What is OCD
Obsessive Compulsive Disorder (OCD) is a neuro-biological illness, classified as an anxiety disorder. The individual with OCD experiences and attempts to suppress recurrent, intrusive thoughts (obsessions) that cause anxiety or discomfort. Ritualistic behaviours (compulsions) follow and are performed to neutralize and prevent this unease, though the relief is only of a temporary nature. The person realizes that the obsessions are a product of his or her own mind and that the behaviour is excessive or unreasonable. Compulsions may consist of mental rituals only, and therefore may be unnoticed by others. Until the illness becomes moderate to severe, the compulsions are often done secretively or are well disguised, so that the person's close associates are not aware of them. Generally the person feels that he/she is going 'crazy', feels ashamed, and fears telling others about it.

OCD-type behaviours can be associated with other illnesses, i.e. Panic Disorder, Tourette's Syndrome, Attention Deficit Disorder, Generalized Anxiety Disorder, Learning Disabilities, dementia, head injury and Schizophrenia.

OCD Spectrum Disorders include: trichotillomania, hypochondriasis, body dysmorphic disorder, and eating disorders.
Treatments
Pharmacological Therapy - Primarily, seven drugs are used in Canada for treatment of OCD. All of these medications have a potent effect on the brain's chemical neurotransmitter, serotonin. It may take up to 3 months, at the higher doses, to know if a drug is helping the OCD. Each drug works differently for any particular individual, and as with all medications, side effects may vary from one person to the other. All of the above drugs are anti-depressants and none are addictive.

Cognitive Behaviour Treatment.htm - CBT - for OCD involves exposure and response prevention. It helps one to face his or her anxiety and fears gradually with the assistance of a trained therapist. This therapy involves daily commitment until the anxiety is reduced.
 Medications
Selective Serotonin Reuptake Inhibitors (SSRI's) are the medications most commonly used first in the treatment of OCD.  Drugs work differently with each individual and side effects will vary.
Typical Obsessions
  • Contamination - fear of dirt, germs, diseases, chemicals, etc.
  • Doubting - uncertainty of having done something.
  • Symmetry or Exactness Needs - concern that things be arranged in a particular order.
  • Fear of losing things.
  • Religious - overwhelming feelings of guilt and/or morality.
  • Aggressive - concerns that one will harm oneself or others; thoughts of impending doom.
  • Sexual - morally repungnant 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
Excessiveness of the following
(not dictated by cultural or religious norms)
  • 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 reassurances; 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 neutralize the obsessions.
  • Excessive Slowness - completing some tasks in a exceedingly 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 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 out hair on head, face or other parts of the body

 

Note:  OCD is often confused with OC Personality Disorder.  For more information about OCPD go to this link: Obsessive Compulsive Personality Disorder: Don't Break the Rules!