Obsessive-compulsive disorder, or otherwise popularly known as OCD is one of the most widely spread disorders across the country today. Many of us have small habits that make us feel better, but we can also live without them. For example, we can think of something as “lucky” or have a regular routine that feels comforting. But for people who experience obsessive-compulsive disorder, these behaviors are much more severe and disruptive and are driven by unwanted and recurring thoughts. Obsessive-compulsive disorder is not always easy to understand, but this disorder can be disturbing and can cause dysfunction in a person’s life. This research paper will therefore discuss the mental illness known as obsessive-compulsive disorder (OCD) and the impact it has on a person suffering from it. This paper will further discuss the diagnostic criteria with specific examples of how these criteria manifest in behavior and the different treatment options for curing OCD.
OCD stands for Obsessive-compulsive disorder. It is a neuropsychiatric disorder that affects adults, adolescents, and children all over the world. It is a psychological condition which involves primarily two kinds of symptoms where you have obsessions and compulsions. Despite the many research attempts to find the exact cause of OCD, it has proven futile. However, OCD is considered to have a neurological basis with neuroimaging studies showing that the brain functions differently in people with the disorder. (CMHA National, 2018).
Abnormalities or an imbalance in neurotransmitters, including serotonin, dopamine are thought to be involved in OCD. In certain individuals, OCD could be triggered by a combination of genetic, neurological, behavioral, cognitive and environmental factors. (International OCD Foundation, 2018). The obsessions associated with the disorder are known to be unwanted thoughts or ideas in which the individual has no control over. Obsessions may involve persistent fears of being harmed or harming someone else, or of a loved one being harmed. People with OCD may have repeated thoughts such as “I must have left the door unlocked” or “I will be injured if I walk along this street.” Other obsessions may have to do with sexual identity (“Am I gay?”) which results in attempts to seek reassurance that one is not gay. Also, fear of loss of impulse control, or a sense that one will act out and do something “crazy”, resulting in obsession such as “maybe I will grab a knife and kill someone before I realize what I am doing,” or “maybe I will just fling my body off a high place and kill myself.” These obsessions result in people avoiding sharp objects or knives, or places of perceived danger, such as the kitchen. (EverydayHealth.com, 2018). Compulsions, on the other hand, are repetitive behaviors that an individual feels the driven need to perform or engage in response to an obsession. People with OCD cope with their obsessions by using repetitive ritualized behaviors which may include frequent hand washing, checking things (such as locks or stoves), counting (example; counting certain items over and over again), rearranging objects persistently and repeating words. OCD, as unique as each individual, often centers around certain themes. A general theme about OCD is that obsessions concern situations where there is some degree of uncertainty (what if “X” happens and I did not do enough to prevent it?). (Clark, 2009). These themes are not limited to the ones we see on every day TV such as germaphobia. This is a term used to describe a pathological fear of germs and infection, hoarding, etc. They can also involve body dysmorphic disorder, scrupulosity, religious OCD, relationship OCD (ROCD) in which people doubt the love they have for their partner or vice versa (EverydayHealth.com, 2018). These obsessions are recurrent and persistent thoughts that are experienced by an individual which trigger intensely disturbing feelings, which in most cases are marked by anxiety or distress. Compulsive rituals are all about trying to get assurance, support and certainty.
Someone with OCD might be afraid to throw anything away and have a strong emotional attachment to many things they own. On the other end of the scale, someone with OCD might turn down a lunch date or other social activities to stick with their cleaning schedule. Most at times, most people with OCD realize that these thoughts do not make sense; however, they are unable to control them. Ignoring or making an effort to stop your obsessions may be accompanied by intense and uncomfortable feelings such as fear, disgust, doubt, or a feeling that things have to be done in a way that is “just right”. Ultimately, you feel the drive to perform compulsive acts to try to ease the stress. Despite efforts to ignore or get rid of the worrisome thoughts or urges, they keep coming back. This can lead to a more ritualistic behavior which is the vicious cycle of OCD.
Most people have obsessive thoughts or behaviors at some point in their lives, but this does not place them in the category of suffering from a mental disorder. There may be some challenges in making a diagnosis for the obsessive-compulsive disorder because the symptoms of this disorder tend to appear similar to those associated with anxiety disorder, depression, schizophrenia, and a number of other mental illnesses. (CMHA National, 2018).
Diagnosis for this disorder should be done by an interview with a skilled clinician. When the symptoms get to a point where it gets in the way of functioning, causing a great deal of distress, or taking a great deal of time, this is when a clinician will conclude if the person meets the criteria for diagnosis for the disorder. (International OCD Foundation, 2018).
Dealing with obsessive-compulsive disorder can be very challenging and hard to explain to other people. One may feel ashamed, uncomfortable, or guilty about their experiences, and as a result, these feelings can make it hard to seek help. Because of the nature of OCD, people can spend hours and hours a day having these disturbing thoughts or carrying out these behaviors. Not only do these people experience extremely high anxiety levels, but the disorder also comprises their ability to work and have a normal life. According to the Canadian Mental Health Association, many people describe OCD as something that takes over their life, and this is not easy to deal with. People living with OCD experience a number of detrimental effects due to their condition. Some of the possible outcomes of living with the disorder include; isolation. A person dealing with OCD is under an immense amount of pressure to complete their rituals. The time spent performing these compulsive behaviors is exhausting, and this can cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. This can lead to isolation and loneliness which usually worsens when the individual avoids leaving home because some public situations may trigger the need to do the rituals. The constant thought of thinking one is “crazy” is also an effect people living with obsessive-compulsive disorder have to deal with. Apart from the stigma mental illness comes with where people are labelled as “crazy”. People who continuously have these intrusive thoughts that intrude on their everyday life, coupled with strong urges to perform certain behaviors and rituals may begin to think they are “crazy” if they do not understand the condition.
People with OCD display symptoms such as signs of depression, excessive worry, extreme tension, and the constant feeling that nothing ever goes right. Depression can cause an individual to lose interest in pursuing their life goals, and can, unfortunately, drive a person to attempt suicide if left untreated. According to “Everyday Health”, over 66 percent of suicides have depression as a factor. Depression not only affects the mind of an individual, but it also affects the individual’s body. Some of the physical effects of depression may include inconsistent sleep patterns, loss of appetite, constant fatigue, muscle aches, headaches, and back pain. Depression is likely to cause loss of appetite, weight loss, and other physical symptoms.
OCD can go a long way in affecting the physical health of an individual. Individuals living with OCD experience incredible pressure as they feel a strong urge to perform their rituals and perform them properly. In long-term, this pressure and the exhaustion due to working the rituals for hours each day can lead to heart disease and ulcers. For example, those whose ritual involves hand washing several times per day can develop serious skin lesions and infections. Other people may wash their hair so fervently and often with that they can end up with lesions on their scalp that could become infected. (CMHA National, 2018).
The best advice on how to live with OCD urges people to educate themselves about their condition. As with any chronic illness, becoming an expert about your disorder will help you to cope with it more effectively. People dealing with OCD or any other mental illness should learn the things that worsen their symptoms. This way, they can come up with an effective coping approach.
Obsessive-compulsive disorder treatment may not result in a cure, but it can bring some symptoms experienced by the individual under control so that they do not rule their daily lives. Approximately, 1% to 2% of the Canadian population will have an episode of OCD, with the possibility that slightly more women experience the disorder than men. The majority of individuals report onset in late adolescence or early adulthood, with very few individuals experiencing a first onset after 40 years of age. (Clark, 2009). While others may need treatment for the rest of their lives; some individuals may experience significant improvements with treatment, while some may achieve remission. It is important to provide the person diagnosed with OCD with information and support. People dealing with the disorder and their family members should be educated about the chronic nature of the disorder and how it is likely to persist if not treated effectively. OCD also affects the entire family of the person who has it. Usually, the family members have difficulty accepting that the person with OCD cannot stop the disruptive behavior. This may arouse feelings such as hurt when a loved one is experiencing distressing symptoms of OCD. Aside from this, families still play a major role in the treatment process of the person with the mental illness. They can learn ways to encourage and support the individual to seek help and follow through with treatment. According to “Psychology Works Fact Sheet: Obsessive-Compulsive Disorder”, a type of therapy known as the cognitive-behavioral therapy or CBT has proven to be an effective treatment method for helping people with most types of OCD. This particular method teaches the individual about how their thoughts, feelings, and behaviors work together and suggests different coping mechanism skills such as problem-solving, managing stress, realistic thinking, and relaxation. This therapy works to manage psychological conditions, such as OCD by changing the way people think and behave. For OCD, some of the common therapies may include an approach called exposure and response prevention (ERP). With this therapy, a person is exposed to situations that provoke obsessive thoughts but is prevented from performing the usual compulsive ritual. (Clark, 2009). This entails gradually exposing the person to the feared obsession. For instance, if the person is obsessed with cleanliness, they may be exposed to dirt for gradually increasing amounts of time. They may be asked to touch a dirty cup and then wait for a predetermined length of time before washing their hands. This helps the person to learn new thought patterns and behaviors about their obsession with dirt. Even though this form of therapy involves a lot of effort and practice, it goes a long way in rewarding the person with a better quality of life. The basic idea behind exposure and response prevention is that compulsion allows obsession to exist by interrupting the habituation process. The process of habituation is what causes a person to have less interest in a certain event once that person has witnessed the same event many times. For example, if your friends threw a surprise party every day, you would eventually stop being surprised and thrilled. In the same manner, if the compulsion did not exist, the obsession would become less and less thought-provoking until it eventually disappeared. (CMHA National, 2018).
Once a compulsion is fulfilled by an obsession, the person feels a short-term relief of anxiety. The relief serves to reinforce the compulsion as a reward, and it becomes a perpetual cycle. Simply put, without compulsion, obsession would not occur and vice versa. According to “Psychology Works” Fact Sheet, studies have shown that 76% of individuals who complete treatment (13 to 20 sessions) will show significant and lasting reductions in their obsessive and compulsive symptoms.
Another remedy for OCD can be with the use of prescription medications. Most medications used to treat OCD affect levels of serotonin, a chemical messenger in the human brain. The most effective medications for OCD are antidepressants such as fluoxetine, paroxetine, fluvoxamine, and sertraline. These medications fall under a category known as selective serotonin reuptake inhibitors (SSRIs). The SSRIs work to increase the levels of serotonin in certain areas in the brain, which is generally low in people with obsessive-compulsive disorders. Clomipramine, a nonselective serotonin reuptake inhibitor, is also commonly used. (CMHA National, 2018). Most of these medications have side effects such as vomiting, diarrhea, abnormal urination, extreme confusion, appetite changes. Immediately an individual experiences the above symptoms, the issue must be reported to the doctor. One negative effect with the use of drugs for the treatment of a mental illness is the possible addiction or dependence on these drugs. The drugs may help to alleviate OCD symptoms, however, taking them too often can make it difficult to get off the use of the drugs when recommended by the doctor. According to research, treatment is said to be most effect when both the behavior therapy and medication are combined together. (CMHA National, 2018).
Although there has not been a profound cure for OCD, and its exact origins are not exactly known by science or medicine at this time, there is help for those who suffer from compulsions, obsessions, and severe or intense anxiety created by unwanted thoughts and inaccurate beliefs. The first step toward treating the disorder is to seek out the help of a therapist or a skilled clinician through a medical clinic, mental health facility, or with the help of family members or friends. Being knowledgeable about the disorder can also provide an approach for coping for the individual.