Although obsessive-compulsive disorder (OCD) was previously deemed an uncommon disorder, the incidence has gradually risen as more individuals around the world experience the psychiatric disease. Obsessive-compulsive disorder is a mental illness characterized by a history of irrational impulses and obsessions. The compulsions and obsessions described above present tremendous difficulties to victims, particularly when going about their daily lives, and may cause considerable distress. Anxiety or depression can increase, particularly when people with OCD try to avoid or neglect their obsessions. In this respect, such people often find the urge to perform compulsive acts to relieve stress. However, the vicious cycle of OCD often appears due to the recurrence of the disturbing thoughts despite the victims’ effort to eliminate or ignore the obsessions. The following discussion highlights the causes of OCD, symptoms, and signs of, diagnosis, as well as the treatment for the disorder.
Symptoms and Signs
Studies show that most individuals with the obsessive compulsive disorder often exhibit both compulsions and obsessions (Jenike 259). However, it is worth acknowledging the fact that individuals may display only compulsive or obsessive symptoms. While individuals may or may not realize the extreme nature of their compulsions or obsessions, such unwanted thoughts and repeated behavior often consume much of their time and hamper with daily activities and social work (Jenike 260).
Obsessions attributed to OCD are unwanted repeated thoughts, images, or urges that are no0t only intrusive in nature but can also result in anxiety or distress among individuals with the disorder. The intrusion often manifests when a person tries to do something or think of doing something. According to Abramowitz et al., individuals with obsession thoughts often exhibit a variety of symptoms, including unwanted thoughts involving sexual subjects or aggression; fear of dirt or contamination; horrific or aggressive thoughts of harming oneself or others; as well as thoughts on just being right (491). Abramowitz et al. outline the symptoms attributed to obsessive thoughts including too much emphasis on moral or religious ideas, and fear of inflicting harm to self or others (491). The authors also argue that patients exhibit excessive stress when things are not in the right manner, fear of failing to acquire things an individual needs or losing them altogether, intrusive sexually explicit images or thoughts, and fear of contamination by germs or other people (492).
OCD compulsions involve acts that are repetitive and often drive an individual to pursue. The repetitive behaviors mentioned above usually reduce or prevent anxiety attributed to a patient’s obsessions or deter the occurrence of a bad thing. However, studies show that engaging in compulsions may fail to provide a substantive pleasure to the patient and only offer temporary relief from anxiety (Mataix-Cols et. 228). According to Jenike, symptoms of compulsions may include; repeated hand-washing and checking, counting in a given pattern, silent repeated prayers or phrase, as well as following a general routine of any nature (259). Different patients may exhibit different contents of compulsions and obsessions but share the adverse nature of intrusions and ritualistic attempts to counteract the obsessions (Mataix-Cols et al. 229).
Most of the OCD cases often occur among individuals below the age of 18 years. The symptoms mentioned above often commence gradually and increase in severity throughout the life of a patient, depending on each and every individual. Previous studies demonstrate that OCD varies from patient to patient and may worsen, particularly when the patient experiences heightened the level of stress. It is noteworthy that OCD may present a broad range of symptoms from mild to moderate through to severe cases where patients may be disabled in the process. Although the prevalence of the disorder may be higher in males than their female counterparts, its onset age is older in males compared to females.
There are enormous diagnostic challenges attributed to the disorder as a result of the similarities in symptoms compared to depression, anxiety disorders, obsessive-compulsive personality disorder, and schizophrenia among other mental disorders (Heyman, Mataix-Cols, and Fineberg 424). In this respect, only trained therapists can successfully and efficiently diagnose an individual with obsessive-compulsive disorder. According to Mataix-Cols et al., the therapists attempt to ascertain whether the patients have compulsive behavior or exhibit obsessive characteristics, or the compulsions and obsessions consume much of their time to the extent that they interfere with their daily routine activities (228).
The steps involved in the diagnosis of the obsessive compulsive disorder may include a physical exam, lab tests, and evaluation of an individual’s psychology, as well as diagnostic criteria for OCD. According to Stein, physical exam intends to help in ruling out other problems that may cause the symptoms exhibited by the patient as well as checking complications related to the disorder (397). Lab test, on the other hand may encompass checking the functioning of the thyroid, taking a complete blood count, and screening for drugs or alcohol. Psychological evaluation involves engaging the patient in discussing the feelings, thoughts, behavior patterns, and symptoms exhibited by the individual. Lastly, the therapist may find it necessary to utilize the criteria stipulated in the American Psychiatric Association-based Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose OCD (Heyman, Mataix-Cols, and Fineberg 424).
There have been cases of incorrect diagnosis of OCD, an issue attributed to several issues. For instance, individuals with OCD usually want to remain secretive about their situation, thereby delaying or complicating the diagnostic and subsequent treatment process. Besides, such people also fail to comprehend the causal factors behind the symptoms they exhibit. Also, many healthcare professionals lack the necessary expertise needed to diagnose and treat OCD as they are not familiar with the disorder. The delayed diagnosis and treatment of OCD may derail proper treatment of the disease and deterrence of associated suffering.
The treatment options available for individuals with OCD may include medication or psychotherapy. Cognitive behavioral psychotherapy (CBT) is one type of OCD treatment that instills in patients the ability to resist the disorder for the rest of their life. The treatment option mentioned above assist the individuals to change their behavior, which in turn help them in changing their feelings and direction of thinking. The behavioral treatment approach strives to detach obsessions from the associated discomfort and get rid of the rituals. According to (Heyman, Mataix-Cols, and Fineberg 423), the treatment strategies stated above revolves around prevention of compulsion and exposure to cues that elicit obsessions. Anxiety is likely to subside once an individual gets into contact with the fear factor for a considerable duration. On the other hand, ritual prevention entails blocking of the ritualistic behavior among people. For instance, the therapy involves preventing an individual who is more concerned with dirt from cleaning his hands repeatedly. Such a move aims to deter the individual from performing the activity on a repeated occasion, thereby helping to decrease the compulsive act.
Therapists may also administer medication as an alternative form of treatment for the OCD patients. Scientists have proven the effectiveness of serotonin reuptake inhibitors (SRIs) in treating the obsessive compulsion disorder. The above medication increases the concentration of serotonin in the brain. The five most common SRIs in the US include fluvoxamine, sertraline, clomipramine, paroxetine, and fluoxetine. Patients on SRIs usually report improvement after 8 to 10 weeks. However, it is notable that only less than 20% of patients subjected to SRI-medication display no OCD symptoms. Nonetheless, previous studies show that a combination of CBT and SRI treatments often present the best therapeutic option for patients with OCD.
Abramowitz, Jonathan S., Steven Taylor, and Dean McKay. “Obsessive-compulsive disorder.” The Lancet 374.9688 (2009): 491-499.
Heyman, I., D. Mataix-Cols, and N. A. Fineberg. “Obsessive-compulsive disorder.” BMJ: British Medical Journal 333.7565 (2006): 424.
Jenike, Michael A. “Obsessive–compulsive disorder.” New England Journal of Medicine 350.3 (2004): 259-265.
Mataix-Cols, David, Maria Conceição do Rosario-Campos, and James F. Leckman. “A multidimensional model of obsessive-compulsive disorder.” American Journal of Psychiatry 162.2 (2005): 228-238.
Stein, Dan J. “Obsessive-compulsive disorder.” The Lancet 360.9330 (2002): 397-405.