Obsessive-compulsive disorder is a mental health condition defined by a combination of anxiety-inducing thoughts and behaviors. With symptoms including common themes such as a need for order and cleanliness and fearing for the safety of loved ones, more and more people are wondering—do I have OCD?
It is vital that anyone considering whether they are facing OCD consult a licensed mental health professional who has been trained to diagnose and offer treatment options in this field. OCD is an official mental health condition, and while most individuals may relate to one or more of its symptoms, the severity, duration and effect on their overall quality of life may not constitute an official diagnosis. As a result, managing and treating an official OCD diagnosis can differ from managing personality or behavioral issues.
OCD can arise at any age, though OCD symptoms usually appear between the ages of ten and early adulthood. It can be a challenging condition to diagnose, since its symptoms are often seen first as idiosyncrasies. As a result, it takes an average of 14-17 years to receive an OCD diagnosis, from the moment its symptoms first appear.
Many individuals facing OCD also suffer from additional mental health conditions, with three out of four having a history of battling an anxiety disorder, and one out of two suffering from depression. Additionally, up to 30% of those diagnosed with OCD also face a lifetime tic disorder.
OCD affects around 1.2% of the US population, with an international prevalence of 1.1-1.8%. In addition to those who receive an OCD diagnosis, many others face specific, sub-diagnostic OCD symptoms. Women tend to develop OCD at a slightly higher rate, with more men developing it during childhood.
OCD can be detrimental to an individual’s well-being, as its symptoms can develop into a time-consuming fixture, introduce significant distress in their daily activities, and impair their life functions in a number of ways. For this reason, it is imperative to seek treatment when faced with this condition.
At its core, OCD is an anxiety-based disorder that typically manifests itself through obsessive thoughts and compulsive behaviors:
At first, the person is assailed with repeated, ruminative, intrusive thoughts about an anxiety-inducing subject. In an effort to assuage these unwanted thoughts, they begin performing a ritual or action meant to calm them down and help them move on from the distressing thought they are focused on.
However, instead of helping them “change the subject,” this compulsive behavior soon becomes its own source of anxiety, highlighting rather than erasing the disturbing content from their minds.
OCD can appear in numerous combinations of symptoms, themes and actions, but is basically manifested through an intrusive, abrasive thought content that greatly disturbs the individual experiencing and causes them to react to these thoughts in an attempt to make them disappear. Here’s one example: an individual who is overly-focused on organization and tidiness (thoughts) may find themselves unable to relax or think of something until they clear their desk of any clutter (behavior). At first, organizing all the items on their desk is enough to satiate their distressing thoughts, but before long they begin expanding the scope of their tidiness, so they have to organize their entire office space, put away all the dishes in the kitchen and sweep the floors before they can feel calm enough to turn their attention to their work tasks. And while a bit of decluttering may help some people concentrate on their job, it is the inability to focus on anything else, as well as the acute disturbance these OCD-related thoughts and actions introduce into their lives, that can severely affect their well-being.
The link between OCD-related thoughts and behavior can be seemingly obvious. An individual who, for example, suffers from obsessive cleaning, might spend all their free time making sure their house is spotless.
Other times, the link between the two factors can appear arbitrary. For example, someone whose OCD-related thoughts center around a disquieting fear that they might carry out a violent act, could find themselves repeatedly locking and unlocking their smartphone as a compulsive ritual that aims to pacify their distress.
It should also be noted that while OCD normally involves both adverse thoughts and the compulsive responses intended to neutralize them, these responses are not always exhibited through physical, external actions. Rather, individuals with OCD may try to counter their distressing thoughts that intrude into their minds with ritual-like thought patterns: for example, a very polite person whose OCD manifests itself through a ceaseless fear of infection, might not change their behavior at all when confronted with a dinner party host who coughed all over the food before serving them; internally, though, they will be fraught with anxiety that they had contracted an illness for the next few days.
Whatever the symptoms, the resulting effect of OCD can be quite detrimental, and seriously hinder an individual’s sense of self-worth, personal self-care and hygiene (think of someone fighting an irrational fear of infection that ends up rubbing alcohol all over their body), ability to experience solace or satisfaction, and various relationships.
Understanding whether you or a loved one are suffering from OCD can also be difficult due to the individual not being fully aware they are facing a mental illness. As such, when assessing OCD severity, the individual’s level of insight is also taken into account: a person with a high level of insight understands their OCD-related actions cannot really protect them from, say, a natural disaster; someone with a lower level of insight, however, would find it harder to accept this and work toward dispelling their symptoms.
Before deciding on a specific form of therapy, which would hopefully turn out to be the best treatment for ocd in regard to the patient’s own manifestation of this disorder, it is important to properly assess the severity of their condition. Several OCD diagnostic tools are available today, with a central one being the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). This test helps mental health professionals assess the diagnosis of OCD through a number of factors:
Several empirically-valid treatment courses have been shown to alleviate OCD symptoms. Though all of them are viewed as generally safe and relatively effective, each patient’s experience in regard to tolerability and efficacy can help them determine which one is “the best treatment for OCD” in their own specific case:
Deep TMS: The only non-invasive device that is FDA-cleared to treat OCD, Deep Transcranial Magnetic Stimulation (Deep TMS) utilizes magnetic fields to safely regulate the neural activity of brain structures found to be related to OCD. Deep TMS’s efficacy was confirmed in 2019, in a large-scale study published in the American Journal of Psychiatry: the study concluded that regulating the functions of “the medial prefrontal cortex and anterior cingulate cortex significantly improved OCD symptoms.”
Cognitive Behavioral Therapy: CBT is a kind of psychotherapy that has been shown to be very efficient in treating OCD. The treatment takes a look at the thoughts, behaviors, emotion and physical reactions associated with OCD, while helping patients feel less anxious when confronted with its different triggers.
Psychopharmacology: The FDA has approved several types of psychiatric medications to treat OCD. These include four selective serotonin reuptake inhibitors (SSRIs), and one kind of tricyclic antidepressant (TCA). Though these medications have been shown to be both safe and effective, they may cause several adverse side effects.
Psychodynamic Therapy: Another form of psychotherapy used to treat OCD is psychodynamics. This branch of therapy looks into interactions between such life-shaping aspects as a person’s significant relationships, major events, needs and desires, and personality, as a means to understand what played a role in the development of OCD. Together, patient and therapist try to deconstruct the maladaptive patterns linked to this disorder, and consider instead more beneficial alternatives that can help the patient develop a greater sense of well-being.
