OCD

OCD Meaning

You’ve had a long day and you decide to retire for the night, when suddenly you realize that you may have left the front door unlocked. You become anxious and go check if it is locked. Once you’ve ensured that it’s locked, you relax and return to bed. This regular anxiety is good for you as it ensures that you’re alert about your environment.

Sometimes, however, these thoughts can be recurring and intrusive. You may go check the door and ensure that it’s locked but when you return to bed, you start to worry about it again. You go check the door again and return to bed but your worry still remains. These recurring thoughts, which make you feel anxious all the time and affect your daily life in the process, are known as obsessions (OCD).

Obsessions can vary; some people are obsessed with cleanliness and may worry that their hands are germ-infested even if they washed them less than a minute ago.

People with OCD experience severe anxiety and distress. To relieve this anxiety, they perform some repetitive acts known as compulsions.

Compulsions offer temporary relief to people suffering from OCD. In severe cases, the urge to perform such actions repeatedly can severely hamper a person’s daily life activities. When this cyclical occurrence of obsessions followed by the compulsive behavior begins to hamper a person’s ability to cope with daily life, it may be a case of OCD.

Few examples of Compulsions in OCD:

Someone who immensely fears being contaminated might have repeated, ritualized hand washing, bathing, brushing which are called compulsions.
Repeatedly checking door locks, gas knobs, electrical appliances in response to intrusive doubts
Checking to prevent harm to self and others
Ordering and arranging rituals in order to have things in symmetry

Few symptoms of Obsession are:

Fear of being affected by external elements like germs, etc.
Fear of causing harm to oneself
Disturbing thoughts on sexual harassment
Extreme attention to rituals and religion
Living in constant fear of losing someone or something
Believing in supernatural elements

What is the treatment for Obsessive Compulsive Disorder?

Treatment options are an antidepressant medicine, behavior therapy, or a combination of the two.

Antidepressant medicines

Although these are often used to treat depression, they can also reduce the symptoms of OCD even if you are not depressed. They work by interfering with brain chemicals (neurotransmitters) such as serotonin which may be involved in causing symptoms of OCD.

Antidepressants do not work straight away. It takes 2-4 weeks before their effect builds up and starts to work. They may take up to 10 weeks to work fully. A common problem is that some people stop the medicine after a week or so as they feel that it is doing no good. You need to give them time to work.
Antidepressants are not tranquillizers, and are not usually addictive.
There are several types of antidepressants, each with various 'pros and cons'. For example, they differ in their possible side-effects. However, SSRI antidepressants (selective serotonin reuptake inhibitors) are the ones most commonly used to treat OCD.
The doses needed to treat OCD are sometimes higher than those needed for depression
If it works, it is usual to take an antidepressant for at least a year to treat OCD.

Symptoms can improve by up to 70% if you take an antidepressant. So, although symptoms may not go completely, they usually greatly improve so the obsessions and compulsions are much less of a problem. This can make a big difference to your quality of life.

You should not stop antidepressants suddenly. You should gradually reduce the dose as advised by a doctor at the end of treatment. In some people the symptoms return when medication is stopped. An option then is to take an antidepressant long-term. However, symptoms are less likely to return once you stop antidepressants if you have had a course of behavior therapy (see below).

REASONS WHY MEDICATION MAY NOT WORK SO WELL IN SOME PEOPLE INCLUDE:

The dose is not high enough and needs to be increased.
Medication was not taken for long enough - it may take up to 10 weeks to work.
Side-effects became a problem and so you may stop the medication. Remember, there are different types of antidepressants with different possible side-effects. If one does not suit, you can try another. Tell a doctor if side-effects are troublesome.

Behavior therapy

This aims to change any behaviors which are harmful or not helpful. Various techniques are used. For obsessive compulsive disorder the therapist will usually help you to gradually face up to feared situations, a little bit at a time. This type of behavior therapy is called ‘exposure therapy’.

For example, say you have a compulsion to keep washing your hands in response to an obsessional fear about ‘contamination’ with germs. In this situation the Psychologist may gradually ‘expose’ you to ‘contaminated’ objects. But, the psychologist prevents you from doing your usual compulsion (repeated hand washing) to ease your anxiety about contamination. Instead, the psychologist may teach you how to control any anxiety in other ways. For example, by using deep breathing techniques. In time, you should become less anxious about ‘contamination’ and feel less need to wash your hands so much.

A weekly session is needed for several weeks in most cases. However, about 1 in 4 people with OCD find behavior therapy too stressful and ‘not for them’. Of those who complete a course of therapy, there is a marked improvement in more than 3 in 4 cases. Symptoms may not go completely, but usually the obsessions and compulsions are much less of a problem.

A combination of behavior therapy and medication is probably better than either used alone.

Cognitive therapy

In some cases this may be used in addition to Behavior Therapy (BT). Cognitive Therapy is based on the idea that certain ways of thinking can trigger, or ‘fuel’, certain mental health problems such as obsessions. The therapist helps you to understand your current thought patterns. In particular, to identify any harmful, unhelpful, and ‘false’ ideas or thoughts which you have. The aim is then to change your ways of thinking to avoid these ideas. Also, to help you’re thought patterns to be more realistic and helpful.

For example, if you have OCD it may be helpful to understand that thoughts or obsessions in themselves do no harm, and you do not have to counter them with compulsive acts. The therapist suggests ways in which you can achieve these changes in thinking.

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Sleep Issues or Insomnia

Insomnia, the most common sleep disorder, involves problems getting to sleep or staying asleep. About one-third of adults report some insomnia symptoms, 10-15 percent report problems with functioning during the daytime and 6-10 percent has symptoms severe enough to meet criteria for insomnia disorder. An estimated 40-50 percent of individuals with insomnia also have another mental disorder.

Some of the symptoms of Sleeping related Disorders are:

If you or someone you know is suffering from this disorders, please contact an Best Psychologist in Delhi at GoodPsyche.