Obsessive-Compulsive Disorder (OCD) & Related Disorders

What Is Obsessive-Compulsive Disorder (OCD)?


Obsessive Compulsive Disorder (OCD) is an anxiety disorder that affects approximately 2.2 Adults in the U.S (see statistics at NIMH).  Individuals with OCD experience either obsessions or compulsions or both obsessions and compulsions at the same time. This disorder causes significant anxiety or distress for the individual, may consume excessive amounts of time or may cause interference with an individual’s functioning in life.


What are Obsessions and Compulsions? 


Obsessions are persistent and recurring thoughts, impulses, or images that an individual experiences as intrusive and causes them significant anxiety or distress.  The individual’s obsessions are not just excessive worries about
every-day problems.


Compulsions are repetitive mental acts or behaviors that an individual feels driven to do in response to an obsession, or according to a system of rules.  The behaviors are aimed at reducing distress or preventing a dreaded event (click source DSM V  for further information).

 

Examples of common obsessions:

  • Thoughts of being contaminated, poisoned, exposed to germs, becoming sick, or making others sick.
  • Fear/thoughts of making a mistake.  Having doubts about whether or not you have completed a task or whether it was done correctly (i.e., did I turn off the stove or lock all of the windows)
  • Fear and thoughts or images of harming yourself or other people.
  • Fear and thoughts that things need to be symmetrical, exact or to feel just right.  Intense stress when things are not ordered in a certain way.
  • Fear and thoughts of doing something embarrassing or disgusting.  Having Sexual Obsessions or thoughts that you have done something to violate a religious or moral belief.

 

Examples of common compulsions are:

  • Washing hands excessively
  • Checking to make sure doors are locked
  • Re-reading e-mails to make sure there are no mistakes
  • Checking environment to make sure you have not left anything behind
  • Calling family members to make sure they are safe
  • Researching health concerns on the internet
  • Saving articles to read for fear of missing out on information
  • Having Rituals and rules for cleaning the bathroom or kitchen, washing laundry, or for grooming yourself and rigidly adhering to them
  • Re-ordering books or clothes until it feels symmetrical or just right
  • Participating in mental rituals to prevent something bad from happening.  You might replace a bad thought (i.e., I might kill somebody) with a good thought (i.e., I am a good person or mentally repeating a prayer to counter bad thought).
  • Confessing excessively to family and friends about their bad thoughts
  • Avoidance of situations that might trigger obsessions (i.e., touching bathroom doorknobs for fear of contamination or not looking at knives in the kitchen for fear you might harm self)


What Causes OCD?

Researchers do not have a clear answer yet to what causes OCD. However, some of the signs point to differences in the genes and brains of individuals with OCD.   For more information on the causes and etiology of OCD, please click on Stanford's Website or the International OCD Foundation's Website.


Diagnosis

Diagnosing mental disorders can at times be quite complicated and OCD is often Comorbid with other disorders (i.e. Anxiety Disorders, Eating Disorders, Depression).  It is important to work with your individual therapist to come up with an appropriate diagnosis, if necessary.


Treatments


Psychotherapy:  The general treatment for OCD is psychotherapy, medication, or a combination of the two.  At Vantage Point we use a combination of  Exposure and Response Prevention, and  Acceptance and Commitment Therapyto treat OCD. These therapies are effective for OCD and teach our client's different ways of thinking, behaving, and reacting to situations that help them cope with their OCD and lead more fulfilling lives


Psychotropic Medications:  While some people with OCD do better with just psychotherapy, others do better with medication, and many find the best treatment to be a combination of both. The most commonly prescribed medications for OCD are anti-anxiety medications and SSRI's, but on occasion, doctors will prescribe other types of medications depending on the individuals unique set of symptoms. Some of the medications may take 10 to 12 weeks to start working and some individuals may or may not find them effective on the first attempt at medications.  We recommend that anyone who chooses to take psychotropic medications is closely monitored by a Physician to ensure the safest and most effective treatment possible.  Here at Vantage Point, we work closely with several respected Psychiatrists in the community and your therapist can facilitate that referral.


Other-Related Disorders


Hoarding Disorder

Hoarding Disorder can be characterized as the persistent difficulty with discarding or parting with personal items, regardless of their actual value. Hoarding is comprised of three problem areas: 1) collecting too many things, 2) difficulty getting rid of things, and 3) difficulty organizing. These issues and the amount of clutter associated with them can cause significant impairment in living and also health and safety risks.  For more information on Hoarding Disorder, please visit the International OCD Foundation's website.


What is Hoarding Disorder Treatment Like at Vantage Point?  At Vantage Point we use Cognitive Behavioral Therapy, Skills Training, and Motivational Interviewing for our  Hoarding client's to help free them from there hoarding behaviors, so they can lead more fulfilling lives.


Trichotillomania (Hair-Pulling)

Trichotillomania is an impulse control disorder that causes people to pull out the hair from various areas on their body resulting in noticeable bald spots.   This disorder causes significant distress for clients and can be treated with Psychotherapy and Medication.  For more information about Trichotillomania visit the  Trichotillomania Learning Center.  


What is Treatment Like at Vantage Point?  At Vantage Point we use Cognitive Behavioral Therapy for our hair-pulling clients to help them discover the precise factors that trigger the hair-pulling and to help the client develop skills to interrupt and redirect hair-pulling to more appropriate behaviors.