Across the world, millions of people suffer from obsessive-compulsive disorder (OCD). Characterized by persistent, unwanted thoughts (obsessions) and repetitive behaviours or mental acts (compulsions), OCD can significantly impair a person’s ability to function in daily life. Understanding the symptoms, types, and available treatment options for OCD is crucial for those affected and their loved ones.

Symptoms of OCD

Compulsions and obsessions are the two fundamental groups into which OCD symptoms may generally be divided, however, they can vary greatly from individual to person.

1. Obsessions

Anxiety and anguish are caused by intrusive thoughts, visions, or urges that are called obsessions.  Common obsessions include:

• Fear of Contamination: Worrying about germs or dirt leads to compulsive cleaning or handwashing.
• Fear of Harm: A persistent worry that something bad will happen to oneself or others, often leading to checking behaviours (e.g., repeatedly checking if doors are locked or appliances are turned off).
• Need for Order or Symmetry: An intense discomfort when objects are not arranged in a particular way, prompting compulsive organizing or arranging.
• Fear of Losing Control: Worries about acting on impulses that may harm oneself or others, leading to compulsive avoidance of certain situations.

2. Compulsions

Compulsions are repetitive behaviours or mental acts that individuals feel driven to perform in response to their obsessions, aimed at reducing anxiety or preventing a feared event. Common compulsions include:

• Washing: Excessive handwashing, showering, or cleaning to alleviate fears of contamination.
• Checking: Repeatedly checking locks, appliances, or personal belongings to reduce anxiety about potential harm.
• Counting: Engaging in counting rituals or performing actions a specific number of times.
• Ordering and Arranging: Organizing items in a specific way to alleviate discomfort.

Types of OCD

OCD can manifest in various forms, and different types of OCD are characterized by specific themes. Some common types include:

1. Contamination OCD

Individuals with contamination OCD have an intense fear of germs or dirt. This fear often leads to excessive cleaning, handwashing, or avoiding public places perceived as dirty. The compulsive behaviours serve as a means to alleviate anxiety about contamination.

2. Checking OCD

Those with checking OCD frequently worry about harm coming to themselves or others. This can manifest in compulsive checking behaviours, such as ensuring doors are locked or appliances are turned off. The fear of causing harm or being responsible for a negative outcome drives these compulsions.

3. Symmetry and Order OCD

Individuals with this type of OCD experience discomfort when objects are not arranged in a certain order or symmetry. They may engage in compulsive organizing and arranging to alleviate their anxiety. This need for order can become time-consuming and interfere with daily life.

4. Hoarding Disorder

While hoarding is often discussed separately from OCD, it can be seen as a related condition. Individuals with hoarding disorder struggle to discard items, leading to clutter that disrupts their living space. This behaviour often stems from a fear of losing important information or items.

Treatment for OCD

Treating OCD often involves a combination of therapy and medication. The most effective treatment approaches include:

1. Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy is a widely used therapeutic approach for OCD, specifically a subtype called Exposure and Response Prevention (ERP). To assist patients in stopping obsessive behaviours, this therapy entails exposing them to their fearful ideas or circumstances gradually.  Over time, this exposure reduces anxiety and the need to perform compulsions.

2. Medications

People with OCD are frequently administered selective serotonin reuptake inhibitors or SSRIs. These medications help regulate serotonin levels in the brain, which can alleviate OCD symptoms. To find the right drug and dosage, it's crucial to speak with a licensed healthcare provider.

3. Mindfulness and Relaxation Techniques

Incorporating mindfulness practices and relaxation techniques can help individuals manage anxiety and intrusive thoughts. Techniques such as deep breathing, meditation, and yoga can promote relaxation and improve overall well-being.

4. Support Groups

Participating in support groups helps foster a sense of belonging and understanding. Making connections with people who have gone through similar things to you might lessen feelings of loneliness and offer helpful coping mechanisms.

5. Online Counseling

With the rise of digital platforms, online counselling has become a viable option for individuals seeking support for OCD. Through platforms like TalktoAngel, individuals can connect with trained therapists from the comfort of their homes. Online counselling can be particularly beneficial for those who may have difficulty accessing traditional therapy or prefer the convenience of virtual sessions.

The Impact of Untreated OCD

When OCD is left untreated, it can severely impact various aspects of life, leading to a range of problems, including:

• Workplace Conflicts: OCD symptoms can interfere with productivity, focus, and relationships with colleagues.
• Poor Physical Health: The stress of living with OCD can weaken the immune system, increase physical tension, and lead to conditions such as headaches or fatigue.
• Substance Abuse: Some individuals may turn to drugs or alcohol as a way to cope with the anxiety caused by OCD, leading to further health complications.
• Depression and Anxiety: The constant worry and stress of living with OCD can lead to comorbid mental health conditions such as depression and anxiety.
• Social Isolation: OCD symptoms can make it difficult to engage in social activities, which can result in feelings of loneliness and isolation.
• Low Self-Confidence: The inability to control obsessive thoughts or compulsive behaviors can erode self-esteem and self-worth.
• Marital Conflicts: OCD can place strain on relationships, especially when rituals and obsessions dominate daily life, leading to communication breakdowns or frustration.
• Stress and Anger: Constantly battling intrusive thoughts and engaging in compulsions can lead to overwhelming stress and feelings of anger, both towards oneself and others.

Seeking Professional Help

It's critical to get professional mental health assistance if you or somebody you know is experiencing OCD symptoms. The best psychologists in India specialize in treating OCD and can provide tailored treatment plans to address individual needs. Early intervention and effective treatment can significantly improve quality of life and help individuals regain control over their thoughts and behaviors.

Conclusion

Obsessive-Compulsive Disorder is a challenging mental health condition that can impact various aspects of life. By understanding the symptoms, types, and treatment options, individuals can better navigate their experiences with OCD. If you are seeking support, consider exploring online counselling services such as TalktoAngel, where you can connect with compassionate professionals committed to helping you manage OCD effectively. Remember, seeking help is a vital step towards recovery and a fulfilling life.

Contribution: Dr (Prof) R K Suri, Clinical Psychologist, life coach & mentor TalktoAngel & Ms Gurleen Kaur, Counselling Psychologist.

References

• Stein DJ, Costa DLC, Lochner C, Miguel EC, Reddy YCJ, Shavitt RG, van den Heuvel OA, Simpson HB. Obsessive-compulsive disorder. Nat Rev Dis Primers. 2019 Aug 1;5(1):52.  doi: 10.1038/s41572-019-0102-3
• Mayo Clinic: Obsessive Compulsive Disorder: https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/symptoms-causes/syc-20354432 
• Jon Hershfield, MFT, & Tom Corboy, MFT Mindfulness and Cognitive Behavioral Therapy for OCD https://iocdf.org/expert-opinions/mindfulness-and-cognitive-behavioral-therapy-for-ocd/ 
• TalktoAngel online counselling platform for OCD: https://www.talktoangel.com/area-of-expertise/ocd