Overview
Obsessive Compulsive Disorder (OCD) is an anxiety spectrum disorder which is chiefly characterised by the occurrence of unwanted and intrusive (interfering) obsessive thoughts or distressing images usually accompanied by compulsive behaviours performed to neutralize the obsessive thoughts or images or to prevent some dreaded event or situation.
Obsessions involve persistent and recurrent intrusive thoughts, images or impulses that are experienced as disturbing and inappropriate. People with such obsessions try to resist, suppress or neutralize them with some other thought or action. Obsessive thoughts consist most often of contamination fears, fears of harming oneself or others, need for symmetry, sexual obsessions and obsessions concerning religion or aggression. Compulsions can involve either overt repetitive behaviours like hand washing, checking or arranging things in an order or more covert mental acts like counting, praying or saying certain words silently. A person having OCD would realise that the obsessions are a product of his own mind but still feels compelled or driven to perform the compulsive act to “prevent something bad from happening”.
Prevalence of OCD
Causes
Like any other psychological illness, there could be various factors causing OCD. The biological factors could be genetic vulnerabilities, heritability, or brain and neurotransmitter abnormalities. Studies suggest that the dysfunction of certain brain areas like orbital frontal cortex, cortico-basal-ganglionic-thalamic circuit could be responsible for the illness. Serotonin, an important neurotransmitter in the brain, has also been shown to be significantly involved in the development of OCD.
There are many psychological theories explaining the aetiology of OCD. According to them, some of the most significant psychological factors responsible for causing and maintaining the illness are – faulty thinking process, irrational beliefs, faulty learning and misinterpretation of intrusive thoughts. Obsessive thoughts lead to significant anxiety which the person finds extremely distressing. In order to get rid of this unpleasant feeling, the person performs the action which reduces the anxiety. This acts like a positive reinforcement and hence an unending, vivious cycle is formed.
As mentioned above, we all experience intrusive thoughts in our day-to-day lives but people with OCD seem to have an inflated sense of responsibility and so misinterpret these thoughts as being very important and significant which could lead to catastrophic consequences. In addition to this, stress is another important aspect that needs to be considered while talking about any psychological problem. Although stress does not seemingly cause OCD, it can trigger the onset of the illness in a person who is biologically or psychologically predisposed to it and can worsen the symptoms in a person having the disorder.
Treatment
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Another important point worth noting is that guilt is the best friend of OCD; whenever there is guilt attached to obsessions, it will exacerbate the problem. Hence, it is important for the person to understand that simply having an obsessive thought (for instance – sexual images) is not equivalent to having actually done that in reality. We all experience such unpleasant or unwanted thoughts, impulses or images almost everyday and so there is nothing abnormal in it. It is just a thought and has no relevance till the time we attach some meaning to it or in case of OCD, there is anxiety due to the increased sense of responsibility. OCD can be an extremely debilitating and distressful illness for the person suffering from it as it hampers the functioning in various aspects. But there is hope as it is definitely a treatable illness with a combination of pharmacological and psychotherapeutic interventions. Homoepathic medicines are very efficient in treating OCD in combination with psychotherapy.