obsessive compulsive disorder (OCD)
When you don’t feel in control of your own mind and behaviours, life can be terrifying at times.Obsessive-compulsive disorder (OCD) can often trap people in an endless cycle of recurring distressing thoughts (obsessions) and repetitive behaviours/rituals (compulsions). Although rituals may temporarily alleviate anxiety, they must be performed again when the thoughts return, which creates a never-ending loop that can begin to take over your life.
People with OCD are often aware that their obsessions and compulsions are senseless or unrealistic, which can make it all the more frustrating to cope with. Unfortunately, the more you try to stop your obsessions and compulsions, the more you feed the anxiety and distress you’re seeking to eliminate.
I am trained to help you face what you’ve been avoiding so that you can break the painful cycle of OCD and get your life back. I will help you transform the damaging habits and beliefs that have led you here by helping you confront the underlying causes head-on. I will gently guide you through the process of healing your inner conflicts and facing and releasing.
OCD SYMPTOMS (DSM-5 DIAGNOSIS)
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Presence of obsessions, compulsions, or both:
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Obsessions are defined by 1) recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress; and 2) the individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralise them with some other thought or action (i.e., by performing a compulsion).
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Compulsions are defined by 1) repetitive behaviours (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly; and 2) the behaviours or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviours or mental acts are not connected in a realistic way with what they are designed to neutralise or prevent, or are clearly excessive.
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The obsessions or compulsions are time-consuming (e.g., takes more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
MORE OCD SYMPTOMS (DSM-5 DIAGNOSIS)
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The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
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The disturbance is not better explained by the symptoms of another mental disorder (e.g., excessive worries, as in generalised anxiety disorder; preoccupation with appearance, as in body dysmorphic disorder; difficulty discarding or parting with possessions, as in hoarding disorder; hair pulling, as in trichotillomania; skin picking, as in excoriation; stereotypes, as in stereotypic movement disorder; ritualised eating behaviour, as in eating disorders; preoccupation with substances or gambling, as in substance-related or addictive disorders; preoccupation with having an illness, as in illness anxiety disorder; sexual urges or fantasies, as in paraphilic disorders; impulses, as in disruptive, impulsive-control, and conduct disorders; guilty ruminations, as in major depressive disorder; thought insertion or delusional preoccupations, as in schizophrenia spectrum and other psychotic disorders; or repetitive patterns or behaviour, as in autism spectrum disorder).
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Specified by “with good or fair insight”, “with poor insight”, and “with absent insight/delusional beliefs”.
OCD CAUSES AND FACTORS
The cause of obsessive-compulsive disorder isn’t fully understood. Factors that may increase the risk of developing or triggering obsessive-compulsive disorder include:
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Biological/Genetic Factors – OCD may be a result of changes in your body’s own natural chemistry or brain functions and it may have a genetic component, but specific genes have yet to be identified. The brain is a very complex structure. It contains billions of nerve cells — called neurons — that must communicate and work together for the body to function normally. Neurons communicate via chemicals called neurotransmitters that stimulate the flow of information from one nerve cell to the next.
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At one time, it was thought that low levels of the neurotransmitter serotonin were responsible for the development of OCD. Now, however, scientists think that OCD arises from problems in the pathways of the brain that link areas dealing with judgment and planning with another area that filters messages involving body movements.
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In addition, there is evidence that OCD symptoms can sometimes get passed on from parents to children. This means the biological vulnerability to develop OCD may sometimes be inherited. Studies also have found a link between a certain type of infection caused by the Streptococcus bacteria and OCD. This infection, if recurrent and untreated, may lead to the development of OCD and other disorders in children. Also, having parents or other family members with the disorder can increase your risk of developing OCD. Individuals with OCD have troubled relationships.
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MORE OCD CAUSES AND FACTORS
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Environmental Factors – Some environmental factors such as infections are suggested as a trigger for OCD, but more research is needed. There are environmental stressors that can trigger OCD in people with a tendency toward developing the condition. Certain environmental factors may also cause a worsening of symptoms. These factors include abuse, changes in living situation, illness, the death of a loved one, work-or school-related changes or problems, relationship concerns. Also, if you’ve experienced traumatic or stressful events, your risk may increase. This reaction may, for some reason, trigger the intrusive thoughts, rituals and emotional distress characteristic of OCD.
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Other – Maladaptive coping skills (e.g. suicidal behaviour, poor quality of life); Lack of healthy activities (inability to attend work, school or social activities; contact dermatitis from frequent hand-washing); Other mental health disorders (OCD may be related to other mental health disorders, such as anxiety disorders, depression, substance abuse or tic disorders).
OCD TREATMENT
Treatment can help bring symptoms under control so that they don’t rule your daily life, which includes a combination of the following options:
Supportive care – Your GP may perform a physical examination to help rule out other problems that could be causing your symptoms and to check for any related complications. There is no lab test to diagnose OCD, though a complete blood count (FBC), a check of your thyroid function, and screening for alcohol and drugs are sometimes included. The doctor bases his or her diagnosis on an assessment (psychological evaluation) of the patient’s symptoms, discussing your thoughts, feelings, symptoms and behaviour patterns (how much time the person spends performing his or her ritual behaviours). With your permission, this may include talking to your family or friends. A referral to a mental health provider will also be made.
Psychotherapy – OCD will not go away on its own so, it’s important to seek treatment. Cognitive behavioural techniques can help put obsessions into perspective. In therapy, a person can learn to recognise unrealistic and distorted thoughts. They may also develop tools to cope with distress without resorting to compulsions.
At first, the therapist only asks the person to delay their compulsions for a short period. As therapy progresses, the gap between exposure and response grows. Ideally, as a person grows desensitised to the obsession, their urge to do compulsions will decrease.