Can You Develop OCD: OCD – Some Facts | Center for the Treatment and Study of Anxiety

28.05.202214.07.2023 by alexxlab

What causes OCD? Why do you have OCD? What are the two important associations in OCD? Get answers to these questions and more in this comprehensive article on OCD.

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Symptoms of OCD

It is estimated that six million people in the USA have obsessive-compulsive disorder (OCD). Men and women develop OCD at similar rates and it has been observed in all age groups, from school-aged children to older adults. OCD typically begins in adolescence, but may start in early adulthood or childhood. The onset of OCD is typically gradual, but in some cases it may start suddenly. Symptoms fluctuate in severity from time to time, and this fluctuation may be related to the occurrence of stressful events. Because symptoms usually worsen with age, people may have difficulty remembering when OCD began, but can sometimes recall when they first noticed that the symptoms were disrupting their lives.

The symptoms of OCD include the following:

Unwanted or upsetting doubts
Thoughts about harm, contamination, sex, religious themes, or health
Rituals like excessive washing, checking, praying, repeating routine activities
Special thoughts designed to counteract negative thoughts

In addition, people with OCD may be aware of certain situations, places, or objects that trigger the distressing thoughts and urges to ritualize, and they may find themselves avoiding these situations, places, and objects.

What Causes OCD?

The reasons why some people develop obsessions and compulsions while others don’t are unknown. Researchers have considered different types of explanations. Some experts have suggested that some specific “thinking mistakes” about harm occur in OCD. Examples of such thinking mistakes are:

Thinking about an action is the same as doing it, or wanting to do it
People should control their thoughts
If I don’t try to prevent harm, it’s the same as causing harm
A person is responsible for harm, regardless of the circumstances

While this theory explains the types of thinking mistakes made by people with OCD, it does not explain why some people develop OCD and others do not.

Many researchers also feel that people with OCD have abnormal brain chemistry involving serotonin, a chemical that is important for brain functioning. Unusual serotonin chemistry has been observed in people with OCD and medications that relieve OCD symptoms also change serotonin levels. However, it is not known whether serotonin chemistry is truly a key factor in the development of OCD. Research results are inconclusive at this point.

There is also evidence that OCD is more prevalent in some families than others. It is difficult to know how much of this is a result of what children learn from their family while growing up, and how much is hereditary.

Why Do You Have OCD?

Many people would like to know what causes this disorder or how they developed it. There are a number of guesses, but there is as yet no satisfactory theory of its development. Most likely, there is a combination of factors (such as biological/genetic and environmental aspects) that contribute to the development of OCD. It is tempting to be overly concerned with the lack of information about how OCD develops. Fortunately, despite our lack of knowledge, there are effective treatments available that do not require an explanation for why or how a person developed OCD. Scientists do understand a great deal about the symptoms of OCD and this is very important for the treatment of the disorder. In fact, your learning more about your OCD symptoms will help you get more improvement from this treatment.

The Two Important Associations in OCD

Two types of associations are a very important part of OCD and understanding both of them will help with your therapy. Therapy is designed to break both types of associations.

The first is the association between certain objects, thoughts, or situations and anxiety/discomfort. For example, think about a situation, thought, or object that you try to avoid or that you endure with suffering because if makes you feel distressed or uncomfortable. It is likely that you have an association between this situation and anxiety or distress.

The second type of association is an association between carrying out rituals and decreasing the distress. When you perform a ritual, such as excessive hand washing or checking, you may experience a temporary reduction in anxiety or discomfort. This reinforces the habit of performing the ritual, even though it provides only temporary relief.

Effective Treatments for OCD

While the causes of OCD may not be fully understood, effective treatments are available. Cognitive-behavioral therapy (CBT), particularly exposure and response prevention (ERP) therapy, has been shown to be highly effective in treating OCD. Medication, such as selective serotonin reuptake inhibitors (SSRIs), can also be helpful in managing OCD symptoms. The key is to work with a mental health professional who specializes in the treatment of OCD to develop a personalized treatment plan.

Coping with OCD

Living with OCD can be challenging, but there are strategies that can help. It’s important to be patient and persistent with treatment, as it can take time to see progress. Engaging in self-care activities, such as exercise, mindfulness practices, and social support, can also be beneficial. Remember, you are not alone in your struggle with OCD, and with the right treatment and coping strategies, it is possible to manage the symptoms and reclaim your life.

Conclusion

OCD is a complex and often misunderstood disorder, but with the right information and support, it can be effectively treated. By understanding the symptoms, causes, and treatment options, individuals with OCD can take the first step towards managing their condition and improving their quality of life.

OCD: Some Facts | Center for the Treatment and Study of Anxiety

Symptoms

What causes OCD?

Why do you have OCD?

The two important associations in OCD

Symptoms

As you may already know, the symptoms of OCD include the following:

Unwanted or upsetting doubts

Thoughts about harm, contamination, sex, religious themes, or health

Rituals like excessive washing, checking, praying, repeating routine activities

Special thoughts designed to counteract negative thoughts

In addition, you may be aware of certain situations, places, or objects that trigger the distressing thoughts and urges to ritualize. You may find yourself avoiding these situations, places, and objects.

What causes OCD?

Thinking about an action is the same as doing it, or wanting to do it

People should control their thoughts

If I don’t try to prevent harm, it’s the same as causing harm

A person is responsible for harm, regardless of the circumstances

While this theory explains the types of thinking mistakes made by people with OCD, it does not explain why some people develop OCD and others do not.

Many researchers also feel that people with OCD have abnormal brain chemistry involving serotonin, a chemical that is important for brain functioning. Unusual serotonin chemistry has been observed in people with OCD and medications that relieve OCD symptoms also change serotonin levels. However, it is not known whether serotonin chemistry is truly a key factor in the development of OCD. Research results are inconclusive at this point.

Why do

you have OCD?

Scientists do understand a great deal about the symptoms of OCD and this is very important for the treatment of the disorder. In fact, your learning more about your OCD symptoms will help you get more improvement from this treatment. OCD is a set of habits that, as you know, involves intrusive, unwanted, and upsetting thoughts, ideas, images, or impulses (obsessions). Along with these thoughts, you have unwanted feelings of extreme discomfort or anxiety and string urges to do something to reduce the distress. Because of this, people get into the habit of using various special thoughts or actions to try to get rid of the anxiety (compulsive rituals). These habits of thinking, feeling and acting are extremely unpleasant, wasteful, and difficult to get rid of on your own.

The two important associations in OCD

Two types of associations are a very important part of OCD and understanding both of them will help with your therapy. Therapy is designed to break both types of associations. First is the association between certain objects, thoughts, or situations and anxiety/discomfort. For example, think about a situation, thought, or object that you try to avoid or that you endure with suffering because if makes you feel distressed or uncomfortable. It is likely that you have an association between this situation and anxiety or distress.

The second type of association is an association between carrying out rituals and decreasing the distress. In other words, after you carry out your rituals you temporarily feel less distress. Therefore, you continue to engage in this behavior frequently to achieve more relief. Try to identify the situations that increase discomfort (association #1) and then the behaviors or thoughts that you perform to neutralize the discomfort (association #2). Doing this will help you in your treatment.

Unfortunately, doing rituals to reduce distress doesn’t work all that well. Your distress goes down for a short time and comes back again. Often, you find yourself doing more and more ritualizing to try to get rid of the anxiety. Even then, the rituals do not reduce the distress, and before long, you are putting so much time and energy into rituals that other areas of your life get seriously disrupted.

In order to treat OCD, the associations described above must be weakened or broken. Your therapy is designed to do this and your therapist knows exercises that will be helpful in achieving this goal. These exercises are called exposure and ritual prevention and you will learn more about them from your treatment provider.

About OCD | Obsessive-Compulsive and Related Disorders

Obsessive-compulsive disorder (OCD) was described as early as the seventeenth century, when the Oxford Don, Robert Burton, reported a case in his compendium, The Anatomy of Melancholy (1621). Modern concepts of OCD began to evolve in France and Germany in the nineteenth century. In the late twentieth century we have begun to understand the biology of this mental disorder, as neurochemical assay and brain imaging techniques have become available.

Age at Onset

OCD usually begins before age 25 years and often in childhood or adolescence. In individuals seeking treatment, the mean age of onset appears to be somewhat earlier in men than women. According to Swedo et al.’s report in 1989, in a series of 70 children and adolescents seen at the National Institute of Mental Health, the mean age of onset was 9.6 years for boys and 11.0 for girls. In a series of 263 adult and child patients, Lensi et al. in 1996 reported that the mean age at onset was 21 years for men and 24 years for women. Still, in another series reported by Rasmussen and Eisen in 1992, the means were 21 years for men and 22 years for women — in this series, major symptoms began before age 15 years in about one-third, before age 25 in about two-thirds, and after age 35 in less than 15%.

In one series of 200 patients reported by Rasmussen and Eisen in 1988, 29% felt that an environmental precipitant had triggered their illness, most frequently increased responsibility, such as the birth of a child, or significant losses, such as a death in the family, while Williams and Koran reported in 1997 that of 100 women in their study, 62% reported premenstrual worsening.

In community surveys, the results are mixed. The Epidemiological Catchment Area survey (ECA), which utilized lay interviewers (trained non-professionals) to examine more than 18,500 individuals in five cities reported a similar mean age of onset for men and women identified as OCD cases (22.4 and 23.0 years). A similar study in Edmonton, Canada reported a slightly later median age of onset for males (age 20 years) than females (age 19 years). Among 56 individuals in their mid-20s with obsessive-compulsive syndrome identified in a Zurich survey, the mean age of onset was 17 years for males and 19 years for females.

Course and Prognosis

For most adult patients who come to treatment, OCD appears to be a chronic condition. In their series of 560 patients in 1988, Rasmussen and Eisen reported that 85% had a continuous course with waxing and waning symptoms, 10% a deteriorative course and only 2% an episodic course marked by full remissions lasting six months or more. An Italian series by Lensi et al. in 1996 reported more patients with episodic or deteriorative courses in which 26% were episodic, 9% were deteriorative, and 64% were chronic. The conclusions drawn from studies that predate current diagnostic criteria, effective treatments and current patterns of health care utilization should not be applied to today’s patients.

The prognosis of children and adolescents who present for treatment appears to be good for half or more. Leonard et al. reported in 1993, that a little more than half of 54 children and adolescents were only mildly affected when evaluated two- to seven- years after vigorous treatment with medications, and less often with behavior therapy. Only six patients (11%) were symptom free, however, and only three of these were taking no medication. A 9 -to 14 -year follow-up study reported that 8 of 14 adolescents who had received medication treatment were medication free and did not meet OCD criteria; the other six had experienced a chronic, or a relapsing and then chronic course, reported Bolton, Luckie and Steinberg in 1995. Finally, Thomsen and Mikkelsen reported in 1995 that a 1.5 to 5 year follow-up of 23 children and adolescents who had recieved drug treatment found that four were free of OCD, eight had subclinical symptoms and the remaining 11 had chronic or episodic OCD. Larger studies from multiple sites are needed to establish accurately the prognosis associated with modern treatment methods.

In community-identified cases, remission, or a course marked by long, symptom-free periods, seems to be the rule. The apparent frequency of this benign course is probably due to the limited diagnostic validity of interviews conducted by lay interviewers and to the large proportion of milder cases in community sample. According to Nelson and Rice in 1997, only 19% (56 of 291 subjects) meeting OCD criteria during their first lay inerview met these criteria duing a lay interview conducted one year later.

Comorbidity

Patients with OCD are at high risk of having comorbid (co-existing) major depression and other anxiety disorders. In a series of 100 OCD patients who were evaluated by means of a structured psychiatric interview, the most common concurrent disorders were: major depression (31%), social phobia (11%), eating disorder (8%), simple phobia (7%), panic disorder (6%), and Tourette’s syndrome (5%). In Koran et al.’s 1998 Kaiser Health Plan study, 26% of patients had no comorbid psychiatric condition diagnosed during the one year study period — 37% had one and 38% had two or more comorbid conditions. These proportions did not differ substantially between men and women. The most commonly diagnosed comorbid conditions were major depression, which affected more than one-half, other anxiety disorders, affecting one-quarter, and personality disorders, diagnosed in a little more than 10%. Panic disorder and generalized anxiety disorder were the most common anxiety disorders. Bipolar mood (manic-depressive) disorder was uncommon, but schizophrenia was rare. Except for eating disorders, which were diagnosed in 1 in 20 women, the rates of specific comorbid conditions were not strkingly different between men and women.

OCD seems to be associated with a mildly increased risk for alcohol abuse and dependence. Rates of OCD observed among alcoholic patients admitted to inpatient and outpatient treatment programs exceed the rate in the general population, but not to the extent suggested by Karno et al.’s study in 1988, which attributed alcohol abuse or dependence to 24% of OCD subjects.

Reports of the lifetime rate of body dysmorphic disorder (fear of imagined ugliness) in OCD patients are also prevalent, as well as findings by Barsky in 1992 indicating that patients with hypochondriasis have an elevated lifetime prevalence rate of OCD compared to medical outpatients from the same clinic. Eating disorders may be more common in OCD patients than in the general population, but the data are sparse. According to Rothenberg in 1990, OCD symptoms are common in patients with anorexia nervosa, second only to depressive disorders. Trichotillomania (compulsive hair pulling with bald spots) is another comorbidity of OCD, as is Tourette’s syndrome (the combination of behavioral and vocal tics).

Quality of Life

OCD impairs patients’ quality of life. In a study of 60 patients, Koran, Thienemann and Davenport reported in 1996 that medication-free patients with moderate to severe OCD reported worse social functioning and performance in work and other activities than the general population and than patients with diabetes. The more severe the OCD, the more impaired the patients’ social functioning, even after controlling for effects of concurrent depression. Moreover, Rasmussen and Eisen noted in 1992 that another indicator of reduced quality of life is lower likelihood of OCD patients marrying.

The high personal cost of OCD is mirrored in high social costs. The estimated 1990 direct costs of OCD to the United States economy were $2.1 billion, and the indirect cost (i.e., lost productivity) $6.2 billion, reported Dupont et al. in 1995. If a greater proportion of individuals with OCD were in treatment, the direct costs would have been considerable higher. For example,according to Nestadt et al. in 1994, among a random sample of the Baltimore study participants, only 1 of 15 individuals (7%) whom a psychiatrist judged to need treatment was receiving it. Rasmussen and Eisen reported in 1988 that the delay between symptom onset and first seeking care is often prolonged by a mean of seven years, while Marks in 1992 reported 10 years. Even with much treatment foregone, OCD accounted for almost 6% of the estimated 1990 cost of all mental illness. High social costs are also reflected in the high rates of unemployment in OCD patients and receipt of disability and welfare payments, reported Leon, Portera and Wissman in 1995. Family members suffer as well. Many studies indicate that patients’ symptoms may create disharmony, angry or anguished demands for participating in rituals, a draining dependency, restricted access to rooms or living space, difficulty in taking holidays and intereference with work obligations.

How to recognize obsessive-compulsive disorder – Lifehacker

Likbez

Health

March 7, 2021

There is a line after which the desire to put everything in order turns into a neurosis.

You can not only read this article, but also listen to it. If it’s more convenient for you, turn on the podcast.

Being a control freak is sometimes good. It is better to make sure five times that you definitely put your air tickets and passports in your bag than to find out later at the airport that the necessary documents are missing.

But for some, the desire to control and double-check becomes obsessive. And so much so that it seriously spoils life. A person is literally obsessed with certain things. For example, he cannot leave the house until he has made sure that the iron is turned off 20 times. Or he won’t wash his hands 10 times. Or, let’s say, does not bring the hallway to a shine.

This behavior is called obsessive-compulsive disorder or obsessive-compulsive disorder (OCD). With this disorder, a person is regularly visited by obsessive disturbing thoughts (obsessions), which he tries to get rid of with the help of equally obsessive rituals (compulsions).

According to the American National Institute of Mental Health, OCD affects 1-2 people out of every 100. In the US alone, the problem affects over two million people.

It is quite difficult to recognize the line where healthy forethought or love of cleanliness begins to turn into a mental disorder. But still it is possible – if you do not miss some characteristic symptoms.

How to recognize obsessive-compulsive disorder

All people, of course, are different. But obsessions most often develop according to several scenarios of the same type. Here they are.

1. Fear of germs or dirt

An uncontrollable passion for hygiene is one of the most common symptoms of OCD.

People with this disorder are desperately afraid that disease-causing microbes will settle on their hands or body. So they wash their hands five times in a row. And repeat the procedure every time you have to touch the doorknob or handset of the office phone. Well, the need to shake hands with a colleague, hug a friend at a meeting, or, let’s say, grab a handrail in public transport, becomes their personal nightmare.

2. Unhealthy passion for cleaning

There are people whose houses literally shine. These are neat people. But if everything is clean and guests walk around the apartment like in a museum, but you are still unhappy and have an irresistible desire to rub mirrors and polish the floor in the hallway again and again, we can talk about it – obsessive-compulsive disorder.

3. The need for things to be sorted out (literally)

A cup left on the table instead of taking its place on the kitchen shelf can send a person with OCD into a natural tantrum. He is enraged by any things that, in his opinion, are not where they should be. Slippers must be placed on a shoe rack, a program must be under the TV, and even a cat must sit in its basket. A person can be nervous even if the thing is located at the wrong angle.

Some might call this behavior a perfectionistic passion for order. But no – this is also a sign of obsessive-compulsive disorder.

4. Excessive self-doubt

Many people worry about how they look, whether they are doing the right thing and what others will think of them. This is not a problem (more precisely, not the worst of them).

Such experiences become a problem when a person cannot keep them inside.

He wonders endlessly: do these jeans really suit him? Is the mascara smudged? Doesn’t he look too fat in this dress? Is he doing the right thing? And now? And now? And here he is also not mistaken?

The neurotic physically needs constant encouragement or reassurance from others that he is all right. This is what obsessive-compulsive disorder is.

5. The need to constantly double-check everything

Standard examples are supposedly an unturned iron or an unturned light, for which a person can return home two or three times. This also includes the need to pull the door handle a dozen times, even if you just locked the door with a lock and bolt. Or, for example, regularly double-check whether the e-mail has exactly gone to the addressee.

6. Obsessive counting

Trying to focus on something, many count to themselves. For example, they whisper: “One, two, three – let’s go.” This is fine.

But if a person counts the most unexpected things – let’s say, the number of trees a tram passes by, or the number of green peas in a brought salad, this is already a reason to be wary. Even worse, if the results of the calculations are disturbing (“There are 13 peas in the salad, the waiter obviously wants to spoil me!”) And they force you to perform some actions (for example, take one pea out of the salad and throw it away). This behavior is already a little beyond normal, yes.

7. Building life according to clear rituals

Maybe you arrange socks in a drawer strictly by color. Or at lunch, eat foods in alphabetical order: first drink broth from the soup (the letter “B”), then eat noodles (L), meat (M) and only after that – a boiled egg (I is the last letter of the alphabet). Or go to work the only, strictly defined route. A step to the left, a step to the right – and you already have a panic in half with the certainty that the day will go “wrong”.

If there is any, even the most harmless, ritual in your life that causes anxiety to deviate from, this may be a sign of OCD.

8. Accumulation of things

Healthy behavior is to get rid of clothes, furniture or appliances that have become obviously unusable.

It is unhealthy to think: “Yes, let it lie down (stay), and suddenly one day it will come in handy.” And do this 100 times, or even 200 times, until the house turns into a warehouse of old things. Uncomfortable, but calm. And it fits perfectly with the symptoms of OCD.

9. Obsession with relationships

Parting with a loved one, quarrel with a friend, conflict with superiors. These are unpleasant, but quite common situations. Everyone has to worry, try to understand what exactly led to the breakup or scandal, everyone has to draw conclusions. But if experiences and self-criticism last for years, you should seek help.

What to do if you suspect obsessive-compulsive disorder

The best option is to see a psychotherapist. The specialist will help you figure out if we are really talking about OCD. Perhaps he will suggest that you take a blood test: sometimes excessive anxiety is a symptom of thyroid disorders, and then you will need to consult an endocrinologist.

Obsessive-compulsive disorder, if confirmed, corrected with psychotherapy. Your doctor may also prescribe antidepressants. All this will help reduce the level of anxiety and get rid of obsessive thoughts and actions.

But you can’t hope for “it will pass by itself”. The fact is that mental disorders tend to increase, worsen with age. And this can lead to very unpleasant consequences. Experts from the American research organization Mayo Clinic name among them:

contact dermatitis due to too frequent hand washing;
inability to go to work or other public places due to anxiety;
difficulties in personal relationships, inability to create or maintain a family;
general decline in quality of life;
craving for suicide.

In general, obsessive-compulsive disorder is not something that can be considered just a personality trait. It is important to win. Until this mental disorder ruined my life.