14 Jan

Obsessive-compulsive disorder is characterized by unreasonable thoughts and fears (obsessions) that lead to compulsive behaviors.

Obsessions are thoughts, images or impulses that occur over and over again and feel outside of the person’s control. Individuals with OCD do not want to have these thoughts and find them disturbing. In most cases, people with OCD realize that these thoughts don’t make any sense.  Obsessions are typically accompanied by intense and uncomfortable feelings such as fear, disgust, doubt, or a feeling that things have to be done in a way that is “just right.” In the context of OCD, obsessions are time consuming and get in the way of important activities the person values. This last part is extremely important to keep in mind as it, in part, determines whether someone has OCD — a psychological disorder — rather than an obsessive personality trait.

Unfortunately, “obsessing” or “being obsessed” are commonly used terms in everyday language. These more casual uses of the word means that someone is preoccupied with a topic or an idea or even a person. “Obsessed” in this everyday sense doesn’t involve problems in day-to-day living and even has a pleasurable component to it. You can be “obsessed” with a new song you hear on the radio, but you can still meet your friend for dinner, get ready for bed in a timely way, get to work on time in the morning, etc., despite this obsession. In fact, individuals with OCD have a hard time hearing this usage of “obsession” as it feels as though it diminishes their struggle with OCD symptoms.

Whilst OCD is considered an anxiety disorder, OCPD, as the name suggests, is actually a personality disorder. It’s also possible to suffer from both OCD and OCPD simultaneously

OCD often centers on themes such as a fear of germs or the need to arrange objects in a specific manner. Symptoms usually begin gradually and vary throughout life.

The cause of OCD is unknown.There appear to be some genetic components, and it is more likely for both identical twins to be affected than both fraternal twins. Risk factors include a history of child abuse or other stress-inducing events; some cases have occurred after streptococcal infections.Diagnosis is based on presented symptoms and requires ruling out other drug-related or medical causes; rating scales such as the Yale–Brown Obsessive Compulsive Scale (Y-BOCS) assess severity.Other disorders with similar symptoms include generalized anxiety disorder, major depressive disorder, eating disorders, tic disorders, and obsessive–compulsive personality disorder.The condition is also associated with a general increase in suicidality

OCD can start at any time from preschool to adulthood.
Although OCD can occur at any age, there are generally two age ranges when OCD tends to first appears:

  • Between the ages 8 and 12.
  • Between the late teen years and early adulthood.

OCD can present with a wide variety of symptoms. Certain groups of symptoms usually occur together; these groups are sometimes viewed as dimensions, or clusters, which may reflect an underlying process. The standard assessment tool for OCD, the Yale–Brown Obsessive Compulsive Scale (Y-BOCS), has 13 predefined categories of symptoms.

Obsessive-compulsive disorder usually includes both obsessions and compulsions. But it’s also possible to have only obsession symptoms or only compulsion symptoms. You may or may not realize that your obsessions and compulsions are excessive or unreasonable, but they take up a great deal of time and interfere with your daily routine and social, school or work functioning.

OCD obsessions are repeated, persistent and unwanted thoughts, urges or images that are intrusive and cause distress or anxiety. You might try to ignore them or get rid of them by performing a compulsive behavior or ritual. These obsessions typically intrude when you’re trying to think of or do other things.

Obsessions often have themes to them, such as:

  • Fear of contamination or dirt
  • Doubting and having difficulty tolerating uncertainty
  • Needing things orderly and symmetrical
  • Aggressive or horrific thoughts about losing control and harming yourself or others
  • Unwanted thoughts, including aggression, or sexual or religious subjects

Examples of obsession signs and symptoms include:

  • Fear of being contaminated by touching objects others have touched
  • Doubts that you’ve locked the door or turned off the stove
  • Intense stress when objects aren’t orderly or facing a certain way
  • Images of driving your car into a crowd of people
  • Thoughts about shouting obscenities or acting inappropriately in public
  • Unpleasant sexual images
  • Avoidance of situations that can trigger obsessions, such as shaking hands

Compulsion symptoms
OCD compulsions are repetitive behaviors that you feel driven to perform. These repetitive behaviors or mental acts are meant to reduce anxiety related to your obsessions or prevent something bad from happening. However, engaging in the compulsions brings no pleasure and may offer only a temporary relief from anxiety.

You may make up rules or rituals to follow that help control your anxiety when you’re having obsessive thoughts. These compulsions are excessive and often are not realistically related to the problem they’re intended to fix.

As with obsessions, compulsions typically have themes, such as:

  • Washing and cleaning
  • Checking
  • Counting
  • Orderliness
  • Following a strict routine
  • Demanding reassurance

Examples of compulsion signs and symptoms include:

  • Hand-washing until your skin becomes raw
  • Checking doors repeatedly to make sure they’re locked
  • Checking the stove repeatedly to make sure it’s off
  • Counting in certain patterns
  • Silently repeating a prayer, word or phrase
  • Arranging your canned goods to face the same way

OCD is not a joke
OCD is a disorder characterized by obsessive thoughts that lead to compulsions. Compulsions are repetitive acts that a person is driven to carry out, in spite of knowing that they are meaningless, unnecessary and excessive. OCD ranges from being mild to being a severely debilitating condition. The symptoms of OCD are complex and can manifest in many different ways. While preoccupation with contamination fears and washing and cleaning are the frequent manifestations, other typical symptoms of OCD include doubts about daily activities and excessive checking or repeating, obsessions of harm and aggression, blasphemy, sexual thoughts, superstitious behaviors and excessive concern with symmetry and orderliness.

Some OCD cases are even characterized by counting compulsions—
as in the case of 30-year-old Satish*, a bank cashier who suffered from a doubt that he was not counting currency notes properly before handing them over to customers. So Satish ended up counting the notes over and over again and soon irate customers were shouting at him for his slowness, and the bank manager decided to send him a memo for being inefficient.

OCD is also characterized by intrusive thoughts, which could range from an irrational fear of contracting a certain disease to constant pondering on what happens after death. The sufferer unendingly looks for a respite from these thoughts and the fact that these thoughts are not produced voluntarily makes it even more distressing for the person.

The cause of obsessive-compulsive disorder isn’t fully understood. Main theories include:

  • Biology. OCD may be a result of changes in your body’s own natural chemistry or brain functions.
  • Genetics. OCD may have a genetic component, but specific genes have yet to be identified.
  • Learning. Obsessive fears and compulsive behaviors can be learned from watching family members or gradually learned over time.

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.
  • Stressful life events. 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.
  • Other mental health disorders. OCD may be related to other mental health disorders, such as anxiety disorders, depression, substance abuse or tic disorders.

Problems resulting from obsessive-compulsive disorder may include, among others:

  • Excessive time spent engaging in ritualistic behaviors
  • Health issues, such as contact dermatitis from frequent hand-washing
  • Difficulty attending work, school or social activities
  • Troubled relationships
  • Overall poor quality of life
  • Suicidal thoughts and behavior

Treatment – obsessive compulsive disorder (OCD)
People often use the phrases “obsessing,” “obsessed” and “OCD” very casually in everyday conversations. But OCD, according to the DSM-V, is diagnosed based on specific factors:

  • The person has obsessions, compulsions or both.
  • The obsessions or compulsions take up a lot of time (more than an hour per day).
  • The obsessions or compulsions cause distress or affect participation in social activities, work responsibilities or other life events.
  • The symptoms aren’t caused by drugs, alcohol, medications or another medical problem.
  • The symptoms aren’t explained by another mental disorder (such as generalized anxiety disorder, eating disorder or body image disorder).

The 3 main treatments are:

  • psychological therapy – usually a type of therapy that helps you face your fears and obsessive thoughts without “putting them right” with compulsions
  • medicine – usually a type of antidepressant medicine that can help by altering the balance of chemicals in your brain
  • Yoga – yoga tends to be an adjunct therapy.. The reason being – there will be no ill side effects, from Yoga practice, while a patient is working toward a recovery.

A short course of therapy is usually recommended for relatively mild OCD. If you have more severe OCD, you may need a longer course of therapy and/or medicine.

These treatments can be very effective, but it’s important to be aware that it can take several months before you notice the benefit.

Psychological therapy
Therapy for OCD is usually a type of cognitive behavioral therapy (CBT) with exposure and response prevention (ERP).
This involves:

  • working with your therapist to break down your problems into their separate parts, such as your thoughts, physical feelings and actions
  • encouraging you to face your fears and have obsessive thoughts without neutralizing them with compulsive behaviors; you start with situations that cause the least anxiety first, before moving on to more difficult thoughts

The treatment is difficult and may sound frightening, but many people find that when they confront their obsessions, the anxiety eventually improves or goes away.

People with fairly mild OCD usually need about 10 hours of therapist treatment, with exercises done at home between sessions. If you have more severe OCD, you may need a longer course of treatment.

You may need medicine if psychological therapy does not help treat your OCD, or if your OCD is fairly severe. The main medicines prescribed are a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs). An SSRI can help improve OCD symptoms by increasing the levels of a chemical called serotonin in your brain.

You may need to take an SSRI for 12 weeks before you notice any benefit. Most people need treatment for at least a year. You may be able to stop if you have few or no troublesome symptoms after this time, although some people need to take an SSRI for many years.

Do not stop taking an SSRI without speaking to your doctor first because suddenly stopping can cause unpleasant side effects. Treatment will be stopped gradually to reduce the chance of getting side effects. Your dose may need to be increased again if your symptoms return.

OCD support groups
Many people with OCD find support groups helpful, as they can:

  • provide reassurance and coping advice
  • reduce feelings of isolation
  • offer a chance to socialize with others
  • provide information and advice for family members and friends

Yoga has been found to help people manage their stress levels, improve their mood and even reduce symptoms of depression. Yoga can also help manage obsessive-compulsive disorder (OCD), a chronic mental health condition consisting of intrusive thoughts and compulsive behaviors.

Obsessive Compulsive Disorder, more commonly referred to as OCD, is a grossly misunderstood and all-too-frequently trivialized condition. Indeed, it has been referred to by sufferers as a ‘waking nightmare’. OCD is defined as a mental health condition and typically presents as obsessive thoughts and compulsive activity. Obsessions are unwanted and unpleasant thoughts, images, or urges that repeatedly enter a person’s mind, causing feelings ranging from mild unease to clinical-level anxiety. A compulsion is a repetitive behavior or mental act that a person feels they must carry out in order to temporarily relieve the often overwhelming feelings ignited by the obsessive thought. For example, a person with a fear of becoming ill may repeatedly and compulsively check the use-by-date on food items to ensure they are not eating anything that could potentially be contaminated.

As is the case with the other anxiety disorders, OCD symptoms can range from mild to severe, with some people engaged in obsessive-compulsive behaviors for a minimal proportion of their day whilst others experience their lives as being completely taken over by these thoughts and behaviors. We are still unsure of what causes OCD although it is clear that it is often preceded by acute anxiety. It is experienced by men, women and children alike, although it most commonly emerges in adolescence.

Given OCD’s strong links with anxiety, with a correlation between yoga and anxiety reduction having been noted in many studies, it would make a tremendous amount of sense to assume that yoga could have some therapeutic benefits for this population. There is a shameful dearth of research into this area however.

The few other earlier studies on yoga for OCD have also been hopeful. Two year-long clinical trials have been conducted, for example, to test the efficacy of yoga and meditation techniques for the treatment of OCD, one of which was a randomized controlled trial. The yoga group demonstrated greater and statistically significant decreases in a range of OCD-related symptoms.