Diagnosing and controlling OCD
Although people with OCD may know that their thoughts and behavior don't always make sense, they are often unable to stop them.
Obsessive-compulsive disorder (OCD) is a common, chronic, and long-lasting disorder in which a person has uncontrollable, recurring thoughts and/or behaviors that they feel compelled to repeat over and over.
This disorder affects people of all ages. Symptoms typically begin during childhood. Most people are diagnosed by about age 19, typically with an earlier age of onset in boys than in girls, but onset after age 35 does happen.
The exact cause is unknown, but researchers believe that activity in several portions of the brain is responsible. More specifically, these areas of the brain may not respond normally to serotonin, a chemical that some nerve cells use to communicate with each other.
The causes of obsessive-compulsive disorder are unknown, but risk factors and contributing causes include:
· Genetics: People with a parent, sibling, or child diagnosed with OCD are at a higher risk for developing it themselves. The risk is higher if the relative developed this disorder as a child or teen.
· Brain Structure and Functioning: Imaging studies have shown differences in the brain’s frontal cortex and subcortical structures in patients with OCD.
· Environment: An association between childhood trauma and OCD symptoms has been reported in some studies.
Symptoms
People with obsessive-compulsive disorder may have symptoms of obsessions, compulsions, or both. The intensity of these symptoms can interfere with all aspects of life, such as work, school, and personal relationships.
Obsessions are repeated thoughts, urges, or mental images that cause anxiety. These thoughts and impulses are upsetting, causing people to try to ignore or suppress them. Common symptoms include:
Fear of germs or contamination
Unwanted, forbidden or taboo thoughts involving sex, religion, or harm
Aggressive thoughts towards others or self
A need to have things symmetrical or in perfect order
Examples of obsessions include:
Thoughts about harming or having harmed someone
Doubts about having done something right, like turning off the stove or locking a door
Unpleasant sexual images
Fears of saying or shouting inappropriate things in public
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 particular, precise way
Repeatedly checking on things
Compulsive counting
Not all rituals or habits are compulsions. Everyone double-checks things sometimes. But a person with OCD generally:
Can't control their thoughts or behaviors, even when those thoughts or behaviors are recognized as excessive
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 cause
Experiences significant interruptions in their daily life due to these thoughts or behaviors
Symptoms may come and go, ease over time, or worsen. People with OCD may try to help themselves by avoiding situations that trigger their obsessions, or they may use alcohol or drugs to calm themselves. Neither tactic is effective. Although most adults with OCD recognize that what they are doing doesn’t make sense, some adults and most children may not realize that their behavior is out of the ordinary. Parents or teachers typically recognize OCD symptoms in children.
Treatment
The first step can be a visit to your primary physician. A general physical with blood tests is recommended to make sure the symptoms are not caused by illicit drugs, medications, another mental illness, or a general medical condition.
Obsessive-compulsive disorder cannot be cured, but it can be treated effectively with medication, psychotherapy, or a combination of the two.
Medication
If you are prescribed a medication, talk with your healthcare provider or a pharmacist to make sure you understand the risks and benefits. Not everyone wants to take new medication. This is the time to ask questions.
If medication is causing side effects, talk to your doctor before making any changes. Suddenly stopping a medication may lead to the return or worsening of symptoms. Other uncomfortable or potentially dangerous withdrawal effects are also possible. Report any concerns about side effects to your healthcare provider right away.
Antidepressants are the most common type of medication used to treat OCD.
Serotonin reuptake inhibitors (SRIs) are used to help reduce obsessions and compulsions. This medication may take 8 to 12 weeks to start working.
Antipsychotic medications may benefit patients if other medications do not improve symptoms. Research on their effectiveness is mixed.
Psychotherapy
Talk therapy can help relieve obsessions and compulsions for adults and children. While medicine may work directly on the brain, these therapies are believed to help retrain the brain to recognize "false threats":
Exposure and response therapy exposes a person to the cause of their anxiety. For example, a person with a fear of germs may be asked by a doctor or therapist to put their hand on something considered dirty, such as a doorknob. Afterwards, they will refrain from washing their hands. The length of time between touching the doorknob and washing hands becomes longer and longer. Ultimately, when the person realizes that not washing right away does not cause a deadly reaction, the compulsion to wash fades.
Cognitive behavioral therapy focuses on the thoughts that are causing distress. Learning how to recognize them, with practice, can gradually lessen the intensity of those thoughts and the behavior they cause.
For many, a combination of medicine and therapy is the most effective approach.
Helping Yourself
Obsessive-compulsive disorder can make work, school, relationships, and other parts of life difficult. Reducing stress, eating well, and avoiding situations that trigger obsessions and compulsions can help you feel better. Ways to help yourself include:
Educate yourself. Learning about your condition can empower you and motivate you to stick to your treatment plan.
Join a support group. Support groups can help you reach out to others facing similar challenges.
Focus on your goals. Recovery is an ongoing process. Stay motivated by keeping your goals in mind.
Stay busy. With these disorders, it is easy to become completely absorbed in an activity or thought. Try to stay occupied with work, hobbies, fitness, or other activities. Focusing on other tasks helps keep your mind away from obsessions and compulsions.
Find healthy outlets. Eating healthy and getting enough sleep will help any treatment plan. Avoid drugs and alcohol: while they might temporarily reduce symptoms, they can make you feel worse over time.
Aerobic exercise can improve the quality of life for people with OCD by naturally reducing their anxiety levels.
Know your triggers. Understand and, if necessary, avoid situations you know bring on your symptoms. If you can't avoid something, ask your mental health professional to help you develop coping skills to deal with anything triggering.
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