Obsessive compulsive disorder, also known as OCD, is a personality disorder characterized by series of unwanted thoughts that cause a person to perform an unwanted action. This results in obsessions and compulsions. According to the National Institute of Mental Health, approximately 2.2 million Americans are affected by OCD every year. Ultimately, the condition affects people differently; however, OCD can present numerous symptoms to support a diagnosis.
Identifying Symptoms
According to the American Psychiatric Association, there are five criteria used to confirm a diagnosis of OCD.
Criteria A requires that the patient experience recurrent obsessions or compulsions.
Criteria B requires the patient to recognize that obsessions or compulsions are excessive or unreasonable, and that they need help to overcome them.
Criteria C requires that obsessions or compulsions are filling a significant amount of the sufferer's time, or they're disruptive to the patient's overall functioning.
Criteria D requires that the obsessions or compulsions are not caused by a previously diagnosed mental illness or disorder.
Criteria E fequires that the obsessions or compulsions are not the result of substance abuse, a side effect of a medication or due to another medical illness.
Obsessive Symptoms
Obsessions are unwanted or uncontrollable ideas, thoughts or impulses. Obsessions often have themes. The patient feels compelled by these thoughts to take some type of action that will rectify the perceived issue or problem. Common obsessive symptoms include: fear of contamination or dirt, an obsession with order and symmetry, aggressive or horrific impulses, sexual images or thoughts, impulses to shout obscenities, intense distress around fixing things or strong doubts about locking doors or turning off electronics. Some obsessive symptoms of OCD are more visible due to the action taken to "relieve" the obsession. For example, many OCD patients will have dermatitis as a result of frequent hand washing due to an extreme fear of germs. Skin lesions from picking at the skin or hair loss and bald spots from hair pulling are also common.
Compulsive Symptoms
Compulsions are repetitive behaviors performed to decrease anxiety or distress caused by an obsessive thought. Compulsions are much easier to identify as the patient takes action to relieve perceived demands of the obsessive thought. Although these can be common actions that many people routinely demonstrate, the difference is that the compulsive patient performs these actions in a highly specific or unusual way. Common compulsions include frequent handwashing or cleaning, repetitive counting or counting in patterns, constant checking or distress around checking to see if doors are locked or electronics are turned off, demanding reassurances to ease worries or turning cans or books so that the labels or words all read the same way.
Treatment of Symptoms
Treatment for OCD is varied, but initial treatment is focused on identifying the cause of these symptoms. Patients suffering from OCD may be treated with exposure and response prevention or cognitive therapy. Exposure and response prevention therapy is aimed at exposing the obsession the patient is experiencing and teaching him behaviors to avoid a compulsion. Cognitive therapy focuses on identifying the unreasonableness behind the obsessions and compulsions. Antidepressants might be used to treat OCD. Family therapy may be introduced to educate family members on the characteristics of OCD and how it is impacting their loved. Those who are suffering from OCD often feel disabled and powerless to stop the thoughts they have and the behaviors they exhibit. Teaching families how to be patient and empathic can be very impactful to their recovery. Group therapy may also be introduced as a way of increasing interaction with others who suffer from OCD and decreasing the isolation some feel as a result of their behavior.
