Introduction

People with obsessive-compulsive disorder (OCD) experience recurrent, unwelcome thoughts, ideas, or feelings (obsessions). They feel compelled to perform something repeatedly to eliminate the ideas (compulsions). A person’s everyday tasks and social interactions can be seriously hampered by repetitive habits like hand washing/cleaning, checking on items, and mental acts like (counting) or other activities. 

Many individuals who do not have OCD have upsetting thoughts or repeated activities. These, however, rarely interfere with day-to-day existence. OCD patients have inflexible actions and intrusive, recurring thoughts. Lack of compliance with the behaviours frequently results in severe anguish and is frequently accompanied by a particular fear of severe repercussions (to oneself or loved ones). Many OCD sufferers are aware of or suspect their obsessional ideas are unfounded; some may believe they are. People with OCD struggle to let go of their intrusive ideas or cease their compulsive behaviours, even when they are aware that they are unreal.

A diagnosis of OCD requires the presence of obsessional thoughts and/or compulsions that are time-consuming (more than one hour a day), cause significant distress, and impair work or social functioning. OCD affects 2-3% of people in the United States, and among adults, slightly more women than men are affected. OCD often begins in childhood, adolescence, or early adulthood. Some people may have some symptoms of OCD but do not meet full criteria for this disorder.

Obsessions

Obsessions are persistent and frequent thoughts, urges, or pictures that bring on unpleasant feelings like dread, revulsion, or worry. Many OCD sufferers know that these thoughts and behaviours are excessive or irrational and result from their own minds. However, logic or reasoning cannot alleviate the discomfort that these invasive ideas generate. Most OCD sufferers use compulsions to alleviate the discomfort of obsessional thought or to negate the perceived risks. They could also try to ignore or repress the obsessions, or they might try to divert their attention with anything else.

Examples of shared content of obsessional thoughts:

• Fear of contamination by people or the environment
• Disturbing sexual thoughts or images
• Religious, often blasphemous, thoughts or fears
• Fear of perpetrating aggression or being harmed (self or loved ones)
• Extreme worry something is not complete
• Extreme concern with order, symmetry, or precision
• Fear of losing or discarding something important
• Can also be seemingly meaningless thoughts, images, sounds, words or music

Compulsions

Compulsions are repetitive behaviours or mental acts that a person feels driven to perform in response to an obsession. The behaviours typically temporarily prevent or temporarily reduce a person’s distress related to an obsession, and they are more likely to do the same in the future. Compulsions may be excessive responses directly related to an obsession (such as excessive hand washing due to the fear of contamination) or actions utterly unrelated to the obsession. In the most severe cases, a constant repetition of rituals may fill the day, making a regular routine impossible.

Examples of compulsions:

• Excessive or ritualized hand washing, showering, brushing teeth, or toileting
• Repeated cleaning of household objects
• Ordering or arranging things in a particular way
• Repeatedly checking locks, switches, appliances, doors, etc.
• Constantly seeking approval or reassurance.
• Rituals related to numbers, such as counting, repeating, excessively preferencing or avoiding certain numbers
• People with OCD may also avoid certain people, places, or situations that cause them distress and trigger obsessions and/or compulsions. Avoiding these things may further impair their ability to function and may be detrimental to other mental or physical health areas.

Treatment for OCD

Patients with OCD who receive appropriate treatment commonly experience improved quality of life and functioning. Treatment may improve an individual’s ability to function at school and work, develop and enjoy relationships, and pursue leisure activities.

Cognitive Behavioral Therapy

Exposure and response prevention (ERP) is a kind of cognitive-behavioural therapy (CBT), which is a successful treatment (ERP). During therapy sessions, patients are shown pictures or frightening scenarios related to their obsessions. While it is customary to begin with those that only produce mild or moderate symptoms, the early effects of the treatment frequently result in elevated anxiety. Patients are advised to refrain from engaging in their typical obsessive habits (known as response prevention). Patients learn that their afraid ideas are merely thoughts by remaining in a dreaded circumstance without anything bad happening. Over time, people become more adept at managing their thoughts without resorting to repetitive actions, reducing their anxiety. Impulsivity is different than OCD.

Using evidence-based guidelines, therapists and patients typically collaborate to develop an exposure plan that gradually moves from lower anxiety situations to higher anxiety situations. Exposures are performed both in treatment sessions and at home. Some people with OCD may not agree to participate in CBT because of the initial anxiety it evokes, but it is the most powerful tool available for treating many types of OCD.

Medication

OCD can be successfully treated with a family of drugs known as selective serotonin reuptake inhibitors (SSRIs), which are normally prescribed to treat depression. SSRI dosages for OCD are frequently greater than those for depression. Patients who do not benefit from one SSRI drug may benefit from a different one. The full extent of the greatest effect often takes six to twelve weeks or more to become apparent. Depending on the patient’s desire, cognitive capacity, level of insight, and the presence or absence of co-occurring mental illnesses, patients with mild to moderate OCD symptoms are often treated with either CBT or medication. Other treatment options may also be available. If OCD symptoms are severe, a combination of CBT and SSRIs is the most effective treatment.

Neurosurgical treatment 

Ventral gamma capsulotomy, a surgical technique, can be quite successful for individuals who do not react to standard therapies and are seriously affected, according to some more recent research. Nevertheless, due to historical prejudice and its intrusiveness, it is underutilised. Deep brain stimulation uses an implanted device, has evidence supporting its effectiveness, and does not permanently damage brain tissue like a capsulotomy does. It is still quite intrusive and difficult to handle, though. The long-term assistance required by DBS patients can be provided by a small number of physicians and hospital systems that have been trained to deliver this treatment.

Conclusion

Everybody eventually develops obsessions and compulsions. For instance, it’s typical to sometimes double-check the stove or the locks. Some folks simply prefer orderly things. However, OCD is more severe. Hours of a person’s day may be consumed by it. It interferes with daily life and activities.

OCD affects 1% of the population, making it a reasonably prevalent condition. People of various racial and ethnic backgrounds, as well as both sexes, experience it. Typically, it begins in early adulthood or in infancy for most people.