It is normal for people to check if they locked the door, turned off the gas etc., but if a person suffers from obsessive-compulsive disorder, obsessive thoughts and compulsive conduct become excessive and negatively influence daily life of this person (Robinson, Smith & Segal, 2012). So, what is obsessive-compulsive disorder and what are its symptoms? How can be this disease treated and prevented?
Obsessive-compulsive disorder (OCD) is a kind of mental disease, an anxiety disorder characterized by uncontrollable, unreasonable, unwanted thoughts, ideas, feelings, fears (obsessions) that usually lead a person to do something repeatedly (compulsions). People with OCD become worried about different things without being able to get rid of certain doubts, fears, thoughts or images in their mind. Such obsessions make people highly anxious and therefore drive them to perform particular behavior (so-called rituals or compulsions) as soon as possible.
The rituals are endeavors to make sure that nothing wrong happens and make obsessive ideas go away. A person with this disorder often realizes the senselessness of his or her behavior, but cannot control it. Unfortunately, the rituals may have only temporal relief and a person will perform the ritual again as the obsessive ideas come back. In fact, the rituals only worsen the situation, strengthening obsessive ideas and thoughts. This means that the disease becomes stronger with each compulsion. That is why, as with any other disease, the earlier a person turns to a doctor and the earlier OCD is diagnosed, the easier the treatment is.
The exact cause of OCD is not completely studied. However, numerous researches prove that particular biological or environmental factors or both may be in charge of the illness. Biological factors may include insufficient level of serotonin, a neurotransmitter that helps to communicate electrical signals between neurons; heredity of serotonin imbalance and therefore heredity of the illness itself; problems with the brain areas that are in charge of judgment, planning and body movements (Katz, 2012). Scientists found that some types of streptococcal infection, especially when these infections recur and are not treated properly, may be the cause of the obsessive-compulsive disorder as well. The environmental factors that may provoke beginning of OCD are as follows: serious changes in a lifestyle and problems connected with them, different diseases, death of close people, relationship difficulties etc. Scientists are also rather sure that people having strong reaction to stress are often predisposed to development of OCD.
The symptoms and signs of OCD are various both for obsessions and compulsions. The most common obsessions to name are:
- Fear of dirt or contamination by germs.
- Need for order and symmetry.
- Excessive belief in superstitions.
- Fear of causing harm to yourself or other people.
- Sexual or violent images and thoughts.
- Fear of making a mistake.
- Excessive focus on morality or religion and fear of sin.
- Fear of not having or losing something.
The most common compulsions include:
- Excessively frequent washing hands, bathing or cleaning.
- Continuously checking such things as locks, switches and others.
- Constantly doing something in a particular order and arranging things in a specific way.
- Hoarding things that are not used or not needed.
- Counting or repeating certain words, phrases, prayers etc.
- Continuously checking if another person is safe.
Obsessive-compulsive disorder is thought to be able to provoke various complications. People having OCD may have depression, suicidal thoughts, inadequate behavior, substance abuse, different eating problems. They may be unable to work or study properly. Their relationships with other people may become worse. This means that people's life may become poor because of not only endless obsessions or compulsives, which are at times extremely time-consuming and take hours, but because of serious problems the disease inflicts, not mentioning possible fatal outcome. Thus, OCD may turn to be rather dangerous.
For obsessive-compulsive disorder diagnosis, a person may go through a serious of tests and exams. While physical exam and laboratory tests may give some general information about a person, this is psychological assessment that plays the main role in diagnosing the disease. During the assessment a doctor asks about symptoms, when they began, how often they appear, how much time is spent on particular thoughts and rituals etc. The Diagnostic and Statistical Manual of Mental Disorders, fourth edition, says that there are criteria one has meet to be diagnosed with OCD ('Obsessive-Compulsive Disorder (OCD)'). According to this manual, a person with OCD must have obsessions, compulsions or both; be aware that his or her obsessions and compulsions are unreasonable and excessive; these obsessions and compulsions must negatively influence everyday life of the person.
There are also certain criteria for obsessions and compulsions. For obsessions these are: recurrent and intrusive ideas, thoughts or images lead to distress, the thoughts are not just simple worries about real problems, a person tries to stop such thoughts, ideas or images, a person knows that such thoughts, ideas or images are made up by his or her own mind. For compulsions, criteria are as follows: repetitive rituals that a person feels he or she must do, these rituals are performed only to get rid of or prevent distress about unreasonable obsessions. However, it sometimes can be rather difficult to diagnose OCD, since its symptoms may be similar to those of depression, schizophrenia and other mental diseases.
Obsessive-compulsive disorder does not go away by itself and it has to be treated, even though the treatment does not guarantee complete recovery and may last years. Still, in most cases treatment helps to reduce obsessions and compulsives, putting them under person's control. The main treatments of OCD include psychotherapy, medications or combination of both, which is proved to be the most reliable. Unfortunately, OCD treatment does not usually show quick results and it may take one from weeks to months to view any improvements. It sometimes happens that a patient tries a several medications before stopping on one that really helps.
Psychotherapy for OCD normally involves cognitive behavioral therapy (CBT), which simply is retraining one's way of thinking and behavioral patterns. The aim of CBT is to show people how to deal with their fears and reduce anxiety without following the rituals (exposure and response prevention). In other words, a patient is exposed to a feared object (for example dirt) and is taught to deal with their anxiety in a normal, healthy way. This therapy is also called to reduce excessive thinking people with obsessive-compulsive disorder usually suffer from.
Medications is another working method of OCD treatment, since the drugs are aimed at serotonin level increase. The first medication usually prescribed is selective serotonin reuptake inhibitor (SSRI), which is an antidepressant. SSRI include Prozac, Luvox, Paxil, Zoloft, Celexa, Anafranil. If these drugs do not help, tricyclic antidepressant (TCA), an older type of depressant may be considered. Such drugs normally help better than SSRI, but in the same time they have side effects, such as problems with urination, sleepiness, dry mouth, low blood pressure ('Obsessive-Compulsive Disorder'). In some rare cases, doctors may opt for a combination of SSRI and TCA.
In some cases, regular treatment does not prove to be effective and the doctor may suggest other options. One of such option is electroconvulsive therapy (ECT). During ECT, a series of electric shocks are delivered to the patient's brain through electrodes that are attached to his or her head (Katz, 2012). These shocks provoke seizures called to release neurotransmitters in patient's brain. The other options include residential treatment, psychiatric hospitalization, deep brain stimulation and transcranial magnetic stimulation. One should realize that these kinds of treatment are not completely studied specifically for obsessive-compulsive disorder, so a serious health risk always exists.
In conclusion, obsessive-compulsive disorder is a mental illness that declares itself through intrusive uncontrollable thoughts or obsessions and repetitive behavior or compulsions. Normally, biological or environmental factors are thought be the cause of this disorder. The symptoms may be different, but generally, these are fears and excessive thoughts about something as well as performing repeating actions. The treatment of OCD is not an easy one and it may take long time. Regular OCD treatment includes the use of drugs and psychotherapy.