Obsessive-Compulsive Disorder (OCD): Symptoms, Causes, Diagnosis and Treatment

Obsessive-compulsive disorder (OCD) is a type of mental illness that affects one's behavior and thinking. 
Obsessive-compulsive disorder (OCD) is a chronic disease of the nervous system and is a common psychological problem associated with anxiety in which a person has unwanted and uncontrollable thoughts, reoccurring ideas, excessive sensations, (obsessions) that make him feel motivated to do something repeatedly (compulsions). 
OCD is characterized by both obsessive and compulsive symptoms. 
People with OCD may have symptoms of obsession, signs of compulsion or both.

Obsessive-compulsive disorder (OCD) is characterized by excessive thoughts and unreasonable fears (obsessions) that lead to repetitive behaviors (compulsions).

Obsessive-Compulsive Disorder (OCD): Symptoms, Causes, Diagnosis and Treatment

What is Obsessive-Compulsive Disorder (OCD)?

Obsessive-compulsive disorder (OCD) is a type of chronic disorder and the common psychological problem associated with anxiety, characterized by irrational thoughts and fears where the patient feels the urgent need to do certain behaviors repeatedly and compulsively out of control and will.

People with obsessive-compulsive disorder are sometimes aware of the fact that their obsessive behavior is illogical and try to ignore or change, but these attempts increase the intensity of distress and anxiety more.

In the final analysis, compulsive behaviors are mandatory to relieve distress.

Obsessive-compulsive disorder may often be concentrated on a particular subject, such as fear of bacterial infection.

Some people with obsessive-compulsive disorder, for example, wash their hands so compulsively that they cause wounds and scars.

Despite attempts and efforts, obsessive-compulsive thoughts are repeated and continue to cause distress and discomfort and may lead to repetitive and ritualistic behavior, a cruel and painful episode that characterizes the obsessive-compulsive disorder.

Symptoms of Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is characterized by both obsessive and compulsive symptoms.

This means that people with OCD can have symptoms of obsession, signs of compulsion or both.

These symptoms and signs can hinder all aspects of life, such as school, work, and personal relationships.

Obsessive Symptoms

Obsessive symptoms are frequently repeated, stubborn, involuntary, or spontaneous motives and intangible intentions that are illogical.

These obsessions are usually troublesome and narrow when trying to direct thoughts to other things or to do other things.

In general, these obsessions revolve around a specific theme, such as:

1. Fear of dirt or pollution.

2. Excessive need for arrangement and requirement of system and symmetry.

3. Unusual Offensive Wishes or aggressive desires.

4. Thoughts or fantasies about sex.

Symptoms related to the obsessive disorder include:

5. Fear of infection as a result of shaking hands with others, or touching objects touched by others.

6. Doubt about door locking or oven closing.

7. Ideas about causing harm to others in road accidents or fear of being harmed by others.

8. Critical crisis or severe distress in those cases where the objects are not properly arranged or are not moving in the right direction.

9. Imaginations about harming children (children of the imaginative person).

10. The desire to shout in inappropriate cases.

11. Avoid circumstances and refrain from situations that can cause obsession, like handshaking.

12. Recurrent fantasies of pornographic images.

13. Swelling of the skin by washing hands at a high rate.

14. Skin scars due to excessive treatment.

15. Hair loss, or localized baldness, as a result of hair fall.

Compulsive symptoms

Compulsive symptoms are frequent behaviors, which are repeated as a result of uncontrollable desires and impulses.

These repetitive behaviors are supposed to alleviate the anxiety or distress associated with obsessive-compulsive disorder.

For example, people who think that they have escaped someone else, they go back to the scene, because they cannot get rid of suspicion and doubts.

Sometimes they can invent laws and rituals that can help in controlling anxiety caused by meditative ideas.

Like obsessive behavior, the compulsive disorder is generally associated with a specific subject, such as:

1. Bathing and cleaning repeatedly.

2. The need for reinforcements.

3. Go back to a particular job several times.

Symptoms associated with compulsive behavior include:

4. Washing hands until the skin flakes.

5. Check the doors frequently to make sure they are locked.

6. Checking the oven repeatedly to make sure it is off.

7. Counting and calculation with certain patterns.

Causes of Obsessive-Compulsive Disorder

Although there is a lot of research on obsessive-compulsive disorder, the exact causes of it have not been identified. 

It is noteworthy that there is a belief that the injured brains work differently than normal, and that the imbalance in the neurotransmitters is related to the disease. 

There are some central theories about the possible causative factors of excessive compulsive disorder that include:

Risk factors for OCD

Biological factors: There is some evidence to suggest that obsessive-compulsive disorder is the result of a chemical change occurring in the person's body or in the performance of his brain.

There is also evidence that obsessive-compulsive disorder may also be associated with certain genetic factors, but the genes responsible for the obsessive-compulsive disorder have not yet been identified and diagnosed.

Environmental factors: Some researchers believe the obsessive-compulsive disorder is caused by habits and behaviors acquired over time.

Insufficient Serotonin: Serotonin is one of the chemicals necessary for brain function.

If the level of serotonin is insufficient and very low, it is likely that this will contribute to the development of the obsessive-compulsive disorder. 

Some studies that compare the images of OCD people with non-infected people have shown differences in brain function in both cases.

Moreover, the symptoms of the obsessive-compulsive disorder have diminished in people with OCD and are taking serotonin-enhancing medicines.

Streptococcal infection in the throat: There is research suggesting that obsessive-compulsive disorder has been developed in children and teens after a sore throat or strep throat which is a bacterial infection in the larynx caused by the Group-A Streptococcus bacteria. 

But the opinion about the reliability and credibility of this research has been divided and it should be reinforced with further evidence until it is recognized that Streptococcus in the throat can actually cause an obsessive-compulsive disorder.

There are other factors that may increase the risk of developing, or provoking obsessive-compulsive disorder (OCD):

• Family History
• Life is overloaded with stress and pressure
• Pregnancy

It was previously thought that obsessive-compulsive disorder was a rare disease, but it is now known that OCD is more prevalent than many other psychiatric illnesses.

Obsessive-compulsive disorder often begins at an early age, in childhood or adolescence, and generally at the age of ten.

In adults, it usually appears at approximately 21 years of age.

Complications of Obsessive-Compulsive Disorder

Complications that may result from Obsessive Compulsive Disorder, or that may be associated with it, include:

• Suicidal thoughts and acts accordingly.
• Addiction to alcohol and other substances.
• Another disorder related to depression and anxiety.
• Eating Disorders.
• Contact dermatitis as a result of handwashing at a high rate.
• Lack of ability to work or learn.
• Problematic social relations.

Diagnosis of Obsessive-Compulsive Disorder

When a doctor or psychiatrist suspects that someone is suffering from OCD, then he performs a series of medical tests and psychological examinations.

These tests help in the diagnosis of obsessive-compulsive disorder, by denying (exclusion) of other medical conditions that can lead to similar symptoms, and help in finding additional complications related to OCD. These include:

• Physical test
• Laboratory tests
• Psychological assessment

The criteria for the diagnosis of obsessive-compulsive disorder are:

The person to be tested acts mandatory, compulsively and inevitably under the examination

The person who comes under the examination observes that his behavior is unclear, obsessive, compulsive, exaggerated or irrational.

Obsessive or compulsive behavior adversely affects daily routine.

Obsessive behavior must meet the following criteria:

Frequent thoughts, desires, motivations or fearsome fantasies cause distress.

Ideas are not just exaggerated concerns about real-life problems.

The examiner tries to ignore or deny ideas, fantasies, and desires.

The person under examination knows that ideas, fantasies, and desires are the fabric of his imagination.

Compulsive behavior must meet the following criteria:

Doing certain actions frequently and involuntarily, such as washing hands or counting whispers.

The goal of compulsive behavior is to prevent or reduce the distress caused by unrealistic whispers.

How is OCD Treated?

Treatment of obsessive compulsive disorder (OCD) includes talk therapy, cognitive behavior therapy drug therapy.

Treatment of Obsessive-Compulsive Disorder

Treatment of the obsessive-compulsive disorder is a complex process and is not guaranteed to be effective and successful in all cases.

In some cases, continuous, lifelong treatment may be needed. However, the treatment of OCD can be helpful in supporting the patient to deal with the symptoms, confront them and prevent them from controlling his life.

Key points

There are two basic types of treatment for obsessive-compulsive disorder:

• Psychotherapy
• Pharmacotherapy

The best and most effective treatment for OC D varies according to the patient, his personal situation and preferences, and often the combination of psychotherapy and pharmacotherapy is very effective.

Psychotherapy for Obsessive-Compulsive Disorder

The so-called therapeutic method Cognitive Behavioral Therapy (CBT) was found to be the most effective treatment of the obsessive-compulsive disorder, both among children and adults.

Pharmacotherapy for Obsessive-Compulsive Disorder

Certain medications for the treatment of mental illness can help control the obsessive-compulsive behaviors that characterize OCD.

The treatment of OCD begins with antidepressants that may be useful in the treatment of OCD because it increases serotonin levels, which may be low in people with obsessive-compulsive disorder.

Antidepressants approved by the US Food and Drug Administration (FDA) in the treatment of OCD include:

• Clomipramine
• Fluvoxamine
• Fluoxetine (Prozac)
• Paroxetine (Paxil)
• Sertraline (Zoloft)

Side effects and potential risks of medications

All psychiatric drugs have side effects and potential health risks. The psychologist should be informed of all the emerging side effects and symptoms and consulted regarding the monitoring and follow-up measures to be taken during the use of psychotropic drugs, specifically: antipsychotic drugs.

Biting drugs may cause serious reactions when taken together with other medications, certain foods or other substances.

You should inform your doctor of all non-prescription medications and preparations, including vitamins, salts, and medicinal herbs.

Other ways of treating obsessive-compulsive disorder

Sometimes, medications and/or psychotherapy may not be effective enough to treat the symptoms of OCD.

In some rare cases, other methods of treatment for OCD are used, including:

Electroconvulsive therapy (ECT):  also called electroshock therapy or simply “shock therapy”. It is a psychological way of treatment.  

In this technique, electrical impulses or electrical seizures are induced in a patient’s body or brain to provide relief from psychological problems and mental disorders such as obsessive-compulsive disorder.

Transcranial Magnetic Stimulation (TMS): It is a non-invasive way of treatment used to stimulate the human brain. 

In this method, electric fields are produced by electromagnetic induction.

Subsequently, they travel through the skull and scalp without any effort, making TMS a non-invasive, painless, and easy way to stimulate the brain.

Deep brain stimulation (DBS): It is a neurosurgical procedure, in which neurotransmitter is implanted that sends electrical impulses or seizures, to specific targets in the brain, through implanted electrodes, for the treatment of psychological or movement disorders.

Note: These methods have not been tested primarily for the treatment of the obsessive-compulsive disorder, so be sure to understand the pros and cons, and the risks, if any.