OCD

Sometimes what gets labeled OCD is simply a person who wants things to be perfect or arranged a certain way, or excessively worrying about something in your life. OCD is more complex than that. Obsessive-compulsive disorder is a chronic mental health condition characterized by obsessions that lead to compulsive behaviors.

OCD has two main elements to it – obsessions and compulsions. A person with OCD need only have one of these symptoms, however. These obsessions and compulsions consume inordinate amounts of time to manage and can interfere with a person’s everyday life and functioning.

Regarding obsessions, a person with OCD will often have images that occupy their mind, impulses, unwanted or intrusive thoughts,and they have no control over them. They may take steps to ignore or stop these obsessions, but the inadvertent result may be significant distress and anxiety instead.

Obsessions can revolve around certain themes, and these may include:

• a fear of contamination from germs or dirt,
• unwanted thoughts of unpleasant sexual images or subjects,
• struggling with uncertainty,
• aggressive thoughts concerning harming yourself or other people, or losing control,
• thoughts of shouting obscenities or acting inappropriately in public,
• or needing things to be perfectly orderly and symmetrical.

These often intrude when a person is trying to focus on a task or when they are trying to think about something else entirely.

The other aspect of obsessive-compulsive disorder is dealing with compulsions. In response to the fears and anxieties caused by the obsessions, a person will have compulsive behaviors they engage in repeatedly to relieve the anxiety caused by their obsessions or to prevent something bad from happening.

They may make up rules to follow that will help them deal with their anxiety. The types of compulsive behaviors a person engages in will vary, and these have themes as well, which include:

• having and following a rigorous routine,
• checking and/or counting,
• washing and cleaning,
• needing reassurance.
• hoarding

Engaging in the compulsive behavior may only bring temporary relief from anxiety, and the compulsions are often not related to the problem they attempt to fix, and they are typically excessive as well. After those compulsive behaviors are engaged in, the obsessions will return unbidden, and the cycle will begin again.

OCD can begin in childhood, but it usually begins in the teen and young adult years. The severity of OCD may vary through the years, as do the symptoms. When a person undergoes a period of great stress, their symptoms of OCD may worsen too. Because of what OCD is, a person with OCD has little to no control over their obsessive thoughts and compulsive behaviors.

This lack of control adds to the general distress and anxiety they experience, and because the obsessions and compulsive behaviors require effort and attention to manage, they can take up significant amounts of time. Having something in your life that you cannot control can be an added burden and agonizing because while you know that what you’re doing might be irrational and disproportionate to the issue, you can’t stop yourself from engaging in the compulsive behaviors, and you’re caught up in a cycle.

It’s not known what causes OCD, but there are several theories.One that suggests that OCD may be a neurobiological disorder wherein the brain is hardwired to behave in a certain way. OCD is linked with low levels of serotonin, a neurotransmitter that helps to regulate one’s mood, among other things.

Additionally, certain parts of the brain may also not respond to serotonin, and the areas of the brain that can be affected are the areas that affect complex cognitive planning, social behavior, emotional and motivational responses, and voluntary movement. These changes in one’s body and brain chemistry may result in OCD.

OCD may also stem from learned behavior and can be triggered through traumatic life events such as the death of a loved one. That traumatic event can trigger the intrusive thoughts and distress that is typified by OCD. Further, a family history of OCD can be a risk factor, implying that there may be a genetic component to developing OCD.

There is no way to prevent the onset of OCD but being able to spot the signs early on and receiving the intervention of a mental health professional can reduce the disruption of OCD and help you manage it better. The obsessive thoughts or compulsive behaviors linked with OCD typically last more than an hour each day and tend to interfere with aspects of a person’s everyday life.

Some of the signs of obsessions include:

• avoiding situations that might trigger your obsessions, such as shaking hands or giving people hugs
• having unpleasant or distressing sexual images
• having images of driving your car straight into a crowd of people
• doubting whether you’ve turned the stove and other kitchen appliances off, locked your door, or closed your windows
• entertaining thoughts about shouting obscenities or acting inappropriately in public
• obsessive thoughts about religious ideas that feel wrong or blasphemous
• seeking reassurance that you’re not a bad person
• persistent worrying that throwing something away might cause harm to you or someone else
• fearing contamination through handling objects others have touched such as doorknobs, a cup, pen, or eating utensils
• experiencing intense stress when things aren’t arranged in an orderly manner or facing a certain direction
• being plagued by excessive doubts or fear of making a mistake

A compulsion is a repetitive action that a person feels driven to perform to relieve the anxiety that flows from their obsessions. It is often excessive and unrelated to the obsession itself or the problem they’re intended to resolve. The signs and symptoms of compulsions include the following:

• washing your hands repeatedly until your skin becomes raw
• checking the stove or other appliances repeatedly to make sure that they are turned off
• saying or doing things a specific number of times in a certain way before being able to open a door or leave the house
• silently repeating a prayer, phrase, or word
• checking your doors or windows repeatedly to make sure they’re locked or closed
• hoarding or buying a lot of the same thing even when you don’t need it
• saying numbers in certain patterns aloud or to yourself
• eating your food in a specific order or arranging your clothes, canned goods, or other products to face the same way or according to a pattern
• needing constant encouragement or assurance from others that what you’re doing is okay or correct.

OCD can cause difficulties in life, including maintaining relationships at work and home, taking up time performing compulsive behaviors and rituals, and lowering one’s quality of life.

If your obsessions and compulsions consume much of your time or interfere with your quality of life, you should see a doctor or mental health professional. Keeping an eye out for the signs of OCD is important, but to receive a proper diagnosis for OCD, you or your loved one need to consult with a mental health professional who will perform the appropriate tests to make that determination. A diagnosis of OCD may be returned after several processes such as:

• a physical exam to eliminate any other possible underlying causes of the symptoms experienced
• blood tests to check thyroid function and blood count
• a psychological evaluation to assess your feelings, fears, obsessions, and compulsions

There are help and treatment options are available for dealing with OCD. Treatment typically involves a combination of psychotherapy and medication.

Psychotherapy for OCD typically takes the form of talk therapy with a psychiatrist or other mental health professional who can assist you by helping you develop tools to become aware of unhelpful thought and behavior patterns and allow you to begin cultivating different patterns that will help you bring your obsessions and compulsions under control.

Therapeutic techniques such as Exposure and Response Prevention (ERP), which is geared toward helping a person with OCD to tolerate their distress and deal with the anxiety associated with obsessive thoughts in ways other than engaging in the compulsive behavior, are effective, as are Cognitive Behavioral Therapy (CBT) and exposure therapy. These therapies can help a person by making them aware of and gradually desensitizing them to their sources of anxiety.

Concerning medication, Selective Serotonin Reuptake Inhibitors (SSRIs) are typically prescribed for OCD. SSRI sincrease the levels of serotonin in the brain by limiting its reabsorption. SSRIs and talk therapy are first-line, non-invasive therapies, meaning that a mental health professional will use these first.

In the event these first-line therapies aren’t effective, alternative treatments such as deep brain stimulation, Electro-Convulsive Therapy (ECT), or surgery such as bilateral cingulotomy (a type of brain surgery) may be used.Surgery and ECT are a last resort for people with severe OCD.

When beginning therapy, it’s important to ask any questions you might have about the process or your therapist’s approach. Therapy may not be as effective if you don’t feel comfortable with your therapist. Whether you’re inquiring for yourself or a loved one, you must receive care that addresses your needs, so ask questions such as whether your therapist has experience treating OCD in people your age.

This will help to ensure that you get specialized care. The journey with OCD can be daunting, frustrating, embarrassing, or all the above, and so feeling comfortable with your therapist and their approach will help create an effective environment for your treatment. At Orange County Christian counseling, the counselors are well-versed in the evidence-based therapeutic techniques outlined above, but they can also combine that with the vast resources from within the Christian faith tradition to create an effective treatment plan that meets you or your loved one where they are.

Your counselor will create a safe space within which to explore your questions and concerns. To find out more about counseling for OCD at Orange County Christian counseling or to book an appointment, feel free to browse the counselor directory and contact the reception.