In our daily lives, we may have often come across conversations where we refer to some routine behaviour as OCD. Whether it’s being particular about keeping things tidy and being labelled a “neat freak”, or constantly worrying if you’ve locked the door or have your belongings on you. However, terming them as OCD is incorrect. So, when do these behaviours become a cause for worry? Let’s find out.
When these seemingly routine behaviours turn into compulsive behaviours; such as when you start getting obsessive about keeping things in a particular place, or getting anxious about whether you did really lock the door, and if there was a break-in in case you didn’t, that’s when it can be termed as Obsessive Compulsive Disorder (OCD). Dr Sameer Kalani, senior consultant psychiatrist and centre head, Sukoon Health, Gurgaon explains that OCD “is an illness which involves a pattern of unwanted/intrusive reoccurring thoughts known as obsessions, leading to high anxiety which causes one to engage in repetitive behaviours known as compulsions. These tend to cause significant distress when they interfere with one’s daily functioning.” He further adds that most cases of OCD fall under the following categories:
• Doubts and checking
• Fear of contamination
• Symmetry and order
• Ruminations and intrusive thoughts
Causes
While the causes of OCD are not fully known, Dr Kalani does share that there are certain factors that are taken into consideration before diagnosing someone. “There is no clear cause of OCD. Biological and psychological theories have been proposed without any clear cause known. However, stress can exacerbate symptoms. Risk factors can include familial history of OCD, physical differences in certain parts of the brain, depression, anxiety, or tics, as well as traumatic experiences,” he says.
Signs And Symptoms
Dr Kalani lists out the signs and symptoms under two broad categories:
● Obsessions
- Reoccurring upsetting thoughts/impulses
- Thoughts that don’t make sense and the person is aware of the irrationality of the thoughts
- Obsessive thoughts can include worries about oneself or others, constant awareness of body sensations
● Compulsions
- Repetitive acts which provide temporary relief from anxiety caused by the obsession
- Habits that don’t make sense but they are unable to quit. There is an inability to stop as it causes them stress.
- Compulsive habits can include completing tasks in a particular order or a certain number or times, feeling the constant need to count things, refraining from touching common surfaces, etc
Some examples for these behaviours include:
- Fear of germs may cause one to fear touching surfaces that other people may have touched (such as doorknobs, shaking hands, contact with table-tops, etc)
- Extreme need for order may cause one to feel anxious when objects or things are out of order
- Fear or inappropriate or hostile thoughts, including warped ideas about sex and perhaps religion, may cause one to imagine troubling sexual or disrespectful scenarios
Diagnosis
To diagnose a patient, a host of criteria is taken into account. “Diagnosis of OCD requires a psychological evaluation, which involves talking about one’s feelings, thoughts, symptomatology, and behavioural patterns. It is based on the level of distress and dysfunction it causes in an individual’s day-to-day functioning,” Dr Kalani elaborates.
There are internationally standardised scales to help diagnose OCD like YBOCS (Yale Brown Obsessive Compulsive Sale) which are administered by trained professionals only. This includes a set of questions to understand the range of your behaviour and obsessive thoughts.
Treatment
Depending upon the severity of the condition, a range of methods may be used to treat someone diagnosed with OCD. Some of the treatment methods as shared by Dr Kalani are:
● Psychotherapy: Cognitive Behavioural Therapy (CBT) can help alter thinking patterns. Exposure therapy and response prevention have proven to be effective as well.
● Relaxation Training: Where the patient is made familiarised with different relaxation techniques which they can practice if they feel their symptoms setting in.
● Medication: Selective Serotonin Reuptake Inhibitors (SSRIs) as well as neuroleptic drugs are often prescribed to treat OCD, depending on the severity of the symptoms.
● Neuromodulation: Repetitive Transcranial Magnetic Stimulation (rTMS) has been found to be giving good results in OCD patients, along with a combination of medications and psychotherapy. This form of treatment targets certain pulses in the brain, which further stimulate it in order to manage how you feel.