Obsessive Compulsive Disorder

Obsessive Compulsive Disorder (OCD) comprises obsessions and compulsions. Obsessions are unwanted, intrusive ideas, thoughts, or images that repeatedly bombard the mind. These thoughts cause extreme discomfort or anxiety which in turn leads to strong urges to do something to reduce this anxiety. For example, a person might have the obsessive thought that he is going to get sick from certain germs, or cause harm to others by not being careful enough. These obsessions cause the person extreme distress or anxiety. Compulsions are the rituals or behaviors that a person feels driven to perform in order to relieve the distress or anxiety caused by the obsessions. Compulsions are the conscious actions that a person takes to reduce anxiety.

There are 3 types of compulsions. The most common are the physical compulsions. These are usually easy to identify. Examples would be excessive washing, excessive checking or repetitive behaviors. Another form of compulsion are mental compulsions. These are mental exercises that a person might do to alleviate the anxiety caused by the obsessive thought. Common examples are thinking good thoughts to neutralize a bad thought,  or replaying a scene over and over in ones head to reassure oneself that nothing bad happened.  The third type of compulsion is avoidance.  For example, one might avoid touching door knobs for fear of contamination or a person might avoid driving because they fear causing an accident.

Unfortunately, performing these compulsions will only provide temporary relief from the anxiety. The obsession returns in a short period of time.  The compulsions become more and more time consuming, and more and more elaborate in order to get just transient relief. Ultimately, the emotional distress from the obsessions and the time and energy taken up with the compulsions will take a toll on a persons day to day functioning, affecting their relationships, their work and their self esteem. 

Although the person with OCD knows at some level  that their obsessions and compulsions don't make sense, they are nevertheless driven to keep doing the compulsions by their extreme discomfort.

OCD occurs in about 2-3% of the population. It is in fact the 4th most common psychiatric condition. It is roughly equal in distribution among the sexes, although men tend to get it a little earlier in life.

 The tried and tested treatment for OCD is a form of Cognitive Behavior Therapy known as Exposure and Response Prevention. This involves the gradual exposure of a person to the object or situation that causes anxiety. The person then has to refrain from doing the compulsions associated with that fearful situation. Over a short period of time, and with repetition the anxiety associated with the obsessions begins to diminish and the urge to do the compulsions also decreases.

Of course, to the person with OCD, this kind of therapy may sound as uncomfortable as the OCD itself. However, the therapy is done in a graduated manner, typically starting with the least distressing obsessions and slowly working up to the more distressing obsessions.



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