Overcoming OCD

Abstract

Obsessive compulsive disorder (OCD) is a highly prevalent psychiatric disorder around the world. OCD affects a variety of demographics, but many common symptoms have been identified. It involves performing compulsive rituals as a response to obsessive thoughts. It is incredibly debilitating to a person’s way of life, and has proven to be somewhat tricky to deal with. However, research has investigated potential solutions, and effective clinical treatments have been developed. These treatments include both targeted medication as well as cognitive behavioral therapy, neurosurgical techniques, and check-ins from healthcare providers. In addition, healthcare professionals have identified prominent personal steps that can improve OCD symptoms and effects. These include steps that can be taken by friends and family, as well as individual practices that should be put in place to ensure a successful healing process. By working with researchers, doctors, and patients, there is hope to finding innovative methods that effectively reduce or eliminate the debilitating factors involved in this disorder.

Introduction

OCD is a chronic psychiatric disorder that has recently been found to be the 4th most common in the world (Pittenger et al., 2005). It shows up in about 2% of the population, and goes undetected or untreated far too often, with predictions estimating that between 38% and 89% of affected individuals don’t ask or receive treatment (Senter et al., 2021). To define it, we have to break OCD into its two constituent words: obsessive and compulsive. 

The International OCD Foundation explains that an obsession is a recurring thought, image, or impulse that the individual cannot repress, and the individual is aware that it is not normal and wants the thoughts to stop taking over their minds ("What is OCD?," n.d.). Meanwhile, the corresponding compulsion is the repetitive behavior individuals used to counteract the obsession ("What is OCD?," n.d.). Thus, we see how OCD is a cycle, in which obsessions cause compulsions even though the individual doesn’t want either to occur.

Who Suffers From OCD?

Obsessive compulsive disorder has a typical onset age range from around 22-36, and it generally appears earlier in men than women  (Pittenger et al., 2005). Studies show that 2.3% of adults meet the psychiatric criteria to be diagnosed with lifetime OCD, while 1.2% can be diagnosed for having it in the past year (Senter et al., 2021). 

OCD can be severely debilitating, with the World Health Organization ranking it as one of the top 10 most debilitating conditions (Pampaloni et al., 2022). Further, it increases rates of “disability, morbidity, and mortality,” and results in a 45.7 day average for days off work due to psychiatric reasons (Senter et al., 2021). Unfortunately, it takes an average of 17 years for it to actually receive treatment (Pampaloni et al., 2022). This disconnect highlights the need for more awareness and advocacy of the condition, and to do that it’s important that people are aware of the clinical and non-clinical ways to reduce and even eliminate OCD.

What Clinical Treatments are Used?

The good news is, the psychiatric community has found effective treatments and therapies for OCD. One common treatment is cognitive behavioral therapy (CBT) (Pittenger et al., 2005). Specifically, a form of CBT known as exposure and response prevention (EX/RP) is most prevalent in treating obsessive compulsive disorder (Senter et al., 2021). Also known as exposure and ritual prevention, this method breaks the association between feelings of distress and the situations and objects that cause the stress, as well as the association between the individual’s typical response behavior and the decrease of distress ("Understanding CBT," n.d.). 

Additionally, certain medications are common for OCD treatment. Selective serotonin reuptake inhibitors (SSRIs) are one of the most common medications prescribed to OCD patients, and they are a type of antidepressant that boosts serotonin levels to reduce the effects of OCD ("Treatment," n.d.). Lastly, deep brain stimulation, in which brain circuitry is reversibly altered, has been gaining attention as a possible treatment for OCD. While this method needs to be further tested, certain case studies have found a reduction of symptoms in some OCD patients (Pittenger et al., 2005).

Video conferencing and in-person home visits by healthcare providers are also useful (Pampaloni et al., 2022). They allow the provider to understand the environment the patient is in, so they can have more insight into how and why their rituals are performed.

Lastly, doctors have developed neurosurgical methods for combating obsessive compulsive disorder, for when medication doesn’t work. For example, craniotomies have been used. Currently, ablative neurosurgical tactics focus on CSTC brain circuits, since they are thought to be heavily associated with OCD (Pittenger et al., 2005). There have been reports of success particularly when epileptic foci are removed from the brain (Pittenger et al., 2005). As research continues to explore the complexities of OCD, we get closer and closer to finding an ideal solution.

What Personal Steps Should be Taken?

If you or a loved one is struggling with obsessive compulsive disorder, there are a number of non-clinical tactics to combating it as well (though these should always be done alongside prescribed treatment). Psychologist Fred Penzel explains that OCD patients must not try to rush the process of healing or be disappointed if progress seems slow (Penzel). Additionally, trying to forcibly suppress these thoughts is pointless; trying not to think about obsessions only causes you to think about them more (Penzel). Instead, allow the treatments to help you naturally make these thoughts less prevalent. Additionally, families play an important role in helping the process of recovering from OCD. 

A paper from the Journal of Comprehensive Psychiatry describes the term “family accommodation,” which is when families get involved in OCD by doing things like changing their behaviors to mitigate the patient’s distress, complying with patient requests to perform certain tasks, helping patients complete compulsions and rituals, and overall providing comfort and reassurance to reduce patient anxiety (Pampaloni et al., 2022). No matter how an individual decides to go about managing their OCD, a strong support group of friends and family is critical to ensuring they recover successfully.