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Obsessive Compulsive Disorder

Obsessive Compulsive Disorder (OCD) Information

Obsessive Compulsive Disorder (OCD) is a problem that you may struggle with if you have thoughts that you cannot control, and you may have behaviors that you feel you need to perform in order to get relief from your thoughts. These recurring, uncontrollable thoughts are called obsessions while the repetitive behaviors to relieve the thoughts are called compulsions. This is a common problem affecting up to 1% of people. (1) OCD can interfere with many, if not all, aspects of your life.

 

Obsessive compulsive disorder is often linked to anxiety because the obsessions and/or compulsions are often worsened with stress or anxiety. It is normal for a person to feel anxiety about one or many problems in life. It is only when temporary or long-lasting fear worsens these uncontrollable thoughts and obsessions that anxiety and OCD becomes  a problem. (2) You may have obsessive thoughts and compulsions about anything ranging from fears about germs/dirt, sexual thoughts, to fears of financial distress . Typically, completing the compulsive behavior assoiciated with the uncontrollable thought (i.e. checking the stock market for fear of financial distress)  will temporarily lessen the obsessions. However, you do not get pleasure from completing the compulsions or "need" to complete. OCD is often typified by "checking" behaviors and can often be accompanied with "counting" behaviors as well.

 

While scientists don't know what exactly causes OCD symptoms, scientists have noted that there appears to be a genetic link associated with the disorder. That is, first degree relatives of someone diagnosed with OCD is more likely to develop symptoms of OCD. (3) Several things have been associated with the development of the disorder. It is very common for worsening stressors to increase the likelihood that you develop this disorder. Worsening stressors can include:

  • Marriage

  • Divorce

  • Change in employment status

  • Move (in-state or out-of-state)

  • Loss of a loved one

  • Illness/injury

 

It is important to note that the symptoms of this disorder will improve and worsen over time. This is often directly correlated to stress levels and life situations over time. Some may look to relieve their symptoms by indulging in their compulsions. Others may relieve symptoms by indulging in alcohol, marijuana, or other drugs. People with OCD know that they have a problem but cannot stop on their own. Left untreated, OCD can interfere with all aspects of your life.

Examples of OCD Obsessive Thoughts

Obsessions are defined as uncontrollable, unwanted thoughts or fears that make you feel restless, anxious, or overwhelmed. The obsessive thoughts associated with OCD can be about anything but commonly include:

  • Fear of dirt

  • Fear of germs

  • Fear of contamination

  • Fear of failure/financial distress

  • Fear of failure

  • Fear of making a mistake/causing harm

  • Fear of not being in control

  • Aggressive or sexual thoughts

  • Religious or morality fears

Examples of OCD Compulsions

Compulsion are defined as behaviors you indulge in to provide temporary relief of the unwanted thoughts you are having. Examples of compulsive behaviors may include:

  • Arranging things in a specific way in order to maintain neatness, symmetry, or perfection

  • Bathing, showering, hand-washing repeatedly

  • Checking behaviors such as checking to ensure the stove is turned off, the front door is locked, or the stock market has not decreased

  • Collecting or hoarding behaviors

  • Repetitive behaviors such as performing a task a certain number of times before you can find relief from your obsessions

How is Obsessive Compulsive Disorder (OCD) Diagnosed?

The diagnosis of obsessive compulsive disorder (OCD) must be diagnosed by a healthcare provider with knowledge of mental health disorders. There is no specific test or imaging that can diagnose the disorder. The symptoms of OCD must meet specific criteria and cannot be better explained with another mental health or medical condition. Drugs, alcohol, and other medical conditions may cause similar symptoms and must also be ruled out for proper diagnosis of this disorder.

Treatment Options for Obsessive Compulsive Disorder (OCD)

Treatment for obsessive compulsive (OCD) symptoms typically involves medications, education, and development of skills to help with the symptoms of obsessions and compulsions. Providers often involved in the treatment of anxiety are family medicine providers and mental health providers such as physician assistants, nurse practitioners, psychiatrists, and mental health therapists. 

Medications

  • Selective serotonin reuptake inhibitors (SSRIs). This class of drugs help anxiety by allowing more of the neurotransmitter serotonin to be available for neuron use. They are overall safe drugs and some in this class are used even during pregnancy. Typical SSRIs include:  citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), vortioxetine (Trintellix), and vilazodone (Viibryd).

  • Serotonin-norepinephrine reuptake inhibitors (SNRIs). This class of drugs help anxiety by allowing more of the neurotransmitters norepinephrine and serotonin  to be available for neuron use. Typical SNRIs include: duloxetine (Cymbalta), venlafaxine (Effexor XR), and desvenlafaxine (Pristiq).

  • Anxiolytics. This class of drugs help anxiety by increasing the action of serotonin receptors on neurons while also increasing levels of noradrenaline and dopamine. Typical anxiolytics include: buspirone (Buspar).

  • Atypical antidepressants. These types of  medications have more than one specific mechanism of action. These include: mirtazapine (Remeron) and trazodone (though it does share many SSRI properties).

  • Tricyclic antidepressants. This class of drugs work in several ways to achieve their effects. They work to increase the levels of serotonin and norepinephrine available for neuron use. Typical tricyclic medications  include: imipramine (Tofranil), nortriptyline (Pamelor), amitriptyline (Elavil), and doxepin.

  • Other medications. Other medications are sometimes needed in addition to the above commonly prescribed drugs. Sometimes drugs are combined or other medications such as mood stabilizers or antipsychotics are used. 

Therapy

 

Counseling therapy can help improve OCD symptoms by helping you develop skills to more effectively deal with the thoughts and feelings you are having. These therapies consist of:

  • Cognitive behavioral therapy. This type of therapy will help you cope better with anxiety by teaching skills specific to management of organization, patterns of thinking, and behavioral patterns. 

  • Family therapy. Because many people with anxiety encounter loved ones, family members, and spouses who are unfamiliar with anxiety, this therapy can help them overcome the stress associated with living with someone who struggles with anxiety symptoms. 

  • Music therapy. This therapy utilizes music to help relax an individual to enhance their mood. Music therapy activates  cognitive, motor, and speech centers in the brain to help improve overall functioning.

  • Talk therapy. This type of therapy employs a variety of techniques to help a person better deal with thoughts and behaviors.

  • Interpersonal therapy. IPT is a type of therapy that focus on personal relationships and how you feel. It is a short-term, intensive therapy.

  • Exposure and Response Prevention. In this type of therapy, you perform the thing that causes your obsession. Then, with your provider, you are prevented from responding with your compulsion.

  • Integrative therapy. This therapy approach takes aspects from different therapy types to create a personal therapy to best treat the presenting problem.

Obsessive Compulsive Disorder (OCD) Resources

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