Causes, Symptoms & Treatment Options

It is likely you have heard the phrase “I’m sooo OCD.” This phrase is often used to describe personality traits associated with cleanliness and organization, however OCD is very different from having a couple of these personality traits. OCD includes many components that interfere with an individual’s ability to function and causes significant distress. It can be frustrating for those who suffer from OCD to hear the stereotypes and stigmas that get attached to this disorder. This article is aimed to help educate on what OCD actually is, how to recognize it, what causes it, and treatment options.

What is OCD? 

Most of us have experienced bizarre thoughts before – have you ever been driving and had a random thought of crashing your car? These types of thoughts are perfectly normal, however, for someone with OCD, these thoughts get stuck. Someone with OCD over interprets the importance of these thoughts. They may think “does this mean I want to crash my car? What if I somehow lose control?” The individual then does actions (compulsions), mentally and/or physically, to avoid the distress associated with these thoughts. For example, an individual with OCD who has thoughts of crashing their car may do some mental compulsions of reassuring themselves they won’t crash the car and trying to figure out if they do want to crash the car. They may also engage in physical compulsions such as pulling over, finding lower risk roads and avoiding driving in general. These are examples of compulsions, however, compulsions will vary from person to person. Situations that trigger OCD thoughts become distressing, and individuals may start to avoid these situations.

OCD Signs and Symptoms  

For people with OCD, obsessions and compulsions take up a significant amount of time, cause anxiety and distress, and interfere with quality of life and functioning. Obsessions can be about a number of topics, and many people experience multiple OCD themes that may change over time. Some individuals only have mental compulsions, leading to OCD being undiagnosed if not screened by an OCD specialist.

....leading to OCD being undiagnosed if not screened by an OCD specialist.

Common Obsessions

  • Fears that yourself or those you love might get hurt
  • Fear and/or disgust related contamination
  • Disturbing sexual thoughts or images
  • Disturbing violent thoughts or images
  • Fear of acting on unwanted impulses or of blurting out an insult or obscenity
  • Extreme concern with order and symmetry
  • Extreme concern with morals and values
  • Superstitious obsessions
  • Fears of being responsible for something terrible happening

Common Compulsions

  • Constantly checking on your loved ones to make sure they are safe
  • Mental rituals
  • Asking for reassurance or giving yourself reassurance
  • Mental review and overanalyzing
  • Excessive praying
  • Confessing or warning
  • Excessive list making or planning
  • Excessive hand washing, showering, or brushing teeth
  • Excessive cleaning of household objects
  • Repeatedly checking on appliances, switches, and locks
  • Checking that nothing bad did or will happen
  • Repeated counting, tapping, staring, blinking, or other tics

What causes OCD? 

The exact cause of OCD is unknown, however, research suggests differences in genetics and the brain are contributing factors. An individual with a family member who has a disorder such as anxiety, OCD, hoarding, body dysmorphic disorder, skin picking, or hairpulling is at higher risk for developing OCD. OCD is often triggered or becomes worse in relation to hormonal changes (e.g. puberty and pregnancy), and stressful environmental factors (e.g. life changes and trauma).

How is OCD treated? 

Exposure and Response Prevention (ERP) is the gold standard treatment for OCD. One of the simplest ways to explain ERP is to relate OCD to an alarm. Each person has an alarm system in their brain that goes off to alert them of potential danger. This prompts behaviors that seek to neutralize the potential threat. In OCD, the alarm system in the brain is going off when it doesn’t need to. The alarm signal gives urges to neutralize the threat, through compulsions and/or avoiding the situation. When these avoidant behaviors are done, the brain learns we are safe because we did the avoidant behaviors or compulsions. The opposite is also true - when an individual can approach a triggering situation (exposures) and practice preventing compulsions (response prevention), the brain learns we can approach those situations and still be safe. It recalibrates the “false alarm” that is going off.

This form of therapy likely sounds intimidating, and it is normal to be apprehensive about what it may entail. Finding a therapist who is familiar with OCD is important. A therapist trained in ERP will walk you through the process and help you learn and implement the skills designed to increase distress tolerance, process emotions, and engage more fully in your life. Common skills used to help an individual engage in ERP are Dialectical Behavioral Therapy (DBT) skills and Acceptance and Commitment Therapy (ACT) skills.

Amanda Gibb, LCSW

Amanda is a specialty therapist for obsessive-compulsive related disorders and anxiety disorders. She is trained in exposure with response prevention, ACT, and DBT skills.

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