Obsessive-compulsive disorder (OCD) is characterized by severe anxiety and the presence of unreasonable thoughts and fears (obsessions) and repetitive and ritualistic behaviors (compulsions). Patients with OCD often spend several hours performing compulsions such as checking, counting, cleaning and washing to reduce their anxieties associated with their obsessions. The symptoms associated with OCD usually begin gradually and vary in severity throughout an individual’s life; during stressful times, their symptoms may worsen.
OCD is a lifelong disorder that affects the brain. Neuroscientists believe that the brain pathways involved with judgment, planning and body movement are altered in patients affected by OCD. Research has also indicated that having a family history of mental illness can contribute to the development of OCD as well as life stressors such as childhood sexual abuse and other stressful or traumatic events.
Obsessions and compulsions
Obsessions are intrusive, unwanted thoughts and fears related to central themes such as contamination. Common obsessions associated with OCD include:
- Fear of dirt, germs and contamination
- Keeping items in extreme order
- Thoughts of harming self or others
- Forbidden or taboo thoughts (e.g., aggression, sexual or religious subjects)
- Harm (e.g., fears of harm to self or others)
People with OCD may attempt to ignore or suppress their obsessions, or unwanted thoughts (e.g., contamination), images (e.g., violent scenes) and urges (e.g., to stab or hurt someone); however, despite their efforts, they are unable to control or stop them from occurring. Compulsions, on the other hand, are performed to reduce the anxiety and stress associated with their obsessions.
Compulsions provide people with only temporary relief and are often time-consuming, as many people spend over an hour per day performing these ritualistic behaviors. Compulsions may include repetitive, ritualistic behaviors such as:
- Hand washing until skin becomes raw
- Ordering, such as arranging canned goods to face the same way
- Checking doors repeatedly to make sure they are locked
- Checking the stove repeatedly to make sure it is turned off
- Repeating, such as silently repeating a prayer, word or phrase
- Demanding reassurances
- Following a strict routine
People may be afraid of being contaminated as a particular obsession, and to ease their fears of contamination, they may wash their hands until they are sore and chapped, refuse to shake hands with others or touch objects others have touched. Other times, people spend several hours per day checking whether or not they turned off the stove because they fear that the house will burn down. Intense stress may be experienced when objects are not orderly or placed a certain way.
How is OCD diagnosed?
A physician will first rule-out physical causes, medical conditions and substance abuse as the reason for a person’s symptoms. If no underlying medical reasons can explain the person’s behavior, the physician will refer the patient to a mental health professional such as a psychiatrist or licensed clinical psychologist.
A mental health professional conducts a thorough assessment and looks for the primary symptoms of obsessions and compulsions to establish a diagnosis. A mental status examination (MSE) is part of the assessment and examines the patient’s current state, thought processes, behavior and thinking patterns to determine whether symptoms of OCD are present.
The symptoms of OCD are outlined in the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). The main diagnostic features of OCD include the presence of obsessions and compulsions. The main diagnostic criteria for OCD outlined in the DSM-5 include:
- Presence of obsessions (thoughts, urges or images), compulsions (repetitive behaviors or mental acts) or both
- Compulsions or obsessions consume a significant amount of the person’s time or lead to a significant impairment in functioning (e.g., social, occupational)
- Symptoms are not due to the effects of a substance, another medical condition or another mental disorder
Sovereign Health of Florida
Sovereign Health of Florida offers behavioral treatment for adult men and women dealing with mental health, substance abuse and co-occurring disorders. We specialize in treating a number of mental health disorders, including OCD. Upon admission, patients receive thorough medical, psychological and psychiatric assessments by our professional staff to rule-out any underlying or co-occurring disorders with the condition.
Patients with milder and shorter-lasting OCD symptoms typically have a better prognosis, or outcome. Our treatment for OCD includes a number of components and evidence-based treatments such as psychoeducation, psychotherapy, group therapy and cognitive behavioral therapy (CBT). A psychiatrist will perform a psychiatric evaluation to determine the patient’s need for medication, which can help reduce the presence of symptoms of OCD.
To learn more about our treatment programs for mental health, substance abuse or co-occurring disorders at Sovereign Health of Florida, please call our 24/7 helpline to speak to a member of our team.