Living With: OCD (Obsessive Compulsive Disorder)
One in 50 Americans has a form of obsessive-compulsive disorder (OCD) according to BBC Health statistics. While many feel alone or isolated from their friends and families, there is actually a lot of support available for those living with the condition and for those helping a family member with OCD. Knowledge of OCD is one of the main keys to dealing with this mental illness, and it is the quickest way to a better quality of life.
Obsessive Compulsive Disorder
Anyone who has obsessive doubts or worries that seriously interfere with the quality of his or her life may be diagnosed with OCD. While OCD is technically a brain disorder, it is usually considered to be a mental illness. Many people describe it as a mental hiccup because they find that their brains get fixated on a single event, such as hand-washing, and won’t let go, so they repeat the event over and over again.
Some people with OCD can be completely cured after treatment. Others may still have OCD, but they can enjoy significant relief from their symptoms. Treatments typically employ both medication and lifestyle changes including behavior modification therapy.
Signs of OCD
There are two parts to OCD: obsessions and compulsions. Many of the signs of the illness deal with obsessions and compulsory acts. Those with OCD usually only have one or two of these signs, but some have a broader range. Not all daily rituals result from OCD; some are completely normal worries and fears. It is only when these rituals interfere with life or are completely irrational that they are considered to be signs of OCD.
Obsessions Typical of OCD
People with OCD may obsess over germs, dirt, toxins and other contaminants. They might obsessively think about harming either themselves or others. They might be overly sexual, both in thoughts and physical urges. Some sufferers feel they must confess everything they do or even think, if they consider it to be forbidden. Some religious thoughts are OCD symptoms, especially if they involve moral doubt taken to extremes. People with OCD often have an overwhelming need to keep things in their proper places.
Compulsions Typical of OCD
Compulsive hand-washing and opening a door repeatedly are commonly used as signs of OCD on television. People with OCD may experience these compulsions in real life, but compulsions also come in many other forms. Examples include checking lights, counting items, arranging things in sets, repeating thoughts a number of times, hoarding, and praying. While most of these acts are fine in moderation, it is their repetitive nature that makes these compulsions signs of OCD. The overwhelming need to perform these actions is also part of a clinical definition of OCD.
Treatment Options for OCD
In addition to education for OCD patients and their families, there are two effective treatment methods for those with obsessive-compulsive disorder: medication and behavior therapy. During treatment, professionals usually try to ameliorate the current OCD episode and then attempt to prevent future episodes.
Behavior therapy, also known as cognitive behavioral psychotherapy (CBT), is the first step in treating OCD. CBT uses exposure and response prevention. Patients are exposed to things that they fear. This exposure helps to lessen anxiety, because increased contact with an object of fear often lessens fears. Response prevention is therapy that attempts to remove people’s normal responses to the fears. For example, people who are afraid of germs can spend time around an object known to have germs (exposure) and then not allow themselves to repeatedly wash their hands afterwards (response prevention).
Cognitive therapy is often combined with behavior therapy. It addresses the thought processes behind the fears and helps patients realize that their rituals will not prevent or lower the chances of catastrophic events occurring.
There are other treatments that can be used with OCD, such as habit reversal, which replaces one ritual with something less severe; suppression, which helps switch off the symptoms; and satiation, which involves prolonged exposure to the symptom.
While there are no side effects to cognitive behavioral therapy, some people respond better to it than others. Patients who are less anxious about receiving treatment generally do better, as do those who are open to changing their habits. Patients should make sure to give feedback to therapists after each appointment to ensure they are getting the best care possible. Patients who cooperate with their therapists generally get the quickest results.
Medical professionals most commonly prescribe selective serotonin reuptake inhibitors (SSRIs), to people with OCD. These raise the amount of serotonin in the body. Brand names of SSRIs include Zoloft, Prozac, Paxil, Luvox, and Anafranil.
Medication typically takes about eight to ten weeks to start working well, but some results can show within three to four weeks. However, of people who use medication and no other therapy, less than 20 percent end up without symptoms. In addition, 20 percent of those who start on medication later need to switch medications to find one that is more effective for them.
Possible side effects of medications include nausea, insomnia, restlessness, diarrhea, sedation, weight gain, lowered libido, dry mouth, and dizziness.
OCD for Families
Many family members of OCD patients have their own questions and worries: When does this illness start? Is it inherited? What can I do? While talking to the doctor can help you understand OCD and what you can do to help, here are some basic answers to those questions.
OCD generally appears before the age of 40, and typically in childhood. According to the OCD Center, studies show that it may take 17 years for someone with OCD to get the correct diagnosis.
Research does not suggest that OCD is inherited; however, there are some genes that may play a part in its development. Children of parents with OCD have a slightly higher risk of developing the illness. Researchers do not know whether that increased risk is a genetic inheritance or comes from the children watching and emulating their parents.
People with OCD need to be handled with patience and understanding. They need you to support them and treat them the same way you do everyone else. Give them independence, a shoulder to cry on when needed, and listen when they need to vent.
For more on the topic of Living with OCD, weâve included the following expert consensus documents as reference materials:
- HealthFinder – more information about OCD
- Illinois – Grammar sticklers may have OCD
- Wright – general information about OCD by Dan Stein
- MIT – Neurobiology of OCD
- Yale – Research clinic for OCD