Understanding OCD

In OCD, or Obsessive-Compulsive Disorder, an individual fixates on small things in life, thinking that they have much larger implications than they do. This pattern of behavior so dominates the patient’s life that he cannot go about the regular tasks of daily life.

Misperceptions about OCD 

The general public has a number of misconceptions when it comes to OCD. For example, many believe that those with OCD are neat freaks. Just because a person is neat or keeps even a very clean house does not mean they have an OCD. If that person had an OCD, their fixation on cleaning would be so intense they might not be able to leave for work, as an example. 

Misconceptions about OCD can make those suffering from this disorder seem foolish. Having a true idea about what this disorder involves can help both patients and the people trying to support them.

Diagnosing OCD

The DSM-V lays out criteria a patient needs to meet to qualify for a diagnosis of Obsessive Compulsive Disorder. First and foremost, the symptoms of the disorder must prevent the patient from conducting normal daily activities. They also should have these fixations for at least an hour each day and also experience stress as a result. OCD does not leave the patient feeling good, as our neat freak might feel after cleaning the house. The rituals of OCD are very stressful because the patient believes that disaster will result from failure to execute these tasks.

Compulsions and Types of Obsessive Thinking in OCD

OCD has two patterns of behavior: compulsions and obsessive thinking.

In obsessive thinking, the patient fixates on thoughts that might never cross the mind of a person without OCD. As an example, a person without OCD might have no problem opening a door, whereas the OCD patient might fixate obsessively on how many dirty hands have touched that knob and left countless germs behind. This obsessive thinking prevents the person from being able to use the knob and open the door– an inconsequential act to someone else.

Compulsions grow out of obsessive thinking. In order to get through the door, to continue our example, the patient might then develop an elaborate ritual whereby it becomes “safe” for him to turn the knob and get through the door. These compulsions are not silly or meaningless to the patient and shouldn’t be dismissed as such. In fact, the patient believes their very safety or life depends on it. 

Symptoms of OCD

  • Obsessive thinking and compulsions 
  • Compulsive execution of rituals
  • Feelings of guilt over behavior
  • Avoidance of OCD triggers
  • Nightmares
  • Hoarding
  • Panic attacks

How to Treat OCD

A mental health professional will tailor intervention for OCD directly to a patient’s needs. This program of intervention might involve:

  • ERP (Exposure and Response Prevention)
  • Cognitive Behavioral Therapy
  • Group therapy 
  • Medication

Patients can benefit from one of these or a combination of two or more. 

In ERP, the patient engages in talk therapy while also going through slow and careful exposure to triggers. The patient may be asked to reduce or eliminate a ritual slowly over time, then discuss with the therapist how there were actually no disastrous results from this. 

Due to the ritual behaviors inherent in OCD, talk therapy on its own is not always the best option. Patients may need the added intervention of medication, including options such as :

  • Fluvoxamine
  • Paxil
  • Sertraline (Zoloft)
  • Fluoxetine (Prozac)
  • Clomipramine (Anafranil)