Obsessive Compulsive Disorder. What is it? How do we help folks wit it?
Updated: Oct 7, 2019
A person uses Obsessive Compulsive (OCD) to manage anxiety. People with this disorder may not disclose it to others because of its embarrassing nature.
What constitutes OCD?
- The person shows obsessions and or compulsions.
- The person has recognised that what they are doing is excessive or unreasonable.
- There is a marked distress about what they are doing.
- It takes more than an hour a day.
- It significantly disrupts the persons normal daily living.
- The disturbance is not due to substance abuse.
- The disturbance is not because of a general medical condition.
The definition of Obsession:
It is a repetitive, intrusive thought, image or impulse that is difficult to control. It has five components:
- Recurrent and persistent thoughts, impulses or images.
- Intrusive and inappropriate causing marked anxiety or distress.
- The thoughts, impulses or images are not simply excessive worries about real life problems.
- The person tries to ignore or suppress these thoughts, impulses or images.
- The person recognises that the symptoms are a product of their own mind.
What are the major types of obsessions?
- Somatic (body image or illness)
- Need for symmetry
The definition of compulsion:
The need to engage in an overt or mental action to decrease the anxiety associated with an obsession. There are two major characteristics:
1. Repetitive behaviours. Mental acts like counting or repeating thoughts.
2. These acts are aimed at preventing or reducing the distress or preventing some dreaded event or situation.
There are major types of compulsions:
- Need to ask or confess
- Symmetry and precision
As more research is done on OCD it has become apparent that biological factors are a major contributor. The fact that medication which inhibits the re-absorption of Serotonin in the body, has a positive affect with this disorder points to a pure biological cause for the concern. There are other times when the same medication has no effect, which means that there could be deep childhood trauma underlying these behaviours. What is interesting to note is that Panic Disorder patients respond to small doses of the Serotonin replacement drug, depressed patients require medium doses, and OCD patients require large doses.
Many life stressors can lead to low serotonin:
- Prolonged periods of stress can deplete serotonin levels.
- Genetic factors, faulty metabolism, and digestive issues can impair absorption and breakdown of our food which reduces our ability to build serotonin.
- Poor Diet. Neurotransmitters are made in the body from proteins. If your nutrition is poor and you do not take in enough protein, vitamins, or minerals to build the neurotransmitters, then a neurotransmitter imbalance may develop.
- Toxic substances like heavy metals, pesticides, drug use, and some prescription drugs can cause permanent damage to the nerve cells that make serotonin and other neurotransmitters.
- Certain drugs and substances such as caffeine, alcohol, nicotine, NutraSweet, antidepressants, and some cholesterol lowering medications deplete serotonin and other neurotransmitter levels.
- Hormone changes may cause low levels of serotonin and neurotransmitter imbalances.
- Lack of sunlight may contribute to low serotonin levels.
As you can see there are so many ways which Serotonin can become depleted in the brain and body. Some we have control over and others we do not.
As a person suffering from OCD continues their repetitive nature, they are building and strengthening the neural pathways in which the habit becomes more ingrained into daily life. This also means that the same biochemical reactions are taking place in the brain and body, creating the same feelings, driving the same thoughts, creating the same behaviours.
There is another disorder called Obsessive-Compulsive Personality Disorder where people believe, that everything they do must be perfect and continue to go over and over their work in an attempt to improve it even though the work is good enough. It also involves extreme discipline. These individuals want perfection and symmetry and order but do not have the compulsions associated with OCD.
Techniques used by a health care workers, psychologist, psychiatrist and counsellors for treating OCD may be:
1. Self-Care – Adequate sleep, balanced diet, exercise, get outdoors
2. Journaling – Writing down all the thoughts leading up to the OCD behaviours. Then bringing the journal to their next session with the therapist to analysis these thoughts.
3. Relaxation techniques – These include slow diaphragmic breathing and moving through the body relaxing each body part.
4. Meditate – The client should practice mental rehearsal where the person daily visualises themselves as functioning a happy life without OCD. Find a good meditation teacher and practice daily.
5. Exposure Therapy – Exposing themselves to the trigger which causes the OCD. This brings about systematic desensitisation.
6. Pairing Therapy – The therapist puts the person in the environment where the OCD occurs then incorporates relaxation techniques instead of the normal OCD behaviours. This reprograms the brain to relax to the signals which trigger the behaviours.
7. Medication – Medication might be prescribed depending on the severity of the disorder. This can kick start the recovery. This must be diagnosed and prescribed by a Mental Health Nurse, Doctor or Physiatrist.
8. Cold Therapy – Reducing the core body temperature by at least 1c releases Norepinephrine and dopamine, giving the individual an emotional lift. This should only be done under guidance of a trained cold therapy practitioner. Otherwise hypothermia could result.
Dealing with this disorder is a complex one but not impossible. A balanced mix of healthy lifestyle choices, therapy, mindfulness, cold therapy, and possible medication will help move a sufferer in the right direction.