrusive sexual thoughts 
🚩 order and symmetry 
🚩 superstitions

 Compulsions:
🚩 excessive checking of things 
🚩 checking safety of loved ones
🚩 counting, tapping, repeating words
🚩 excessive washing or cleaning
🚩ordering or arranging things
🚩 praying excessively 
🚩 accumulating items

Diagnosing Obsessive-Compulsive Disorder

Seeking a psychiatric evaluation from a psychiatrist or psychologist will provide a formal diagnosis of the disorder. Diagnosing practitioners compare signs and symptoms of OCD to the criteria found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), guidelines used for psychiatric diagnosing and treatments to decrease labels and stigmas. Though the DSM may counteract the goal of decreasing labels, it does positively attempt to separate client experience and symptoms by stating:

“While the specific content of obsessions and compulsions varies among individuals, certain symptoms dimensions are common in OCD, including those of cleaning, symmetry, forbidden or taboo thoughts, and harm (2013).” 

The certain symptoms mentioned are as follows:

⚠️ presence of obsessions, compulsions, or both
⚠️ recurrent, persistent, intrusive thoughts, urges or images marked anxiety or distress
⚠️ inability to ignore, suppress or neutralize thoughts, urges, or images
⚠️ repetitive behaviors or mental acts performed in response to an obsession
⚠️ behaviors or mental acts unrealistically aimed at preventing or reducing distress, event or situation. 
⚠️ time consuming or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

The diagnosis of OCD also includes the determination of its type. There are four types of OCD to consider as follows: 

🔸 contamination – characterized by excessive cleaning and washing
🔸 forbidden thoughts – often referred to as taboo thinking
🔸 perfection – involving symmetry, ordering, and exactness
🔸 doubt/harm – continuous checking and rechecking

The OCD diagnosis includes also includes the following subcategories for other specific panic disorders related to obsessive thoughts or compulsive behaviors, such as:

🔸 hoarding disorder 
🔸 trichotillomania 
🔸 body dysmorphia 
🔸 excoriation disorder

Conditions Commonly Mistaken for Obsessive-Compulsive Disorder

Diverse sets of diagnosing from the DSM have created many common overlaps in symptoms. Accounting for the overlap, the DSM is critical to highlight clinicians’ responsibility of establishing internal mindfulness on the commonalities when assessing and screening for OCD. With trendemous overlap causes misdiagnosis, which OCD is most commonly mistaken for:  

✳️ Anxiety disorders are known to be commonly diagnosed for OCD due to the recurrent thoughts, avoidant behaviors, and repetitive tendencies for reassurance. 
✳️ Major depressive disorder can be mistaken for OCD due to the recurrent rumination of thoughts. 
✳️ Obsessive-compulsive personality disorder has a similar name to OCD though do not share the same cause. 
✳️ Eating disorders can be mistaken for OCD, specifically anorexia nervosa as there is an obsession to gaining wait and a compulsion to soothe it through limiting food intake.
✳️ Tic disorders such as Tourette’s have been mistaken for OCD as tics are caused by sensory impulsive while OCD is linked to repeated behaviors to soothe obsessive thought. 
✳️ Psychotic disorders such as schizophrenia have been considered in replace to an OCD diagnosis due to the commonality of delusions.

Treating Obsessive-Compulsive Disorder

There are many options for treating OCD and best practice includes the combination of various types of treatments to increase successful outcomes. Most commonly recommended first is medication to increase serotonin levels. Prescribing physicians may require lab testing, such as heart monitor reading (EKG) and blood work. This is considered common practice to rule out any biological causes. In combination with medication, psychotherapy is recommended to monitor symptoms and assist in behavioral changes affecting one’s everyday life. Here are some treatments often considered to help manage OCD:

🧬 psychotherapy                     🧬 cannabis 
🧬 support groups                    🧬 medication
🧬 brain stimulation                 🧬 habit training

🧬 psychotherapy
🧬 cannabis 
🧬 support groups
🧬 medication
🧬 brain stimulation
🧬 habit training

Healthcare Professionals Who Treat Obsessive-Compulsive Disorder

For the best results in a successful treatment of OCD, seek providers that have specialties in the assessment, treatment, diagnosis, and continuing support of patients diagnosed with OCD. 

Many medical and mental health providers are familiar with the diagnosis of OCD.  Psychiatrists and psychologists, as stated above, are the best option for seeking a formal diagnosis with medication management. However if your chosen provider is not, they should always provide a knowledgeable referral source. Specialized providers will have the capabilities to diagnose using various testing methods to decrease the likelihood of misdiagnoses and unnecessary treatments. 

If you choose to utilize medication, psychotherapy should always be incorporated in treatment planning. 

The following are professionals involved in the treatment of OCD:

🧠 physicians                         🧠 nurse practitioners
🧠 psychiatrists                     🧠 licensed professional counselors 
🧠 psychologists                    🧠 marriage & family therapist
🧠 social workers

🧠 physicians
🧠 nurse practitioners
🧠 psychiatrists                     
🧠 licensed professional counselors 
🧠 psychologists
🧠 marriage & family therapist
🧠 social workers

Recognizing Immediate Need for Obsessive-Compulsive Disorder Treatment

It is important to remember, you are the expert of your life. If there are uncertain feelings regarding the stability of your mental health, consider this a sign to seek support. 

A key warning sign to immediate need is the drastic change in relationships as they will most likely be the first characteristic affected. Relationships with family and friends may alter with experiencing negative feelings causing isolating behaviors. Changes in relationships with one’s self, home space, work life, hobbies, and hygiene are key factors to needing treatment. If you are struggling to complete your daily functions and routines, consider finding support right away. 

OCD is a serious disorder that ranges widely in severity. Behaviors and symptoms can vary in severity though it is not uncommon for individuals to mentally soothe through planning their own death, harm or another person’s death / harm. For those who experience severe OCD- suicide is a real threat. 

The following warning signs should alert you to the immediate need for treatment:

🚨 suicidal thoughts and behaviors        🚨 negative thinking
🚨 negative affect on relationships         🚨 low-self esteem
🚨 expressing hopelessness                      🚨 decreased work performance  
🚨 stating having no reason to live          🚨 decreased academic achievements 
🚨 substance abuse                                    🚨 self harm
🚨 low mood and emotional changes    🚨 isolation / withdrawn
🚨 talking about feeling stuck                   🚨 noting being in unbearable pain
🚨 feeling like being a burden to others

🚨 suicidal thoughts and behaviors
🚨 negative thinking
🚨 negative affect on relationships
🚨 low-self esteem
🚨 expressing hopelessness
🚨 decreased work performance  
🚨 stating having no reason to live
🚨 decreased academic achievements 
🚨 substance abuse
🚨 self harm
🚨 low mood and emotional changes
🚨 isolation / withdrawn
🚨 talking about feeling stuck
🚨 noting being in unbearable pain
🚨 feeling like being a burden to others

Obsessive-Compulsive Disorder Professional Organizations

Provided are some resources to help the start of seeking support for OCD. Though these are national links, consider narrowing options down by searching in your current location. 

https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml
https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t13
https://iocdf.org/blog/2013/03/01/5-things-ocd-is-not/
https://adaa.org/understanding-anxiety/obsessive-compulsive-disorder-ocd/what-doesnt-cause-ocd
https://www.helpguide.org/articles/anxiety/obssessive-compulsive-disorder-ocd.htm
https://www.verywellmind.com/diagnosis-of-ocd-2510606
https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/diagnosis-treatment/drc-20354438
https://medcircle.com/articles/what-are-the-4-types-of-ocd/