Your brain is a very beautiful and powerful organ and as much as it is true that your brain is what makes you function every day, it is equally important to understand that this brain may have some imperfections too.
Mental health is in focus and a hot topic these days. It becomes imperative to understand the conditions related to the brain, not to treat them but to first understand yourself better and then treat if the conditions are severe enough.
Let us have a look at one of the most common disorders, obsessive-compulsive disorder or OCD.
What Is OCD?
As the name goes OCD has two parts Obsessions and Compulsions.
Obsessions are unwelcome thoughts, images, urges worries, or doubts that repeatedly appear in your mind. They can make you feel very anxious (although some people describe it as mental discomfort rather than anxiety).
Compulsions are repetitive activities that you do to reduce the anxiety caused by the obsession. It could be something like repeatedly checking a door is locked, repeating a specific phrase in your head, or checking how your body feels.
Either obsessions or compulsions (or both) present on most days for at least two weeks to classify it as OCD. You might find that sometimes your obsessions and compulsions are manageable, and other times they may make your day-to-day life difficult. They may be more severe when you are stressed about other things, like life changes, health, money, work, or relationships.
Who Can Suffer And Why Does It Matter?
Obsessive-compulsive disorder can occur throughout the lifespan. It may also affect children as young as 6 or 7 years. At the other end of the age range, patients may present for the first time in old age too. Most adults with the disorder report onset in childhood or adolescence.
The condition is extremely important to understand as it can result in considerable disability; for example, children may drop out of education and adults can become housebound. The World Health Organization rates obsessive-compulsive disorder as one of the top 20 most disabling diseases. Recent epidemiological studies report prevalence rates of 0.8% in adults and 0.25% in 5-15-year-old children (1).
Symptoms of OCD
Most patients with obsessive-compulsive disorder experience both obsessions and compulsions.
The common symptoms of obsessive-compulsive disorder are
Obsessions
- Fear of causing harm to someone else
- Fear of harm coming to self
- Fear of contamination
- Need for symmetry or exactness
- Sexual and religious obsessions
- Fear of behaving unacceptably
- Fear of making a mistake
Compulsion Behaviours
- Cleaning
- Handwashing
- Checking
- Ordering and arranging
- Hoarding
- Asking for reassurance
Mental acts
- Counting
- Repeating words silently
- Ruminations
- “Neutralising” thoughts
Common obsessions include unrealistic distressing worries about harm, such as being responsible for an accident or the fear of contamination, accompanied by avoidance of situations in which harm or contamination may occur. These obsessions are linked with compulsive behaviors, which may temporarily reduce the associated anxiety, such as excessive checking or cleaning rituals.
Other common obsessions include a need for symmetry or orderliness, often associated with counting, ordering, and arranging compulsions; unwarranted fears and images about committing aggressive or sexual acts; and compulsive hoarding.
People of all ages, but especially children, may involve family members in their compulsions or persistently demand reassurance. Excessive doubt, the need for completeness, shame, and abnormal assessment of risk in the mind of the patient is thought to underlie most obsessions.
Aggressive obsessions are common and must be differentiated from violent thoughts occurring in other disorders, such as urges to hurt people in psychopathy. People with pure obsessive-compulsive disorder worry that they might commit an offense but do not carry out the feared act and spend an excessive amount of time and energy resisting and controlling their behavior to avoid the risk of harm.
Causes of OCD
There are different theories about why OCD develops. None of these theories can fully explain every person’s experience, but researchers suggest that the following are likely to be involved in causing OCD (2)
- personal experience
- personality
- biological factors
Personal Experience
Some theories suggest that OCD is caused by personal experience.
For example:
If you’ve had a painful childhood experience, or suffered trauma, abuse, or bullying, you might learn to use obsessions and compulsions to cope with anxiety. If your parents had similar anxieties and showed similar kinds of compulsive behavior, you may have learned OCD behaviors as a coping technique.
Ongoing anxiety or stress, or experiencing a stressful event like a car accident or starting a new job, could trigger OCD or make it worse. For some women, pregnancy or birth can trigger perinatal OCD.
Personality
Some research suggests that people with certain personality traits may be more likely to have OCD. For example, if you are a neat, meticulous, methodical person with high standards, you may be more likely to develop OCD.
Biological Factors
Some biological theories suggest that a lack of the brain chemical serotonin may have a role in OCD. However, it’s unclear whether this is the cause or an effect of the condition. Studies have also looked at genetic factors and how different parts of the brain might be involved in causing OCD, but have found nothing conclusive.
References:
Heyman, I., Mataix-Cols, D. and Fineberg, N.A., 2006. Obsessive-compulsive disorder. Bmj, 333(7565), pp.424-429.
‘OCD mind 1’ (2019), pp. 1–16.
Author: Dr Pooja Nilgar (Content writer and editor)
