Obsessive Compulsive Disorder
Overview
Obsessive-compulsive disorder (OCD) is a pattern of unwanted thoughts and fears that lead you to do repetitive behaviors . These obsessions and compulsions interfere with daily activities and cause significant distress. These are often aggravated by distress and anxiety, and despite your efforts to ignore or control these bothersome thoughts and urges, they keep coming back.
Signs and Symptoms
People with OCD may have symptoms of obsessions, compulsions, or both.
Obsessions are repeated thoughts, urges, or mental images that cause anxiety. Common themes include:
- Fear of germs or contamination
- Having things symmetrical or in a perfect order
- Unwanted forbidden or taboo thoughts involving sex, religion, or harm
- Aggressive thoughts towards others or self
Compulsions are repetitive behaviors that a person with OCD feels the urge to do in response to an obsessive thought. Common compulsions include:
- Excessive cleaning and/or handwashing
- Ordering and arranging things in a precise way
- Repeatedly doing or checking things, such as repeatedly checking to see if the door is locked or that the oven is off
- Compulsive counting
These are accompanied by:
- One can’t control his or her thoughts or behaviors, even when those thoughts or behaviors are recognized as excessive and undesirable
- Spends at least 1 hour a day on these thoughts or behaviors
- Doesn’t get pleasure when performing the behaviors or rituals, but may feel brief relief from the anxiety the thoughts have caused
- Experiences significant problems in their daily life due to these thoughts or behaviors
Co-existing/Co-morbid disorders
Tic disorder. Motor tics are sudden, brief, repetitive movements, such as eye blinking and other eye movements, facial grimacing, shoulder shrugging, and head or shoulder jerking. Common vocal tics include repetitive throat-clearing, sniffing, or grunting sounds.
In addition, many people may have bipolar disorder along with another mental disorder or condition, such as an anxiety disorder, substance use disorder.
Risk Factors
- Personal history of anxiety
- Family history of OCD
- Major life changes, trauma, or stress
- In some cases, children may develop OCD symptoms after a Streptococcal infection called Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS)
Treatment and Therapies
Depression, even the most severe cases, can be treated. The earlier that treatment can begin, the more effective it is. Depression is usually treated with medications, psychotherapy, or a combination of the two. If these treatments do not reduce symptoms, electroconvulsive therapy (ECT) and other brain stimulation therapies may be options to explore.
Medications
Antidepressants are medicines that treat OCD. Medicines usually take higher dose and longer duration (8-12 weeks) to work compared to the treatment of depression. Once you start feeling better, usually after a course of 6 to 12 months, you may be able to gradually taper off the medicines. Stopping them abruptly can cause withdrawal symptoms.
Please Note: In some cases, children, teenagers, and young adults under 25 may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. This warning from the U.S. Food and Drug Administration (FDA) also says that patients of all ages taking antidepressants should be watched closely, especially during the first few weeks of treatment.
If you are considering taking an antidepressant and you are pregnant, planning to become pregnant, or breastfeeding please let us know prior to starting the medicines.
Psychotherapies
Several types of psychotherapy (also called “talk therapy” or, in a less specific form, counseling) can help people with depression. Examples of evidence-based approaches specific to the treatment of depression include cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and problem-solving therapy.
Brain Stimulation Therapies
Transcranial magnetic stimulation (TMS): TMS is a newer approach to brain stimulation that uses magnetic waves.
Holistic approach
- Getting regular exercise such as brisk walk, swimming, jogging etc. helps with anxiety and depression and promote sleep in addition to the physical benefits of work out
- Yoga and anaerobic exercise have also shown beneficial effects on mental health
- Keep a mood log
- Be mindful of your triggers and warning signs
- Eat healthy and nutritious diet
- Maintain regular follow ups with your care providers
- Take all medicines as prescribed, consult your doctor before making any medicine changes
- Avoid misuse of alcohol or other drugs
- Adopt good sleep habits
- Mindful breathing