This article looks at what obsessive-compulsive disorder (OCD) is, and the standard therapies and medications that are used to treat OCD. It also looks at the risks and side effects of treatment, and tips on how to live with the condition.
What is OCD?
One ritual or compulsion that may stem from OCD is excessive hand washing.
OCD is marked by unwanted repetitive behaviors. The condition causes people to have repeated feelings, thoughts, and ideas called "obsessions" that make them feel driven to do something. This "urge to do something" is known as a compulsion.
Usually, the person carries out certain actions referred to as "rituals" to get rid of obsessive thoughts. However, the relief is often temporary, and the rituals have to be repeated. Not repeating the rituals can cause severe anxiety.
Obsessions that people with OCD may experience include fear of germs, unwanted forbidden or taboo thoughts, aggressive thoughts, or having items in perfect order.
Compulsions that may be carried out in response to an obsession include excessive hand washing, arranging things in a precise way, and compulsive counting.
If a person thinks they may have OCD, they should speak with their doctor about their symptoms. OCD that is left untreated can cause a person great distress and affect the way a person functions day to day.
OCD is equally common among men and women. One-third of adults affected by the disorder first experience symptoms in childhood.
What is PANDAS?
Pediatric autoimmune neuropsychiatric disorder associated with streptococcus is a condition that is also known as PANDAS. It refers to when symptoms of OCD are suddenly triggered in children caused by the body's immune response to a strep infection.
Researchers suggest that it is the immune response to the infection, not the strep infection itself, that causes OCD symptoms.
PANDAS is usually managed with antibiotic treatment. If symptoms are ongoing, children are treated with standard OCD treatments including psychotherapy and SSRI medication.
Common forms of therapy
There are many forms of therapy to help treat OCD. These treatments can help reduce the impact the disorder has on everyday activities. OCD is treated with psychotherapy, medication, or a combination of both.
Cognitive behavioral therapy
Cognitive behavioral therapy is a type of psychotherapy, or talking therapy. The aim of CBT is to help a person with OCD manage obsessions and compulsions by altering the way that they think and behave. These steps often lead to an improvement in mood and functioning.
CBT has proven a highly effective treatment and can be just as effective as medication for some people.
CBT may help with OCD by challenging irrational beliefs and proving them wrong.
The idea behind CBT is that a person's thoughts, feelings, and actions are all linked. CBT focuses on how the way a person thinks can determine how they feel and their behavior.
For example, unrealistic or negative thoughts can cause distress. Distress can then affect how a person interprets a situation and have a negative impact on their actions. The person can become trapped in an ongoing cycle.
CBT concentrates on current problems rather than delving into issues from a person's past. A therapist helps an individual deal with overwhelming problems by breaking them down into smaller parts.
People with OCD are also shown how to cope with and change negative patterns in a more positive way to improve how they feel.
CBT teaches how to recognize, observe, and monitor thoughts. The goal is for people to challenge their irrational beliefs and prove them wrong, resulting in a change of belief. The therapy looks at practical ways for a person to improve their state of mind on a daily basis.
Depending on the individual, improvements to mental wellbeing are usually seen in 12-16 weeks.
Exposure and response prevention therapy (ERP) is a type of CBT. The aim of ERP is to provide a person with exposure to the thoughts, images, objects, or situations that trigger their obsessions. The response and prevention parts then come into play for the individual to make a choice not to carry out their compulsive behavior.
ERP takes place under the guidance of a therapist. In time, the person with OCD will be given ERP exercises to practice on their own to help them manage their symptoms.
While ERP may cause anxiety to rise initially, the individual will experience a drop in anxiety levels over time and with practice.
Medications to treat OCD
In many cases, CBT successfully tackles OCD. However, for some people, a combination of CBT and medication may be effective.
The drugs that are prescribed to someone with OCD may vary depending on their age. A type of antidepressant medication called selective serotonin reuptake inhibitors (SSRIs) are usually prescribed for OCD, although a doctor may prescribe other psychiatric drugs.
Researchers suggest that people with OCD may have abnormalities or an imbalance in a brain chemical called serotonin. This imbalance may cause OCD symptoms.
Serotonin sends messages between nerve cells in the brain and may regulate functions such as memory, sleep, and anxiety.
SSRIs work by slowing down the collection of serotonin from nerve cells by message transporters. This allows serotonin to stay in the space between cells longer, therefore increasing the likelihood that the next nerve cell will receive the message correctly.
SSRIs enable the body to use the reduced amounts of serotonin efficiently. As natural serotonin levels rise, a doctor can decrease SSRI dosage.
While most SSRIs are safe, the FDA require all antidepressants to carry the strictest warning for prescriptions. Children, teenagers, and young adults under age 25 may have a higher risk of suicidal thoughts and behavior when starting antidepressants.
People should never stop taking antidepressants without first speaking with a doctor, even if the person feels better.
Other treatments for OCD
Feelings of isolation may be common with OCD so seeking support is important.
Research continues to explore an experimental neurosurgical treatment for OCD called deep brain stimulation (DBS). DBS delivers electric impulses to stimulate specific areas of the brain via electrodes placed in the brain.
The FDA approved DBS under a "humanitarian device exemption" in 2014 to treat OCD, which safeguards its appropriate use and prevents overuse of the therapy.
It has been suggested that DBS works by using high-frequency pulses to restore normal activity to areas of the brain that have become impaired.
DBS involves brain surgery, which can pose some potentially serious health risks. At present, the long-term side effects and risks of DBS are unknown.
Living with OCD
People with OCD may feel alone or isolated from their friends and family. However, there is support available for individuals with the disorder and their family members.
Receiving the appropriate treatment, advice, and support from healthcare professionals, and sticking to a treatment plan is the key to recovery from OCD.
While OCD is a chronic condition, it is also treatable. By learning to manage symptoms and with support, a person with OCD can understand and identify their symptoms and triggers more effectively and achieve recovery from the disorder.