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OCD or Obssesive Compulsive Disorder Management

 

 

Obsessive-Compulsive Disorder (OCD) is a potentially disabling psychiatric/mental disorder characterized by obsessive thoughts and/or compulsive behaviors that significantly interfere with normal life. Obsessions are unwanted, recurrent, and disturbing thoughts which the person cannot suppress and which can cause overwhelming anxiety. Compulsions are repetitive, ritualized behaviors that the person feels driven to perform to alleviate the anxiety of the obsessions. Approximately 80 percent of patients with OCD have both obsessions and compulsions; 20 percent have only obsessions or only compulsions. The obsessive and compulsive rituals can occupy many hours of each day.

The symptoms of OCD, which are the obsessions and compulsions, may vary. Common obsessions include:

  • Fear of dirt or contamination by germs.
  • Fear of causing harm to another.
  • Fear of making a mistake.
  • Fear of being embarrassed or behaving in a socially unacceptable manner.
  • Fear of thinking evil or sinful thoughts.
  • Need for order, symmetry, or exactness.
  • Excessive doubt and the need for constant reassurance.

Common compulsions include:

  • Repeatedly bathing, showering, or washing hands.
  • Refusing to shake hands or touch doorknobs.
  • Repeatedly checking things, such as locks or stoves.
  • Constant counting, mentally or aloud, while performing routine tasks.
  • Constantly arranging things in a certain way.
  • Eating foods in a specific order.
  • Being stuck on words, images or thoughts, usually disturbing, that won't go away and can interfere with sleep.
  • Repeating specific words, phrases, or prayers.
  • Needing to perform tasks a certain number of times.
  • Collecting or hoarding items with no apparent value.

Causes of OCD?

Although the exact cause of OCD is not fully understood, studies have shown that a combination of biological and environmental factors may be involved.

1. Biological factors: Research has found a link between low levels of one neurotransmitter - called ‘serotonin’ and the development of OCD. In addition, there is evidence that a serotonin imbalance may be passed on from parents to children. This means the tendency to develop OCD may be inherited. Some studies that compare images of the brains of people who have obsessive-compulsive disorder with the brains of those who don't, show differences in brain activity patterns. Certain areas of the brain appear to be affected by the ‘serotonin’ imbalance that leads to OCD. This problem seems to involve the pathways of the brain that link the area of the brain that deals with judgment and planning, and the area of the brain that filters messages involving body movements. In addition, people with obsessive-compulsive disorder who take medications that enhance the action of serotonin (selective serotonin reuptake inhibitors- SSRI ) often have fewer OCD symptoms.

Streptococcal infection: Some studies suggest that some children develop OCD after infection with group A beta-hemolytic streptococcal pharyngitis. However, these studies are controversial and more evidence is needed.

2. Environmental Factors: 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
  • Death of a loved one
  • Work or school related changes or problems
  • Relationship concerns

Diagnosis:

A diagnosis of obsessive-compulsive disorder (OCD) is based on your symptoms, medical history, and a physical examination. Your doctor may also want a mental health assessment, which is an evaluation of your emotional functioning and your ability to think, reason, and remember (cognitive functioning). A mental health assessment may include an examination of your nervous system, written or verbal tests, and laboratory tests (such as blood and urine tests) as well as a review of your appearance, mood, behavior, thinking, reasoning, memory, and ability to express yourself.

Many people with OCD live with the condition for years before being diagnosed, or they go without treatment because they are afraid or embarrassed to talk about their symptoms. Answers to three initial questions may help your health professional diagnose whether you have OCD:

  • Do you have repeated thoughts that cause anxiety and that you cannot get rid of no matter how hard you try?
  • Do you wash your hands frequently or keep things extremely clean and neat?
  • Do you excessively check things?

If your doctor suspects you have OCD, he or she will look for a full range of symptoms that will confirm the diagnosis, including:

  • Recurrent and persistent thoughts, impulses, or images that are intrusive and inappropriate, cause anxiety or distress, and are not simply excessive worries about real-life issues.
  • Attempts to suppress or ignore the thoughts or get rid of them with other thoughts or actions.
  • Recognition that the obsessions are created in your own mind and don't make sense.
  • Repetitive behaviors, such as hand-washing, ordering, praying, or checking that you're driven to do in response to the obsession. The behaviors are aimed at preventing or reducing distress or preventing a dreaded event.

For a diagnosis of OCD, the obsessions or compulsions must be time-consuming (more than 1 hour a day) or greatly interfere with your normal routine at work or school and affect social activities and relationships.

Early Detection

Early detection and proper treatment is very important in improving the course of OCD. This disorder is often a long-lasting (chronic) condition that will need to be monitored throughout your life.

Risk factors

Factors that may increase the risk of developing or triggering obsessive-compulsive disorder include:

  • Family history. Having parents or other family members with the disorder can increase your risk of developing OCD. However, researchers haven't identified any genes responsible for obsessive-compulsive disorder.
  • Stressful life events. If you tend to react strongly to stress, your risk may increase. This reaction may, for some reason, trigger the intrusive thoughts, rituals and emotional distress characteristic of obsessive-compulsive disorder.
  • Pregnancy. Some studies show that pregnant women and new mothers are at increased risk, but it's not clear why. In these cases, OCD symptoms center mainly on thoughts of harming the baby.

Obsessive-compulsive disorder often begins during early childhood or adolescence, usually around age 10. In adults, OCD typically begins around age 21. It strikes men and women equally One-third of adults with OCD develop symptoms as children.

What Happens

With obsessive-compulsive disorder (OCD), you develop disturbing, obsessive thoughts that cause fear or anxiety. In order to rid yourself of these thoughts and relieve the fear, you perform rituals, such as repeated hand-washing or checking that something has been done. Unfortunately, the relief is only temporary. The thoughts return and you repeat the rituals.

The rituals or behaviors become time-consuming and have a significant impact on your daily life. If your particular fear involves unfamiliar situations, it is possible for you to become so obsessed by the fears that you stop going outside of your home. Quality of life can be substantially lowered by OCD since it can greatly affect your ability to work and have relationships.

Many people are too embarrassed by their symptoms to seek treatment, and they go for years before seeing a doctor. Symptoms of OCD can be reduced with treatment.

OCD can have a negative effect on those who care about you. Family members can become angry and frustrated at the strain the rituals or behaviors put on them. Talk to your health professional about ways your family members can help with OCD. en.

 

Complications

Complications that obsessive-compulsive disorder may cause or be associated with include:

  • Suicidal thoughts and behavior
  • Alcohol or substance abuse
  • Other anxiety disorders
  • Depression
  • Eating disorders
  • Contact dermatitis from frequent hand washing
  • Inability to attend work or school
  • Troubled relationships
  • Overall poor quality of life

How Is Obsessive-Compulsive Disorder Treated?

OCD will not go away by itself, so it is important to seek treatment. The most effective approach to treating OCD combines medications with counseling.

  • Counseling: Counseling for the disorder includes a type of cognitive-behavioral therapy called exposure and response prevention. The goal of cognitive-behavior therapy is to teach people with OCD to confront their fears and reduce anxiety without performing the ritual behaviors. It also focuses on reducing the exaggerated or catastrophic thinking that often occurs in people with OCD.
  • Medication therapy: In allopathic system, Tricyclic antidepressants, such as Anafranil, and selective serotonin reuptake inhibitor (SSRI) antidepressants, such as Paxil, Prozac and Zoloft may be given to help to the people with OCD. But these medicines produce lots of side effects and unwanted symptoms and many times complicate the conditions.
  • Homeopathic medication: Homeopathic treatment helps a lot to a OCD patient if given constitutionally along with counseling.
  • Electroconvulsive therapy (ECT): In severe cases of OCD and in people who do not respond to medical and behavioral therapy, electroconvulsive therapy (ECT) or psychosurgery may be used to treat OCD. During ECT, electrodes are attached to the patient's head, and a series of electric shocks are delivered to the brain, which induce seizures. The seizures cause the release of neurotransmitters in the brain.
  • Surgery: A surgical procedure called bilateral cingulotomy interrupts the pathway of the brain involved in the development of OCD. With the pathway disrupted, OCD symptoms should stop. This procedure also may be done using stereotactic radiosurgery, also called a Gamma Knife. The Gamma Knife is a non-surgical machine that emits hundreds of powerful, highly focused gamma radiation beams aimed at the area of the brain where the problem is located.

How Can Someone Get Help for OCD?

People who think they have OCD or think they know someone who might have should talk to a psychiatrist.

You have OCD if:

1. You spend a lot of time thinking about (or avoiding) your obsessions and/or performing your compulsions.

2. You feel quite anxious or nervous most of the time.

3. Your daily life is significantly affected by it. For example, your OCD might cause you to take hours to do a small task (e.g., writing a casual email), get in the way of spending time with your family and friends, or prevent you from meeting work deadlines or even getting out of the house.

What you should know about OCD

  • OCD is a psychiatric illness recognized by experts throughout the world.
  • OCD is an anxiety disorder characterized by symptoms that can include powerful, unwanted, or recurrent thoughts and/or compulsive, repetitive behaviors.
  • OCD is the fourth most common mental illness and affects over 4 million people in the United States.
  • People with OCD are not "crazy," although they may sometimes feel that way because they are troubled by thoughts and actions that they know are inappropriate.
  • People with OCD are often anxious and depressed.
  • People with OCD often believe they are the only ones who have irrational, obsessive thoughts, and are therefore often ashamed and afraid to tell anyone or to seek help. Diagnosis is delayed until these symptoms are "unmasked."
  • Having OCD is not a sign of weakness or a lack of willpower in stopping the thoughts and behaviors.
  • Although the exact cause is not known, experts believe that OCD may be caused in part by an imbalance of a chemical in the brain called serotonin.

Treatment of OCD:

OCD is a treatable disease; effective homeopathic medications, counseling, psychotherapy, hypnotherapy, and behavioral therapy can cure OCD completely if utilized at proper time.

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