Obsessive-Compulsive Disorder - Types, Causes, and Treatment

What is an Obsessive-Compulsive Disorder (OCD)?

Obsessive-compulsive disorder is a long-lasting, chronic, and very common mental illness in which a person has uncontrollable thoughts. People with OCD feel the urge to repeat a particular behavior again and again.

According to obsessive-compulsive disorder definition:

“It is an anxiety disorder that causes sensation (obsession) or a need to repeat certain behavior over and over again (compulsion).”

People with OCD repeatedly perform a specific routine to the extent that it impairs general function and generates distress. They are unable to control their behavior or unwanted thoughts for a longer period.

Common compulsion includes counting things, thinking a number or color is good or bad, hand washing. These activities occur to the extent that the person’s daily life is affected negatively, causing distress. These conditions are linked with an increased risk of suicide, anxiety disorder, and tics.

Obsessive-Compulsive Disorder Symptoms

The signs of obsessive-compulsive disorder are sometimes hard to recognize, as all habits or rituals are not OCD. However, a person with OCD usually shown the following symptoms:

• Spend a minimum of 1 hour a day on repetitive thoughts and behavior.
• Cannot control the repetitive behavior or thoughts, even when those behavior or thoughts are recognized as excessive.
• May feel relief from anxiety sometimes.
• Do not get pleasure while performing the rituals or behavior.
• Experience significant problems due to intrusive thoughts.

Some individuals may have a tic disorder, vocal tics, or motor tics. Tics are unwanted, uncontrollable, brief, sudden, repetitive movements of muscles. Motor tics include shoulder or head jerking, shoulder shrugging, facial grimacing, or eye blinking. Involuntary repetitive sounds like throat clearing, grunting, or sniffing are known as vocal tics.

However, the signs of obsessive-compulsive disorder can be categorized into “obsession” and “Compulsion.” People can have the symptoms of obsession or compulsion or both at the same time.

Signs of Obsession

The most common obsession symptoms include irrational or intrusive thoughts, urges, or deep brain stimulation that cause anxiety. These problems interfere when the person is trying to think of or do something else. Other symptoms of obsession are as follow:

• Persistent, repeated, or unwanted thoughts
• Aggressive behaviors towards self or others
• Fear of contamination, germs, or dirt
• Urge to keep things in symmetry or proper order
• Difficulty in tolerating uncertainty
• Taboo or unwanted forbidden thoughts involving aggression, religion, or sex

Examples of obsession symptoms include:

• Unpleasant sexual images
• Images of driving a car into a crowded area
• Doubts that whether locked the door or turned off the stove
• Fear of being contaminated if they touch something that others have touched
• Thoughts about misbehaving or shouting obscenities in public

Signs of Compulsion

The symptoms of OCD compulsion are associated with repetitive behavior. An infected person urges to perform compulsive behavior repeatedly in response to an obsessive thought. The compulsive behavior is meant to reduce anxiety related to the obsession. But, compulsion brings only temporary relief from anxiety and offers no pleasure.

The common signs of compulsion are:

• Compulsive counting
• Demanding reassurance
• Excessive cleaning or hand washing
• Arranging or reordering things in a specific way
• Checking on things over and over again
• Following a strict routine

Examples of symptoms related to compulsion include:

• Counting in particular patterns.
• Washing hands until the skin becomes raw.
• Frequently repeating words, prayers, or phrases.
• Arranging the goods to find the same way

Some rituals or rules can be made that help control the anxiety while having obsessive thoughts. The compulsive behavior may be extreme and usually not actually relate to the problem they are intended to fix.

Symptoms may come and go, ease, or worsen over time. However, a person with OCD does not have control over themselves. They may try to help themselves by avoiding situations that trigger compulsive behavior or obsession. Some people get help from drugs and alcohol to calm themselves or control their abnormal behavior.

Some adults realize that what they are doing doesn’t make sense. But, some might not recognize that their behavior is out of the ordinary. Teachers, parents, or other family members generally recognize such signs in kids or adults.

If you observe symptoms of OCD or someone around you shows signs of OCD, talk to the doctor immediately. Because if the OCD is left untreated, it can interrupt all aspects of life.

Obsessive-Compulsive Disorder Causes

OCD is a common mental illness that affects people of all ages; adolescents, children, adults worldwide. Most people are diagnosed by the age of 19; the onset of symptoms is earlier in boys than in girls. However, the cause of OCD is still unknown; genetics and environmental factors are considered to play a vital role.

The risk factors associated with OCD include a history of child abuse or other stress-inducing events. Other factors may include:

• Drug-induced OCD

  Various medicines can induce pure OCD in people who never had symptoms before. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has a complete chapter specifically about drug-induced OCD. Olanzapine - Atypical antipsychotics have proved to induce de-novo OCD in people.

• Genetics

  OCD might have a genetic element, but certain genes are not yet identified. Family and twin studies revealed that people who have first-degree relatives with OCD are at higher risk of getting OCD. Identical twins are often more affected by genetic components than non-identical twins. Researchers have been researching to explore the relationship between OCD and genetics to improve the diagnosis and treatment.

• Autoimmune

  A relationship between OCD symptoms and childhood trauma has been reported in some literature. However, more research work is required to understand the association better. In some cases, the quick onset of OCD in kids is caused by a Group A Streptococcal Infection syndrome. It is commonly known as Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection (PANDAS).

• Biology

  A change in brain function or the body’s natural chemistry can result in OCD. Genetic defects, faulty brain circuitry, and chemical imbalances in the brain are described as biological causes.

Types of Obsessive-Compulsive Disorder

OCD is merely checking light switches, or washing hands presents itself in many guises. There are infinite forms of OCD, but all have similar symptoms, often overlapping between categories. There are seven types of OCD; contamination, harm, symmetry, checking, intrusive thought, rumination, and hoarding.

Contamination Obsession

It is a fear of getting contaminated by touching things or objects touched by others. People with mental contamination feel like they have been treated like dirt. They have a suspicion that contamination may harm them or their loved ones. The usual compulsion might be to clean or wash.

Common compulsion and obsessive contamination worries include:

• Clothes and dead skin
• Outside air
• Places
• Eating in public places
• Shaking hands
• Public toilets
• Door handles

The repetitive body or hand washing accompanied by other cleaning is often carried out several times. The whole cleaning and washing can take up to the entire day. It may have a severe influence on a person’s ability to handle relationships and jobs.

Constant cleaning or scrubbing on the skin impacts badly on secondary physical health. Hands are affected more as people will scrub them until they are bleeding. Some people can go to extremes by bathing in bleach. Some people might avoid objects, people, and entire places in case of experiencing contamination fears before.

Harm Obsession

Harm obsession is characterized by intrusive thoughts focused on the possibility of harming others. People with a harmful obsession feel that they may hurt someone close to them or a stranger. They may fear that they have harmed someone in the past and did not realize or do not remember it.

Symmetry Obsession

People with symmetry and order need to have things lined up in a certain way. They need to see everything in symmetry, just ‘right’ to prevent discomfort. Examples of symmetry obsession include:

• Spotless without blemish
• Books and CD’s
• Clothes
• Tinned Cans
• Pictures
• Neatness

Affected people will spend plenty of time getting the symmetry ‘just right’. This time-consuming obsession will get them extremely late for appointments and work. If the compulsion takes considerably more time, people can become physically or mentally drained. The infected person also avoids social contact to prevent order and symmetry from being disrupted.

Checking

Checking includes light switches, an oven, an alarm system, locks, or think you have a medical condition like Schizophrenia or pregnancy. People with checking compulsion need to check things repeatedly to prevent obsessive fear like harm, leaks, fire, and damage. Common checking compulsion and obsessive worries include:

• Valuable items (phone, purse, wallet)
• Sexual arousal
• HIV and AIDS
• Re-reading text
• Checking with a camera
• Emails and letter
• House lights and candles
• Electric appliances
• Stove knobs
• Memories
• Reassurance

Checking is usually done several times and might last for several hours, causing a significant influence on people’s life. Being late for appointments, social occasions, work, school, or college are a few examples. Another consequence is, they may damage things that are continually being prodded, pulled, or over-tightened.

Rumination

Rumination or significant distress is an obsession with a line of thought which can be disturbing or violent. It describes all the intrusive thoughts and prolonged thinking about productive and undirected things. Unlike obsessive thoughts, rumination is not considered objectionable, and it is indulged rather than resisted. Many ruminations dwell on philosophy, religion, or metaphysical themes like the nature of morality, life after death, etc.

Some common examples of rumination are:

• Questioning about the origin of the universe.
• Is everyone actually good?
• What would happen after death?
• What will happen in hell or heaven?
• What is beneath the earth?

People ruminate on these things for an extended period. They also contemplate what superficially appeared to them to be compelling evidence. Most of the time, it never leads to a satisfactory conclusion or a solution. Some people seem to be detached, thoughtful, and deeply preoccupied.

Intrusive Thoughts

It is another form of rumination and almost similar to it but not the same. In this condition, a person suffers from disturbing, repetitive, and obsessive thoughts that are often appalling and horrific. Intrusive thoughts that do not involve immediate compulsion are sometimes mistakenly referred to as ‘Pure O’.

People without OCD may also have intrusive thoughts, which can be both positive or negative. But, from an OCD perspective, intrusive thoughts are repetitive unpleasant thoughts that cause significant distress. Common OCD related intrusive thoughts cover the following areas:

• Sensorimotor OCD - body focusses obsession.
• Violent
• Religious
• Sexual
• Relationship

These thoughts are not voluntarily produced and may cause extreme distress sometimes. The idea, fear, or thoughts can often seem profoundly shocking. However, these are not impulsive or fantasies that will be acted upon.

Hoarding

Hoarding is an inability to discard useless or worn-out possessions. It is a persistent difficulty parting or discarding possessions due to the perceived need to save them. The thought of getting rid of anything or an item causes distress to the sufferer. People with hoarding OCD keep things often because of the following reasons:

• They feel safer when surrounded by the things they kept with them.
• They believe that they might need these things at some point in life.
• These things are unique, and they might not be able to find them again.
• They have an emotional attachment to them.

However, refusing to discard and excessive acquiring items results in:

• Having difficulty in organizing things
• Conflict with people who try to remove clutter from home
• A buildup of trash and food items to unsanitary levels
• Keeping themselves or others safe in the home
• Disorganized stack or piles of items

Collection and hoarding are two different things. People who have collections of different things categorize them and carefully display their collections. They may have large collections of items, but they are not usually cluttered. And, collections don’t cause distress or impairment, which happens due to hoarding.

How to treat Obsessive-Compulsive Disorder?

Obsessive-Compulsive Disorder Treatment typically consists of medication, psychotherapy, or a combination of both. Some people may respond to treatment well, but some may continue to experience the symptoms.

Moreover, in some cases, people with OCD also experience other mental illnesses like depression and anxiety. However, while deciding on treatment, it is essential to consider the other disorders as well.

Medication

The most frequently used medication for OCD are Selective Serotonin Reuptake Inhibitors (SSRIs). Tricyclic antidepressant, Clomiparine is also used to reduce OCD symptoms. It performs as well as SSRIs, but it has higher side effects.

Serotonin Reuptake Inhibitors (SRIs) often require a higher daily dosage in the treatment of OCD. It may also take up to 12 weeks to start working, but in some cases, the improvement is rapid. However, if the symptoms do not improve with SRIs, antipsychotics are given as alternative medication.

According to research, some patients respond well to antipsychotic medication. It also manages symptoms for people who have both tic disorder and OCD. However, some research indicates that the efficacy of antipsychotics to treat OCD is mixed.

Many other medications are also used to treat OCD. However, a lot more research is required to know their exact benefit.

Psychotherapy

Therapies are proved to be an effective treatment for children and adults with OCD. According to research, Cognitive Behavior Therapy (CBT) and other psychotherapies are as effective as medications. In some cases, therapy treatment is more effective than medication.

Research about Exposure and Response Prevention (EX/RP), a type of CBT, effectively reduces compulsive behaviors. EX/RP is also useful for people who do not respond well to the SRI medication. Like other mental illnesses, OCD treatment is often personalized and may begin with psychotherapy or medication.

In some cases, medication and therapies are given in combination. EX/RP is given explicitly as an add-on treatment if SSRIs or SRI do not effectively treat OCD. If the treatment is started with medication, then therapies are offered as add-on treatment.

Some other treatment options, including Transcranial Magnetic Stimulation (TMS), are also approved by the Food and Drug Administration (FDA). Deep brain stimulation, augmentation treatments, or a combination of these approaches are used as add-on treatments. Many researches have been conducted to find new treatment approaches for OCD.

Other than these approved treatments, an emotional support animal also helps reduce symptoms of OCD. An ESA is a companion pet that offers several benefits for people with OCD. These animals provide unconditional love and affection for their owner.

If you decide to get an ESA, ask for an ESA letter by contacting us. We are a legitimate website that provides real ESA letters written by certified medical professionals.