obsessive compulsive disorder (ocd)

what is it?


Obsessive Compulsive Disorder (OCD) is a mental health disorder that affects people of all ages and walks of life, and occurs when a person gets caught in a cycle of obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, images or urges that trigger intensely distressing feelings. Compulsions are behaviors an individual engages in to attempt to get rid of the obsessions and/or decrease his or her distress.  

Compulsive hoarding, which is a form of OCD, is a pattern of behavior that is characterized by excessive acquisition and an inability or unwillingness to discard large quantities of objects often causing significant distress.

Most people have obsessive thoughts and/or compulsive behaviors at some point in their lives, but that does not mean that we all have “some OCD.” In order for a diagnosis of obsessive compulsive disorder to be made, this cycle of obsessions and compulsions becomes so extreme that it consumes a lot of time and gets in the way of important activities that the person values.


Who is affected by ocd?

It is estimated that OCD affects two to three percent of the population.  In a city the size of Winnipeg, with a metro population of over 730,000, there are between 15,000 – 27,000 people faced with the challenges of OCD.   When you add in the number of family, friends, co-workers, health professional and others who are indirectly impacted by OCD  the number of people affected is very significant.


When can it develop?

OCD knows no racial, religious, or socio-economic boundaries.  It often surfaces at puberty although it can start as early as 18 months or as late as 40 years depending on the circumstances of the individual. 


how is it diagnosed?

OCD is a complex disorder.  It can only be properly diagnosed by trained therapists and doctors. 


treatments

Cognitive Behaviour Treatment (CBT) – A trained therapist can help the patient overcome fear and discomfort of obsessions and compulsions by practicing gradual exercises to reduce the fear. This is done through cognitive-behaviour therapy (CBT), which is comprised of exposure and response prevention (ERP). ERP is the most effective psychological form of treatment for OCD. It involves triggering the patient’s obsessions by exposing them to real or imagined objects or situations that cause anxiety. The patient is then guided to respond without the compulsions that usually follow the obsessions. Over time, exposure arouses less anxiety limiting the obsessions, and compulsive behaviours are reduced.

Pharmacological Therapy – Selective Serotonin Reuptake Inhibitors (SSRI’s) are the most common type of medication prescribed by a physician, who will monitor the drug’s effectiveness and side effects. .

Typical Obsessions

  • Contamination – fear of dirt, germs, diseases, chemicals, etc.
  • Doubting – uncertainty of having done something
  • Symmentry or Exactness Needs – concern that things be arranged in particular order
  • Fear of losing things
  • Religious – overwhelming feelings of guild and/or morality
  • Aggressive – concerns that one will harm oneself or others; thoughts of impending doom
  • Sexual – morally repugnant thoughts and images
  • Superstitions – bad magical thoughts or impulses
  • Hypochondriasis – obsessive, irrational fear of having a serious medical condition
  • Appearance – obsessive, irrational concern about appearance (not due to an eating disorder)
  • Terrible Thoughts – thoughts of having done or thought something inconsistent with ones own values

 Typical Compulsions

  • Washing/Cleaning – handwashing, showering, cleaning, using paper, cloth or gloves to avoid touching contaminated articles
  • Checking – locks, appliances, machinery, nuts and bolts, checking that one has not run over someone while one is driving
  • Arranging and Ordering – things or thoughts in a particular way, list making
  • Ritualistic Behaviours – attempting to do things to ‘perfection’ or ‘until they just feel right’
  • Confession – need to confess or pray in order to alleviate feelings of guilt or fears of harm to oneself or others
  • Constant demands for reassurance – constantly asking questions
  • Hoarding – inability to discard useless or worn out possessions in case they are ever needed
  • Avoidance and undoing rituals
  • Superstitions – good magical thoughts/actions meant to neutralise the obsessions
  • Excessive Slowness – completing some tasks in an excessively slow, methodical and fastidious manner
  • Constant worry about health – excessive doctor visits, medical tests, repetitive checking for symptoms, avoiding situations where one may contact a disease
  • Constant checking face or body – looking for minor or imagined flaws, avoiding mirrors, constantly seeking reassurance about appearance, over-grooming, multiple medical visits and/or procedures to correct perceived imperfections
  • Constant picking at face and body – resulting in scars and sores
  • Pulling our hair – on head, face or other parts of the body