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What is OCD?

Written by Iman Mansoor 


What is OCD?


Obsessive-Compulsive Disorder (OCD) is a persistent mental health condition marked by recurring, distressing thoughts (obsessions) and repetitive behaviors or mental acts (compulsions). Individuals feel compelled to engage in these actions to alleviate anxiety or distress. OCD can significantly disrupt daily activities and diminish the quality of life due to the distress and interference it may cause.



Obsessive-Compulsive Disorder (OCD)
OCD


The OCD Cycle


The OCD cycle demonstrates how obsessions and compulsions occur in a loop that is very difficult to break. There are four stages of the OCD cycle as displayed in the diagram below.


Obsessive thoughts are persistent intrusive thoughts that can be disturbing, especially if they challenge an individual’s self-concept or are given significant meaning. The distressing nature of obsessions triggers anxiety. As a result of seeking relief from distressing thoughts, compulsive behaviors, which may be external behaviors or internal patterns of thoughts, are performed. The compulsions may lead to temporary feelings of relief, however, the longer the cycle is sustained, the harder it is to break. OCD is fueled by high levels of fear and anxiety and the cycle will repeat itself, even as an individual attempts to resist obsessions.


Risk factors


  • Anxiety and Depression

  • Genetics/ Family History

  • Brain Chemistry and Functioning 

  • Neurotransmitter imbalances are thought to play a role in OCD.

  • Childhood Trauma

  • Environmental Factors 

  • Stressful life events/ changes, trauma, and abuse can trigger OCD symptoms.

  • Temperament/ Personality Traits

  • Behavioral Conditioning 

  • Reinforcement of certain behaviors or thought patterns may lead to worsening or development of OCD symptoms.

  • Neurobiological Factors

  • Abnormalities in the structure and function of specific brain regions may contribute to OCD symptoms.

  • Illnesses or Infections 

  • Research has shown a link between OCD and streptococcal infections in childhood - referred to as Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection (PANDAS) or Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). See page on Child Mind Institute for more information.


Symptoms


The symptoms of OCD will vary amongst individuals. There are different patterns of unwanted, obsessive thoughts and different patterns of compulsive behaviors in relation. The symptoms will always vary in how significantly they impact someone’s daily activities but there are some obsessions and compulsions that are similar and common for individuals with OCD. Here are examples of common obsessions and compulsions.


Obsessions


  • Distressing thoughts about harm coming to oneself or others.

  • Aggressive thoughts of harming oneself or others.

  • Worrying about losing control of actions and words.

  • Fear of losing/ forgetting things. 

  • Distressing thoughts that challenge beliefs or self-concepts.

  • Undesired thoughts and mental images regarding the subjects of violence, sex, or religion.

  • Worrying about physical contact with dirt and germs.

  • Persistent feelings of doubt.

  • Difficulty dealing with uncertainty.

  • Hyper awareness/ constant awareness of body sensations such as breathing or blinking.

  • Strong desire for things to be clean, orderly, and balanced.


Compulsions


  • Rituals of washing and cleaning.

  • Arranging items in certain orders.

  • Performing tasks in a specific order/ following a strict routine.

  • Checking several times that doors are locked and appliances/ devices are off.

  • Persistent desire/ demand for approval and reassurance.

  • Providing self-reassurance (e.g. countering negative thoughts with positive thoughts). 

  • Avoiding situations that trigger obsessions.


Coping Strategies and Treatments (See page on WebMD)


  • Resisting Compulsions

  • Mindfulness Meditation

  • Relaxation Strategies

  • Cognitive Behavioral Therapy (CBT) 

  • Exposure and Response Prevention (ERP)

  • Acceptance and Commitment Therapy (ACT)

  • Inference-based CBT

  • OCD Medications

  • Neuromodulation (Used if CBT and medications prove ineffective)





     References


Miller, C., & Susan, S. (2016, February 2). What are PANDAS and PANS? Child Mind Institute. https://childmind.org/article/pandas-and-pans-about-acute-onset-ocd/

Obsessive-compulsive disorder. (n.d.). National Institute of Mental Health (NIMH). Retrieved May 4, 2024, from https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd

Obsessive-compulsive disorder (OCD). (n.d.). WebMD. Retrieved May 4, 2024, from https://www.webmd.com/mental-health/obsessive-compulsive-disorder

Obsessive-compulsive disorder (OCD). (2023, December 21). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/symptoms-causes/syc-20354432

Pedersen, T. (2022, September 16). OCD cycle: What it looks like and how to break it. Psych Central. https://psychcentral.com/ocd/ocd-cycle





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