Everything You Need to Know About OCD

OCD Guide: Everything You Need to Know About OCD

Author: J. Flowers Health Staff

Obsessive compulsive disorder, more commonly known as OCD, is one of the most common mental health disorders. Here is your complete OCD guide to understanding this disorder.

OCD Guide: What is OCD?

Obsessive compulsive disorder, more commonly known by the acronym OCD, is a mental disorder characterized by obsessions and compulsions. Obsessions are excessive and unwanted thoughts. Obsessions can act as a trigger for compulsive behavior, which are repetitive behaviors often thought to remedy the fear and anxiety produced because of obsessions.

OCD Guide: How Common is OCD?

While rare in infants and young children, OCD symptoms can manifest at nearly every age, though it is more common for symptoms to come about in early adulthood.

In the United States, an estimated 2.2 million people have been diagnosed with obsessive-compulsive disorder, which is equivalent to around 1.0% of the entire population. OCD affects men and women at an equal rate, though the type and severity of symptoms may vary.¹

Obsessive compulsive disorder is one of the most common mental health disorders, along with anxiety disorders, panic disorders, and depression.

OCD Guide: How Is OCD Diagnosed?

Recognizing and diagnosing OCD symptoms can be difficult and requires a health professional, who may conduct one or a combination of three main tests.

First, the health practitioner may refer to the diagnostic criteria to ensure that OCD is a plausible source of day-to-day pathological behaviors. The standard for OCD diagnosis can be found in the Diagnostic and Statistical Manual of mental disorders, also known as the DSM-5, which was published by the American Psychiatric Association.

The DSM-5 lists several common signs and symptoms as defined by:²

Recurrent, persistent, and intrusive thoughts, images, and action

Attempts to suppress the aforementioned thoughts and images

Behaviors or thoughts that are time-consuming and unwanted

These disturbances are not better described as another disorder

A mental health professional may also conduct a mental examination to diagnose OCD. This examination allows for the practitioner to study an individual for the descriptors listed in the DSM-5. In some circumstances, with consent, the health practitioner may even reach out to the family and friends of the patient to receive an unbiased description of behaviors for proper OCD diagnosis.

Lastly, a physical examination can ensure that the source of the compulsions and obsessions are caused by OCD and not an underlying illness. If an underlying illness is discovered, treatment for it can start. If OCD symptoms persist, then a re-diagnosis may be considered to test once more for obsessive-compulsive disorder.

OCD Guide: Triggers

While OCD is mainly an executive function disorder revolving around obsessions and compulsions that cause mental distress, certain circumstances can trigger increased symptom prevalence or cause a flare-up. One of the number one triggers for OCD is mental distress. Distress can occur in many forms, but the most common are stress and trauma. Other mental health disorders such as anxiety, depression, or tic disorders can trigger OCD, as can a substance use disorder.

Do I Have GAD or OCD?

Though OCD has outgrown its historic definition as an anxiety disorder, which we will discuss further below, there are still many similarities between GAD (generalized anxiety disorder) and OCD, which can pose a diagnostic difficulty.

When differentiating between GAD and OCD, one of the most important factors to consider is whether the worry is usual. While heightened and more severe, general anxiety is typical and revolves around plausible events. The worry associated with OCD is heightened by the obsession and made better by compulsions, and it is not uncommon for it to revolve around unusual and unlikely events.

The best way to determine whether you have GAD or OCD is to learn more about both and their symptoms.

What is GAD?

GAD is the acronym for generalized anxiety disorder, which refers to severe and continuous anxiety which can occur at any age.

The keystone symptom of generalized anxiety disorder is disruptive anxiety and worry about day-to-day life – sometimes severe enough to impair daily life. Many times, GAD and OCD exist together and require dual diagnosis and treatment. OCD obsessions and compulsions can lead to the development of GAD because of severe impulsive thoughts or the worry of incomplete compulsions and their consequences.

While treating OCD may aid in the treatment of GAD, sometimes generalized anxiety disorder can cause OCD symptoms to manifest. Thus, treating GAD can reduce the severity and occurrence of OCD symptoms.

Why is OCD Not an Anxiety Disorder?

In the fourth edition of the DSM, obsessive-compulsive disorder had been considered an anxiety disorder. This aspect changed in the fifth edition, where OCD is now categorized as obsessive-compulsive and similar disorders. There are two specific reasons for this change.

First, imaging research has shown that the neurochemistry of OCD is different compared to that of anxiety disorders. OCD is also rooted in executive function rather than emotional processing, though the symptoms experienced with OCD can lead to emotional process disorders such as generalized anxiety disorder.³

OCD Guide: Symptoms in Adults

The main symptom of OCD in adults can be surmised as a repeating cycle of unwanted thoughts followed by rituals, or compulsions, to alleviate the associated anxiety. However, OCD can also manifest in different symptoms depending on the severity of the disorder. Some of the other OCD symptoms in adults can include:

Difficulty concentrating

Self-isolation

Other mental health disorders such as depression or anxiety

Unusual anxiety

OCD Guide: Symptoms in Children

While OCD is less common in younger children than teenagers and adults, it still occurs, though the manifestation of symptoms may differ. Symptoms of obsessive-compulsive disorder in children can include:

Having trouble concentrating

Irritability

Indecisiveness

Taking too long to do everyday tasks

Perfectionism

Diagnosing OCD in children can be difficult due to the overlap between signs and a developing personality. It is especially difficult in children who are too young to articulate their feelings and the symptoms that they are experiencing, leaving parents to rely on external signs alone.

Although OCD presents equally among men and women in adulthood, the statistic is not the same for youth. During childhood, boys are more likely to develop and demonstrate the signs and symptoms of OCD over girls, who tend to develop the disorder later into adolescence.

How are OCD and Addiction Connected?

Obsessive compulsive disorder is a highly disruptive disease that can decrease day-to-day quality of life. Severe obsessions and compulsive behavior can cause severe mental distress, which is why adolescents and young adults who develop OCD at an early age are more likely to develop a substance use disorder later in life.

In over 25% of individuals seeking treatment for OCD, dual diagnosis is needed for a substance use disorder, and the risk of addiction is increased proportionally with the early onset of symptoms. Those developing obsessions and compulsions at an early age are more at risk for addiction.⁴Often, substance abuse and misuse are used to treat the symptoms that occur because of OCD.

Since the disorder itself is not being treated, however, substances only provide temporary relief. As misuse continues and tolerance builds, the risk for the development of addiction is increased greatly.

Is OCD Social Isolation a Factor in Addiction?

Humans are social animals. As a result, positive social interaction is an important aspect of a healthy life. The obsessions and compulsions of OCD, though, can make maintaining relationships and meeting societal expectations such as work or school difficult.

The effects of this disorder are internal as well as external. Studies have shown that a leading cause of addiction is social isolation. Being alone can heighten feelings of anxiety or depression, which can act as a trigger for those suffering from a substance use disorder.

OCD Guide: Effects

OCD can affect individuals in many ways depending on a variety of other factors. For some, OCD is a manageable though inconvenient part of every day, while for others, OCD makes everyday tasks and activities significantly more difficult.

Each component of OCD, the obsessions and compulsions, can impact the body and the mind in their distinct own ways. There are a few notable differences between compulsions vs obsession and understanding these differences can be beneficial in understanding the disorder better.

Obsessions

Obsessions are intrusive and unwanted thoughts that can appear in the form of hypothetical situations, images, or other unwelcomed impulses. For many, obsessions are persistent and unusual anxiety that can be triggered by different circumstances.

Common Types of Obsessions

Common types of obsessions include:

Contamination or otherwise becoming dirty (physically or morally such as through sin)

Acts of violence against self or others

Intrusive sexual thoughts or images

Fears of carelessness (such as leaving doors unlocked or ovens on)

Physical illnesses

Superstition and supernatural

Effects of Obsessions

Obsessions can lead to the individual seeking different forms of remedies to alleviate the associated anxiety and sense of dread. While the disorder itself encompasses obsessions being followed by compulsions, substance use disorders and addictions can also become an effect of obsessions.

Addiction vs Obsessions

There are a few differences between addictions vs obsessions. Obsessions are negative and intrusive thoughts that, with OCD, are temporarily remedied by compulsions. Addiction can occur as a dual diagnosis with OCD.

Compulsions

Compulsions are actions or behaviors that occur to alleviate the anxiety and stress of obsessions.

Common Types of Compulsions

The most common types of compulsions or rituals are:

Washing compulsions (including handwashing)

Checking compulsions

Religious or otherwise spiritual rituals including praying

Hoarding

Arranging and rearranging

Effects of Compulsions

Compulsions can lead to a variety of effects depending on the type of compulsions. Washing compulsions can lead to dermatitis due to frequent hand washing, while hoarding can decrease quality of life. The impact and severity of the effect of compulsions vary.

Addiction vs Compulsion

While both addiction and compulsion can be a response to obsessions, they do have differences. Learning the difference between addiction vs. compulsion can be beneficial when seeking treatments.

Compulsions usually align with the obsessions: for example, a contamination obsession can cause a washing compulsion. Addiction, however, usually occurs as a response to self-treatment in which a substance use disorder develops to manage symptoms.

OCD Guide: Complications

Both the obsessive and compulsive aspects of OCD can lead to complications. One of the most concerning complications is isolation.

For many people with OCD, the ritualistic behaviors that come as a result of obsessions and compulsions can lead to isolation. This isolation can be due to fear as well as the inability to complete compulsions outside of the home. Studies have shown that isolation is one of the key causes of several other mental health disorders, including depression and substance use disorders.

OCD can also create difficulty in social interactions. This struggle can manifest in the form of difficulty attending social activities and responsibilities as well as trouble maintaining relationships. It can further increase the isolation experienced because of obsessive-compulsive disorder.

As a result, OCD can lead to an increased risk for suicide, from both the development of other mental health disorders as well as the severity of symptoms. OCD is a disruptive disorder the impairs daily life, greatly reducing the quality of life for many individuals.

OCD and Genetics

Obsessive compulsive disorder can be caused by a variety of factors, including someone’s genetics. Studies in molecular science have identified a series of genes with the potential to cause OCD, though further research will still be required to establish a clear connection between genetics and the prevalence and manifestation of obsessive compulsive disorder.

Obsessions and compulsions are not only prevalent in OCD, though they are the namesake keystone for this disorder. Both of these components can be found in other conditions, including those with a genetic origin. Studies have also demonstrated that affecting the levels of serotonin in the brain has proved efficient in controlling obsessions and compulsions, indicating a biological disorder rather than purely psychiatric.

As mentioned above, obsessive compulsive disorder also demonstrates unique brain pathways in imaging. As a result, while the evidence is still being gathered through research, it is highly plausible that OCD occurs because of genetics.

Treating a Dual Diagnosis of OCD and Addiction

For many mental health disorders, including OCD, addiction can be a significant risk – more so than compared to individuals without any conditions. As a result, treating dual diagnosis is a significant step in treating OCD while also aiding in recovery from addiction for people with substance use disorders.

What is a Dual Diagnosis?

Dual diagnosis is a condition in which the body is affected by two different disorders. The first would be a mental health disorder, such as OCD. Without proper treatment, mental health disorders can lead to self-treatment, which can result in addiction. When a mental health disorder is combined with a substance use disorder, which most often develops as an effect of the former, this situation is a dual diagnosis.

How Taking an OCD Test Could Benefit You?

For those suffering from a different mental health disorder, such as a substance use disorder, taking an OCD test to screen for the disorder can be beneficial for dual diagnosis.

By identifying and diagnosing OCD, especially earlier in life as soon as symptoms and signs begin to manifest, treatment can begin earlier. This early treatment can decrease the symptom’s severity while also decreasing the risk for other mental health disorders. Undergoing screening can also provide health answers for other disorders with ambiguous origins.

OCD Guide: Treatment

There is no current cure for obsessive compulsive disorder. However, there are many treatments available that help reduces the severity and occurrence of symptoms to restore ease in day-to-day living for an increased quality of life. The two most common forms of OCD treatment are medication and psychotherapy, although some individuals have also turned to brain mapping.

Medication

While medication cannot cure OCD, it can treat many of the side effects and symptoms. Some of the medication used in the treatment of OCD include:

Clomipramine

Fluoxetine

Fluvoxamine

Paroxetine

Sertraline

Psychotherapy

Psychotherapy can occur in different forms, though many of the ones utilized for treating OCD aim to establish a healthier connection between the mind and behaviors. Cognitive-behavioral therapy (CBT) is one of the most common, but it is not the only form of therapy available.

Brain Mapping

Another method of treatment for OCD is brain mapping, which utilizes neuroscience to create an appropriate treatment plan.

How Can Brain Mapping Help in OCD Treatment?

Brain mapping itself is a step in the treatment of OCD rather than the sole treatment. Brain mapping allows for medical professionals to form an image of one’s brain, allowing these professionals to understand how the brain functions. This discovery can be beneficial in identifying triggers and otherwise problematic areas for treatment.

What is Brain Mapping?

Brain mapping utilizes different techniques of neuroscience to map the brain and analyze brain waves. The result of brain mapping is maps that can then be used to identify triggers and sources of OCD symptoms.

For dual diagnosis, brain mapping can provide additional benefits by helping to identify the triggers of substance use disorder.

Neurofeedback Therapy

Neurofeedback therapy, also known as neurotherapy, utilizes electroencephalography (EEG) to measure brain waves. During OCD treatment, neurofeedback therapy is used alongside brain mapping to provide a comprehensive image of the brain and its function.

Process of Neurofeedback

Because OCD is a disorder that originates in the brain, identifying, regulating, and altering brain waves can help treat the associated symptoms. Many sessions revolve around rewarding the patient for beta waves and positive brain function to alter function away from pathophysiology.

How to Prepare for Neurofeedback

The best way to prepare for neurofeedback is to avoid and reduce factors that could negatively affect your sessions. This includes reducing stress and anxiety beforehand healthily and naturally, such as going to the gym, while avoiding substances like excessive sugar and caffeine.

It is also vital to wash your hair before your appointment and avoid using styling products so you can provide a clean surface for the receptors to attach to.

How Many Sessions Would You Need?

While the number of sessions varies between individuals and depends on the severity of symptoms and the disorder itself, patients seeking neurofeedback for OCD have been able to see results within only a few sessions.

Benefits Of Brain Training for OCD

The main benefit of brain training for OCD is that it provides a continuous treatment. Since brain training focuses on rerouting how the brain functions, results continue even during periods of hiatus, unlike medication.

Brain training is also a newer, innovative form of treatment for OCD that, though lacking the quantity of research compared to older, more traditional methods of treatment, shows positive results in patients.