Obsessive-Compulsive Disorder (OCD): Symptoms, Causes, Risks, Complications, Diagnosis, Treatment, Outlook and Prevention

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A women with OCD that looking on her hands,

1Overview

It is just normal for some people to feel anxious at times, especially when faced with stressful events. However, if a person has obsessive thoughts and compulsive behaviors brought about by anxiety, it’s a condition called obsessive-compulsive disorder (OCD).

Obsessive-compulsive disorder (OCD) is characterized by unreasonable fears (obsessions) and thoughts that may lead to repetitive actions, which are also dubbed as compulsions. These behaviors may alter one’s activities of daily living and eventually cause severe distress. The repetitive tasks become a vicious cycle.

For most people with OCD, no matter what they do, they can’t help the obsessive behaviors they do. The compulsive behaviors and obsessive thoughts become so consuming, these interfere with the daily lives of those who have it.

OCD is an anxiety disorder that entails uncontrollable thoughts and repetitive behaviors a person feels compelled to perform. These repetitive actions are more like rituals.
For instance, a person goes to a specific place to check if it was cleaned over and over. Another example is repeatedly washing the hands to make sure there are no germs present.

Obsessive-compulsive disorder can begin early between the ages of 7 and 12 years old. About half of adults with the disorder claim that their symptoms started when they were younger. Also, the condition is more commonly seen in boys than in girls. However, when these children grow up, the condition is now seen more in women than in men.
Obsessive-compulsive disorder (OCD) affects about 2.2 million people in the United States.

2Symptoms

Most individuals with obsessive-compulsive disorder (OCD) have both compulsions and obsessions, but some experience just one or the other.

Obsessive thoughts

Obsessions are characterized by persistent, repeated and unsolicited thoughts or unwanted urges that may cause anxiety of distress. These include:

  • Fear of becoming dirty, contaminated by microorganisms or germs
  • Focusing too much on moral and religious ideas
  • Fear of losing the things you need and not having these things
  • Fear of losing control
  • Fear of harming others and yourself
  • Having violent thoughts
  • Things must be lined up or arranged properly
  • Too much attention on superstitions (lucky and unlucky)
  • Fear of making a mistake
  • Fear of being embarrassed or behaving unacceptably in public
  • Excessive doubts that need constant reassurance
  • Need for perfection and exactness

Compulsions

  • Checking things too often like switches, the stove, locks, and appliances.
  • Repeatedly bathing, showering or washing hands
  • Cleaning a lot
  • Fixing or arranging things just because he or she feels like it
  • Repeatedly checking in on loved ones to make sure they’re sage
  • Praying excessively and engaging in spiritual rituals caused by religious fear
  • Refusing to shake hands or touch doorknobs
  • Constant counting while performing routine tasks
  • Hoarding or accumulating junk like empty food containers and old newspapers
  • Eating foods in specific order
  • Being stuck on images, words or thoughts that interrupt sleep
  • Repeating certain phrases, words or prayers

3Causes

The exact cause of obsessive-compulsive disorder (OCD) remains unclear. The theories scientists have suggested include:

Genetics – According to some studies, OCD may be caused by mutations in the genes. However, the specific genes responsible for it is yet to be identified.

Biology – Some studies have suggested that OCD may be a caused by the changes in the brain function, neurotransmitters, and the body’s natural chemistry.

Environment – Studies have shown that environmental factors like infections caused by viruses or bacteria. Other environmental factors include abuse, illness, changes in living situations, loss of a loved one, work or school-related problems, and relationship issues.

Risk Factors

Even though the cause of the obsessive-compulsive disorder is yet to be determined, some factors may heighten the risk of this condition, including:

Family history – Some individuals are more likely to develop OCD if they have relator members of the family with the same disorder.

Other psychiatric conditions – OCD may be related to other psychiatric illnesses such as depression, anxiety disorders or substance abuse.

Personality – Some people who are neat, meticulous, and methodical with extremely high standards are more likely to develop OCD.

Stressful life events – People who’ve experienced stressful or traumatic life events may increase the risk of OCD. Some stressful life events include bullying, neglect, abuse, loss of a loved one or failure.

Differences in the brain – Some individuals with OCD have areas in the brain with unusually high activity or low levels of serotonin, a type of brain chemical.

4Complications

If left untreated, obsessive-compulsive disorder (OCD) may lead to more severe complications including:

  • Health problems such as skin problems (dermatitis) because of excessive hand washing
  • Relationship problems
  • Poor or reduced quality of life
  • Not able to attend school and work
  • Suicide and suicidal thoughts
  • Depression
  • Eating disorders
  • Trichotillomania
  • Tourette’s syndrome
  • Body dysmorphic disorder

5Diagnosis

Diagnosis of obsessive-compulsive disorder may become difficult because some of the symptoms of OCD are similar to those of anxiety disorders, depression, schizophrenia, or other mental health disorders.

The doctor can refer you to a mental health professional for further evaluation:

Physical examination – The doctor will conduct a thorough physical examination to rule out some problems that can produce the same symptoms, such as physical diseases.

Laboratory examinations – Laboratory tests are recommended such as complete blood count (CBC), screening for alcohol, thyroid function tests, and drug use. These tests will rule out the other causes of the signs and symptoms of OCD since some symptoms may signal underlying diseases such as a pituitary adenoma or enlargement of the adrenal glands.

Psychiatric examination – The doctor may refer you to a mental health professional. This entails discussing your feelings, thoughts, symptoms and behavioral patterns.

Diagnostic criteria for OCD – The health care provider may utilize the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association (APA).

6Treatment

Obsessive-compulsive disorder is usually treated with a combination of medications and psychotherapy. Though most patients improve with treatment, some may continue to experience symptoms even after treatment. Here are the treatments and therapies for OCD:

Medicines

The doctor will prescribe medications to manage the symptoms of OCD. Serotonin reuptake inhibitors (SRIs) and selective serotonin reuptake inhibitors (SSRIs) are used to reduce the symptoms of OCD. Some examples include clomipramine, fluoxetine, fluvoxamine, and sertraline.

These medications often take about 8 to 12 weeks to start working. If the symptoms do not improve, the patient may need further management through therapy to manage the symptoms of OCD.

Precautions when taking medications:

  • Choose the proper medication. The doctor may recommend a drug and see if it will take effect on the symptoms of OCD. These medications, however, may take several weeks before working.
  • All drugs or medications for mental health problems have possible side effects. Know more about these side effects by talking to your psychiatrist.
  • Some medications may pose a risk of suicidal thoughts among the patients. Some patients may experience suicidal thoughts in the first few weeks after initiating the medication. If these symptoms occur, make sure to contact your healthcare provider immediately.
  • Do not stop your medications abruptly. Though these medications are not considered addictive, stopping abruptly may cause withdrawal symptoms. These symptoms may gradually become severe, in some cases, hospitalization is required.
  • When you’re taking antidepressants, talk to your doctor about other prescription medications you’re taking.

Psychotherapy

The doctor may also recommend cognitive behavioral therapy (CBT), which has been effective in many people with OCD. However, the treatment may not be effective for everyone. Hence, the patients may try the therapy for a period.

7Outlook

Usually, patients with obsessive-compulsive disorder may seek treatment when they reach 27 years old on average. This is despite the fact that the symptoms started when they were younger. The average onset age of this condition varies among men and women.

In men, they may feel the onset when they are still children between the ages of 6 and 15. On the other hand, women may experience onset during adulthood, between the ages of 20 and 30 years old.

Those with OCD who experienced the symptoms before they reached 15 years old, about 80 percent also had depression symptoms. Despite the fact that OCD develops gradually and slowly, psychosocial stressors may trigger a sudden onset. An estimated 70 percent of people experience a lifelong struggle with OCD, with the symptoms becoming worse in time. In some cases, however, the symptoms improved.

Some factors are linked to a good outlook or prognosis such as a brief duration of symptoms, good functioning before having a full-blown OCD and those with milder symptoms.

8Prevention

Obsessive-compulsive disorder can’t be prevented but there are many factors and self-help tips to aid in a person’s journey in managing the condition. Here are self-help tips for OCD:

  • Don’t avoid your fears. Be aware of what scares you and expose yourself to OCD triggers to lessen the anxiety you feel.
  • Refocus your attention on other things and activities such as jogging, exercise, music or video games.
  • Write down your obsessive and compulsive thoughts and feelings.
  • Practice relaxation techniques to effectively manage stress and anxiety.
  • Exercise regularly to manage stress
  • Get adequate sleep
  • Live a healthy lifestyle by eating a well-balanced diet.
  • Avoid alcohol and cigarette smoking
  • Stay connected with family, friends and loved ones.
  • Joint obsessive compulsive disorder (OCD) support groups