Obsessive Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a complex psychological condition characterized by persistent, intrusive thoughts and urges (obsessions) that trigger intensely distressing feelings of anxiety. As a result, those with OCD engage in repetitive behaviours or mental rituals (compulsions) aimed at reducing anxiety and making their obsessive thoughts feel less disturbing.

OCD obsessions tend to revolve around themes like contamination, doubts, order/symmetry, unacceptable thoughts, or harm. For example, an obsessive thought could be an exaggerated fear of germs or an irrational concern about having accidentally hurt someone. The compulsive rituals can be overt behavioural acts like excessive hand washing, counting, checking locks, or repeatedly organizing items. Compulsions can also be mental acts like praying, repeating phrases, or fixating on numbers.

While OCD symptoms typically start emerging in childhood or early adolescence, peak prevalence occurs between the ages of 10 and 12 years old. Estimates indicate OCD afflicts 1-2% of adults and up to 4% of adolescents and children. Studies reveal OCD has a neurobiological basis and runs in families, suggesting a genetic component. Brain imaging shows differences in regions like the frontal cortex and basal ganglia, which regulate planning, motivation, and inhibition.

Symptoms of OCD

OCD has two primary symptoms – obsessions and compulsions. Obsessions are persistent, unwanted, intrusive thoughts or images that trigger intensely distressing feelings and anxiety. Common obsessions centre on themes like

Contamination

Excessive fears of dirt, germs, or chemicals

Doubting

Irrational doubts about leaving appliances on or locks unlocked

Order

Need for perfect order, symmetry, and organization

Aggressive thoughts

Fears of harming self/others violently

Sexual

Taboo sexual thoughts the person finds repulsive

Compulsions are repetitive behaviours or mental acts aimed at reducing the anxiety caused by the obsessions. Some examples are:

Excessive cleaning, handwashing, showering
Checking locks, appliances, and electronics excessively
Repeating, ordering, and arranging things until it “feels right”
Seeking constant reassurance for doubts
Avoiding triggers
Mental rituals like counting, praying, repeating phrases

Causes of OCD

While the exact causes are unclear, contributing factors include:

Genetics

OCD runs in families, suggesting a hereditary component.

Brain Structure

Differences are seen in regions like the basal ganglia.

Neurochemistry

Disruptions in serotonin play a role in OCD.

Risk Factors

Childhood trauma, infections, and stress increase risk.

Treatments for OCD

Proven treatments for OCD include:

Cognitive Behavioural Therapy

Helps modify thoughts and behaviours.

Exposure and Response Prevention

Helps the subject gradually face fears and dispense with elaborate compulsive rituals.

SSRIs or Antidepressants

Help correct serotonin imbalance.

Mindfulness-Based Therapy

Reduces OCD anxiety.

Support Groups

Help cope with OCD challenges.

With proper treatment, individuals with OCD can manage symptoms and regain quality of life. A combination of therapy, medication, lifestyle changes, and self-help strategies can provide relief.