Obsessive-compulsive disorder (OCD) is characterized by obsessions (compulsive thoughts) and compulsions (compulsive actions). Obsessions are worrying, disturbing, pointless and nasty, but keep coming back. Compulsions are intended to ignore, neutralise or stop the obsessions.
Cause
In case of an obsessive-compulsive disorder, there is a combination of causes. Factors that may play a role in the development of this condition are:
- Heredity. When one of the parents has OCD, chances are three to five times higher that the child will also develop this condition.
- Childhood experiences. Growing up in an emotionally unsecure environment, with little regard for feelings or just overprotectiveness, can cause OCD.
- Stress.
- Major events. This puts pressure on the sense of security and self-confidence.
- Physical changes, for example after pregnancy.
Symptoms
When a person has an obsessive-compulsive disorder, he or she may suffer from only obsessions, only compulsions or both.
With compulsions, one feels the urge to perform particular actions over and over again; the person has no control over himself. Mysophobia is an example of a compulsion. Checking and organizing can also be a compulsion. If the compulsion is not being performed, the person is anxious and restless. Compulsions are often preceded by obsessions. Obsessions include frequent nonsensical, terrifying and unwanted thoughts. For example, the obsession to hurt someone else.
In both compulsions and obsessions, the person concerned knows that they really are absurd and useless. Yet, someone may be so preoccupied with these thoughts, that he or she can no longer function normally.
Diagnosis
The diagnosis of obsessive-compulsive disorder is mainly made on the basis of the history of the patient. If the doctor suspects that the problem is a mental illness, the patient will probably be referred to the professional mental health professional for evaluation and treatment. A psychiatrist or psychologist will determine the diagnosis of OCD by asking questions about the patient’s obsessions and compulsions and their consequences in work and relationships.
Treatment
Obsessive-compulsive disorder can be treated in several ways:
- Psychological treatment. When a person suffers from OCD, he or she often knows that the actions or thoughts are not normal. Often, one feels ashamed. The most effective psychological treatment of an OCD is behavioral therapy. The patient learns to endure frightening situations and to control the compulsion.
- Medication. In the past, tranquillizers were often given for OCD. The best known are benzodiazepines, such as oxazepam and diazepam. The disadvantage of these drugs is that they are addictive. The patient needs more and more of these drugs to sufficiently suppress the anxiety. Antidepressants don’t have this adverse effects and are therefore preferred in dealing with OCD. They well suppress the fears and let them often disappear completely.
Prognosis
An obsessive-compulsive disorder rarely disappears spontaneously. Because OCD can be a chronic (long-term) disease, it may take years of treatment (five to ten years). The early start of treatment may reduce the impact of the disease. However, the prospects are good. In about half of the patients, improvement occurs and about ten percent recover completely. In only ten percent, the disorder deteriorates, in spite of therapy.
Considerations
- Follow a therapy based on Exposure & Response Prevention (ERP). This therapy is actually the most successful of all types to address the compulsion. It comes down to the following: a person exposes himself to actions or situations that trigger the anxiety and obsessions and then postpones the compulsions or don’t do them at all. Although this will highly increase the anxiety in the beginning, one will notice, by consistently appying this therapy, that this tension eventually always disappears and the obsessions ultimately lose power.
- When following a therapy, it’s a golden rule to start small. Compulsive people are often perfectionists and tend to start addressing their greatest fear. If, for example, a person has the idea that his hands are dirty or contaminated, wait for five minutes until washing, then ten minutes, etc. Build it up slowly.
- Eat healthy. In the combat against OCD, it’s also very important to eat healthy. Unhealthy diet makes a person tired and listless, so one is mentally less able to cope with the compulsion.
- Fighting the obsessions makes little sense. What does make sense is to combat the compulsions that almost always follow the obsessions in OCD patients.
