The term OCD nowadays can be heard in general conversation used by normal people. Although normal people use it to describe rigid meticulous rituals that people take up and are often reluctant to let go of, in the clinical sense of psychology, OCD means something a bit different. Obsessive-compulsive disorder is known to affect about 2.3% of people at some point in their lives and around 50% of affected patients experience adverse effects to daily life before age 20.

What is OCD?

Obsessive-compulsive disorder (OCD) consists of two symptoms – obsession and compulsion. Obsession involves uncontrollable unwanted recurring thoughts and urges that trigger intensely distressing feelings. Usually, it is seen that people who have obsessions actively try to resist or suppress them, or at least overcome them with some other thought or action. The most common type of obsession is dirt or contamination. For example, people feel that their hands are dirty after touching a doorknob, or worry that they will contaminate others with their germs.

The second symptom is a compulsion. These are repetitive behaviours that a person with OCD feels the urge to do in order to make the obsession go away. A person with contamination obsession washes his/her hands frequently to reduce the distressing feeling which in turn reinforces the repetitive behaviour.

OCD or “Just a ritual”?

Not all repetitive behaviour or rituals are compulsions. A lot of people who do not have anxiety or OCD will have repetitive thoughts or engage in repetitive behaviours. For example, bedtime routines, religious practices, and learning a new skill, all involve some level of repeating an activity over and over again but are usually a positive and functional part of daily life. Arranging and ordering books for eight hours a day is not a compulsion if the person works in a library.

People without OCD engage in these repetitive rituals because it makes their life easier by giving things structure. A person may have a certain pattern of washing their hair and would not deviate from this pattern because it would make their task less efficient. Also, such rituals do not affect the person’s daily functioning. However, a person with OCD cannot help but perform the rituals related to the obsession because they experience a constant state of anxiety and a range of distressing thoughts and feelings in the absence of the behaviour.

Signs of OCD

OCD involves two main types of symptoms: obsessions and compulsions. Many people living with OCD experience both obsessions and compulsions, but some people only experience one or the other.

Types of obsessions

The content of obsessive thoughts can vary widely, but a few common themes include

  • Worrying about germs, dirt or illness

  • Fearing of harming yourself or someone else

  • Needing things to be arranged symmetrically

  • Repeated intrusive words or phrases coming into awareness

  • Repetitive and vivid images occupy the mind

  • Having explicit sexual or violent thoughts

  • Being aware of bodily functions such as swallowing, breathing and blinking

  • Worrying about the health and safety of yourself and your loved ones

Types of Compulsion

Common types of compulsive behaviour in people with OCD include

  • Cleaning and hand washing

  • Checking – such as checking doors are locked or that the gas is off

  • Counting

  • Ordering and arranging

  • Hoarding

These are some forms of OCD that are usually seen in patients. The presence of one or more than one form of these OCDs in a person is a sign of obsessive-compulsive disorder. However, besides these symptoms, there are certain other criteria that are to be met for OCD.

These criteria are

  • Presence of obsession, compulsion, or both

  • The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

  • The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.

  • The disturbance is not better explained by the symptoms of another mental disorder.

Treatment

  • Psychotherapy
    Psychotherapy can be an effective treatment for adults and children with OCD. It is effective in reducing the intensity and frequency of OCD symptoms. The two main types of psychological therapy for OCD are cognitive-behavioural therapy (CBT), and a type of behavioural treatment, called exposure and response prevention (ERP) therapy.

    CBT works toward breaking the automatic bond between an obsessive thought and ritualistic compulsive behaviour.

    Exposure and response prevention therapy (ERP) – In this process the patient is exposed to the situation which induces the person’s obsessive thoughts, and which triggers their compulsion (e.g., touching dirty objects) but they are prevented from engaging in compulsive behaviour (e.g. handwashing). This prevents the person from experiencing the temporary relief received from the compulsion and forces them to face their anxiety until anxiety fades away. From this, the person learns that his/her anxiety will automatically fade away without having to perform the ritual.
    Therefore, it is effective in reducing compulsive behaviour in OCD.

  • Deep breathing exercises
    Breathing exercises are highly helpful for managing anxiety related to OCD symptoms. This exercise could also be used in exposure and response prevention therapy (ERP). The exercise serves the purpose of slowing down breathing and heart rate, creating a calming effect.

  • Medication
    Medicines are needed if therapy doesn’t help treat the OCD, or if the OCD is severe. Antidepressants called selective serotonin reuptake inhibitors (SSRIs) are prescribed, which improve OCD symptoms by increasing the levels of the chemical, serotonin.

Taking the first step towards seeking help is recognizing that there is a problem and that this problem is making it hard for you to continue with your daily life. The next step is to go see a medical professional, where both the patient and the professional work towards mitigating the problem. 

As with any illness, the treatment should be tailored to a specific individual. In addition to providing consultation services, the Center for Mental Health offers you a complete solution. You can visit our centre to get the best OCD treatment in Pune if you feel you suffer from this disorder.