Most people, at some point in their lives, have temporary fascinations, fixations, or "obsessions" with people, places or things. But for approximately 2% of Canadians, obsessive-compulsive disorder (OCD) transforms their lives into a constant series of unwanted thoughts and repetitive behaviours that they cannot control.
OCD is a chronic and relapsing anxiety disorder. It's a medical condition and not something that someone with OCD can control. But, with treatment, the impact of OCD on a person's life and relationships can be minimized.
Facts about OCD
- Researchers have found that, in a given year, 1 person in 100 experiences OCD.
- The first symptoms of OCD usually appear before the age of 40, and most commonly during childhood or adolescence.
- OCD affects men and women equally.
- OCD is sometimes associated with depression, substance abuse, eating disorders, or other anxiety disorders.
- OCD is partially genetic, but more research is needed to better understand.
- Left untreated, OCD symptoms can last for years or decades and have a serious impact on your life and health.
Key features of OCD
Obsessions: People with OCD have repeated, persistent, and unwanted ideas or impulses, and find these disturbing, illogical, and intrusive. Most people with OCD recognize that their obsessions are not reasonable but cannot control them. Obsessions may involve persistent fears of being harmed or harming someone else, or of a loved one being harmed. Many people with OCD have concerns about contamination, or may have an excessive need to do things correctly. The person may have repeated thoughts such as "I must have left the stove on" or "I'll be injured if I walk along this street." These thoughts often cause great anxiety. Sometimes the obsessions can be sexual or aggressive in nature.
Compulsions: People with OCD cope with their obsessions by using repetitive ritualized behaviours called compulsions. These can include behaviours such as frequent hand washing, checking things (such as locks or stoves), counting (e.g., counting certain objects over and over again), repeating a specific word or phrase, rearranging objects persistently, or collecting food or objects. They may also compose mental checklists or insist on eating foods in a specific order. Compulsions may help relieve anxiety temporarily, but most often these behaviours worsen with time.
OCD is often misunderstood
OCD can start gradually, and people with OCD often do not seek help until years after the onset of their condition. At first, obsessions and compulsions may be mild and have little impact on the person's life. Most people try to ignore their obsessions and compulsions, and may even be successful doing so at work or in social situations. However, in most cases, OCD worsens and will eventually have a significant impact on a person's life, family, and friends.
All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Obsessive-Compulsive-Disorder-OCD
There is no single established cause of OCD. However, researchers believe the disorder may be affected by brain chemistry, genes, and even infections. Current research is examining the role of chemical messengers called serotonin, dopamine, and glutamate in the brain and is looking at how different parts of the brain communicate with each other. Researchers are also looking into whether the immune system may be involved in causing OCD.
People with OCD may experience symptoms of the disorder after a stressful life event, such as a death in the family or job loss. However, it is thought that OCD is only worsened by stress, and not caused by stress.
All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Obsessive-Compulsive-Disorder-OCD
A physician or psychiatrist can diagnose OCD on the basis of an assessment that includes:
- asking questions about obsessive thoughts and compulsive behaviours
- assessing the extent to which obsessive thoughts and compulsive behaviours are affecting a person's life and relationships
- checking for symptoms of other forms of mental illness, including depression, anxiety, and phobias
Devices that study patterns of brain waves, called magnetic resonance imaging (MRI) scanners and positron emission tomography (PET) scanners, help researchers study the brains of people with OCD. Recent research suggests that people with OCD have patterns of brain waves that differ from those without the disorder. However, these scanners are not standard diagnostic tests for OCD. A diagnosis can usually be made based on a physician's assessment.
Are you concerned that you might have OCD? Use the following list to check:
- I have upsetting thoughts or images that enter my mind repeatedly.
- I feel as if I can't stop these thoughts or images, even though I want to.
- I have difficulty stopping myself from doing things again and again, such as counting, checking on things, washing my hands, doing things until they seem perfect or collecting objects.
- I worry a lot about things that could happen to me or my loved ones.
If you answer "yes" to some of the statements above, you may have OCD. Because the symptoms of OCD rarely disappear without treatment, you should contact your family doctor if you have obsessive thoughts or compulsive behaviours that are interfering with your life. A family doctor can refer you to a psychiatrist for appropriate and effective treatment.
All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Obsessive-Compulsive-Disorder-OCD
OCD is usually treated with a combination of behaviour therapies and prescription medications, which aims to improve the daily function of the individual.
Cognitive-behavioural therapies (CBT)
These treatments aim to examine and evaluate a person's fears and to develop appropriate methods of coping with stress and anxiety. People react differently to CBT, and although it is not associated with many side effects, people will experience some anxiety during treatment. Common therapies include the following:
- Exposure and response prevention (ERP): With this therapy, a person with OCD is exposed to situations that provoke obsessive thoughts, but is prevented from performing the usual compulsive ritual. For example, the person may be asked to touch a dirty cup and then wait for a predetermined length of time before washing their hands. This is one of the most common types of CBT. This is one of the most common types of CBT. Studies have found that up to 75% of treated patients experience long-term improvement in their symptoms after 2 to 3 years of therapy.
- Habit reversal: In this therapy, the person is asked to substitute a different response (such as deep breathing) for the usual compulsive ritual.
- Thought stopping: This therapy involves thought stopping and distraction whenever an obsessive thought appears. However, this is usually less effective than other types of CBT.
- Saturation: This approach asks the patient to concentrate intensely on the obsessive thought until the thought loses its impact and becomes meaningless. As with thought stopping, this technique is usually less effective than other types of CBT.
Prescription medications
Most medications used to treat OCD affect levels of serotonin, a chemical messenger in the brain. The most effective medications for OCD are antidepressants such as fluoxetine, paroxetine, fluvoxamine, and sertraline. These medications belong to a class of medications called selective serotonin reuptake inhibitors (SSRIs). SSRIs work by increasing levels of serotonin in certain areas of the brain. Clomipramine, a nonselective serotonin reuptake inhibitor, is also commonly used.
Clomipramine and the SSRIs are used in their normal antidepressant dosage ranges to treat OCD. Note that it may take up to 12 weeks of therapy to produce a noticeable change in OCD symptoms and that a trial of at least 4 to 6 weeks at the maximum tolerable dosage is required to fully evaluate the medication's effectiveness. Other medications used in addition to treat OCD may include anti-psychotic medications (e.g., aripiprazole) or a glutamate receptor (e.g., memantine). People with OCD must work closely with their doctor and pharmacist to find the most effective medication with tolerable side effects.
Children with OCD usually have additional psychiatric problems, such as depression, learning disorders, panic disorders, and social phobias. Medication may be helpful in treatment, but is often only used when cognitive-behavioural therapy has proven ineffective.
What the family can do to help
OCD affects the entire family of a person who has it. Family members may have difficulty accepting that the person with OCD cannot stop the disruptive behaviour. They may feel angry and resentful. But families can learn ways to encourage and support the person with OCD to seek help and follow through with treatment. Some families find that family therapists trained in OCD can help them deal with their loved one's disorder.
For more information, contact the Canadian Mental Health Association.
All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Obsessive-Compulsive-Disorder-OCD
