What exactly are obsessions and compulsions?

Obsessive compulsive disorder (OCD), although very common, is often misunderstood. Many people fear that they suffer from OCD when they have a personality quirk that causes them to perform a particular task on a routine basis. That per se does not constitute OCD.

A person suffering from OCD experiences obsessive, distressing, intrusive thoughts and related compulsions or rituals. For the problem to be OCD it must take up at least one or more hours per day and interfere with the daily functioning.

The thoughts or compulsions are time-consuming and cause distress. They cause impairment in social, occupational, or school functioning. The sufferer often experiences feelings similar to those associated with depression.

The depression usually occurs after the OCD has a significant impact on the life of the sufferer. He/she may find that the compulsions take up increasingly more time and thus the impacts on his/her life are greater. A vicious cycle can develop with one disorder perpetuating the other.

The compulsions (repetitive behaviours or rituals) are used in an attempt to neutralize the obsessions (recurrent and persistent thoughts). The thoughts cause anxiety or stress and although the sufferer understands that the thoughts are not based on reality he/she is not able to ignore them.

The compulsions, repetitive behaviours, are aimed at preventing or decreasing the distress or at preventing some dreaded event or situation. The compulsions are usually not connected in a realistic way with what they are designed to neutralise.

Panic attacks can also be present in this disorder. However, some OCD patients claim to experience panic attacks after being faced with their major dread. This could be anything really, but an example is a person that has obsessions about keeping his hands clean.

If this person somehow gets the most imaginable disgusting filth on his hands he may go into a panic. Although he may describe this as a panic attack, technically it is not.

True panic attacks come without warning and the fear or anxiety felt is not based on reality. In this case, however, the OCD patient is not fearful of the attack (as panic attack sufferers are) itself but rather of the consequences of the contamination.

As mentioned earlier, OCD patients often experience some of the same feelings associated with depression. It seems there is a small thread that connects most anxiety disorders and if one disorder is not treated it can result in the addition of others.

Treatment

The most common treatment for OCD involves a combination of medication and professional counselling. In some cases, a physician may feel as though it is necessary to prescribe an antidepressant as part of the treatment regimen, particularly if the patient is found to be suffering from depression along with OCD.

Some of the most common antidepressants prescribed to assist with reducing the symptoms of OCD include Prozac, Luvox and Zoloft.

Counselling is also commonly used to treat OCD; including a specific type of cognitive-behavioural therapy known as exposure and response prevention. In fact, this type of therapy is considered to be the best type of counselling treatment for OCD. In this type of treatment therapy, the patient is repeatedly exposed to their particular obsession. The therapy is sometimes performed with a therapist as well as individually with direction provided by the therapist.

The patient is commonly asked to provide a list of their obsessions along with their rituals or compulsions when they begin treatment for OCD. The therapist may also request the patient to provide information on things or situations which they tend to avoid as well as rank their obsessions in terms of the amount of anxiety that is created by them.

Ranking the obsessions will help the therapist determine where the patient should begin with exposure therapy. For example, a patient may begin this type of therapy by exposing himself or herself to an obsession they consider to cause them a moderate amount of stress or anxiety. Then they may begin working their way up the list until they are exposed to the obsessions that cause them the most stress or anxiety.