Obsessive-compulsive disorder (OCD) is a serious anxiety-related condition in which a person has frequent intrusive and unwanted obsession thoughts, commonly referred to as obsessions. Obsessions are unwanted, repetitive, and persistent thoughts, impulses, or images that cause significant anxiety or distress. They are frequently unrealistic or irrational. They are not simply excessive concerns about real-life issues or preoccupations. Compulsions are repetitive behaviors or rituals such as hand washing, keeping things in order, or repeatedly checking something, or mental acts like counting or repeating words silently. To learn more about OCD, consult with the “Best Clinical Psychologist near me” at TalktoAngel Asia’s No. 1 Online OCD Therapy Platform.

Obsessions or compulsions cause significant anxiety or distress in children with OCD, or they interfere with their normal routine, academic functioning, social activities, or relationships.

The definitive signs of obsessive-compulsive disorder (OCD). OCD is obsessive thoughts and compulsive behaviors even though only one of them is required to diagnose OCD over ninety percent of OCD patients experience both obsessive and compulsive behaviors. Compulsive behaviors are the obsessed mind's solution to horrific thoughts and fears. They act as the release value and allow some short respite from the overwhelming anxiety and obsessive thoughts compulsive behaviors or rituals can be either physical or mental actions and must be performed fully before the mind feels any relief.  Obsessive-compulsive disorder is the only anxiety disorder that causes patients to doubt themselves constantly. Maybe they didn’t perform the ritual correctly. Maybe they forgot to complete the ritual and schedule or maybe their eyes or their minds are deceiving them. They became completely lost in the loop of obsessive thoughts and compulsive behaviors. And they often lose themselves completely to the cyclic.

Obsessive-compulsive disorder can be identified by observing a person's compulsive behavior.

Most common types of OCD:

1. OCD of Aggressive or Sexual Thoughts– An obsession that frequently affects people is associated with a fear of hurting other people, of lashing out violently, or of having persistent images of violence and aggression. These kinds of thoughts can also be sexual, such as worrying about acting in an inappropriately sexual way or having troublesome, recurrent sexual imagery. There may be other accompanying compulsions, but these types of obsessions are frequently accompanied by the need for validation of one's goodness. In some cases, the patient is having Homosexuality Obsessive Compulsive Disorder (HOCD), in which the patient often thinks that his/her sexual orientation is different, or has excessive fears of being Homosexual.

2. OCD of Germs and Contamination/washing- Fear of contamination frequently entails overly worrying about the possibility of contracting an illness or another disease, feeling physically unclean, or even experiencing mental pollution. Feared contaminants can include things like blood, household chemicals, sticky materials or residues, individuals who appear unclean or unkempt, as well as different species of insects or animals. They are not just limited to dirt, germs, and viruses. People who suffer from this form of OCD might go to great lengths to avoid situations and locations that are linked to feared contaminants such as public restrooms, etc.  And they may engage in several protective rituals, such as cleaning throwing away "contaminated" objects, frequently changing their clothes, and designating "clean" areas of their homes that are off-limits to guests. People frequently turn to excessive washing or housecleaning to decontaminate themselves and their possessions if contaminants cannot be avoided.

3. OCD of Magical Thinking- Magical thinking OCD is a subtype of OCD marked by persistent intrusive thoughts and compulsive behaviors centered on superstition or magical thinking to ward off unpleasant events or harm to one or others.

4. OCD of Relationship Intrusive Thoughts- Relationship worries in OCD, it is a type of OCD in which the sufferer has intrusive and upsetting thoughts about their feelings of attraction or love for their significant other. Relationship obsession compulsive disorder includes being preoccupied with the relationship, questioning whether their spouse is the right one, or reflecting on the general attractiveness, desirability, or potential compatibility of their loved one. In otherwise healthy relationships, obsessions frequently surface and can lead to issues in subsequent relationships.

5. OCD of Religious Intrusive Thoughts- A person who has religious OCD bases their compulsions and obsessions on a set of religious or moral convictions. The symptoms of this type of disorder include persistent doubts, unwanted and intrusive "blasphemous" thoughts, and other intrusive thoughts. The person then tries to compensate for or gain control over these unsettling thoughts by partaking in a number of religious rituals, asking for assurance from other people, or seeking to avoid the situation entirely. Examples of religious OCD include:

• Fear of lacking sufficient faith
• Apprehension about hell
• Apprehension about consuming contaminated or inappropriate foods
• Aversion to committing sin
• Unwanted sexual or improper ideas about religious figures or God
• Seeking feedback from others on your behavior 
• Excessive begging for forgiveness or apologizing to God

6. OCD of Violent Intrusive Thoughts– You might be thinking about hurting yourself or someone else, or other dark or violent themes. Most of the time, they are merely harmless, repetitive thoughts that you have no plans to act upon. Even in your head, you don't want them. They will eventually pass, too. You may need help from the Best Psychologist in India to manage your emotions if you find yourself intending to act aggressively.

7. Body Body-focused obsessions (sensorimotor OCD)- A subtype of OCD known as body-focused (or somatic) OCD causes intrusive thoughts that are concentrated on unconscious bodily functions and processes, such as breathing, blinking, or physical sensations.

9. Hoarding OCD- Old magazines, clothing, receipts, spam mail, notes, and containers are just a few examples of the things people who hoard tend to collect and believe to have little value. Often, clutter takes over your living space to the point where it is unlivable. When compared to those with other subtypes, those with the hoarding symptom subtype frequently exhibit higher levels of anxiety and depression. A lot of the time, they struggle to keep stable jobs. And this is significant: compulsive hoarding can exist without OCD.

Common Causes of OCD

OCD can be inherited from one's parents in some cases. There are numerous reasons for OCD which are discussed below:

1. Biological factors: According to some research, the development of OCD is linked to a chemical imbalance of serotonin in the brain.OCD can be inherited from one's parents in some cases

2. Major life changes, such as a new job or the birth of a child, can place a person in a position of increased responsibility. This can set off OCD as a predisposition to the disease.

3. Perfectionism: People who are extremely organized, neat, and meticulous, as well as those who like to be in charge from a young age, are at risk of developing OCD.

4. Personal experience: A person who has been subjected to severe trauma is more likely to suffer from OCD. For example, getting a severe rash from touching rat poison in the house can cause hand-washing compulsions.

OCD in Children & Adolescent 

The World Health Organization (WHO) places OCD in the top ten of the most handicapping disorders of humans (1). OCD can begin in childhood, and approximately 8 in 10 of those developing OCD initiate it by 18 years of age (2). Parents are usually the first to notice when their child is having emotional or repetitive behavioral issues, which could be due to ADHD, ASD or OCD, or other psychological challenges. Some of the other signs that are important to note are significant drops in academic performance, despite best efforts. Severe worry amongst kid or adolescent anxiety, as evidenced by a consistent refusal to attend school, sleep, or participate in activities appropriate for the child's age. And physical complaints are common: fidgeting; constant movement outside of regular play with or without difficulty paying attention, recurring nightmares, disobedience or aggression, and threats of harm or death.  Even so, the decision to seek professional help could be difficult and painful for a parent due to stigma. A significant drop in academic performance, inability to deal with problems and carry out daily activities, significant changes in sleeping and eating habits, and extreme difficulties in concentrating.

Therapies/Treatment of OCD

The first step is to gently attempt to observe keenly and converse with the child openly, in an honest discussion about feelings can often be beneficial. Parents should consult with the child's psychologist and teachers. These steps may help the child and family solve their problem at the earliest. 

Treatment for obsessive-compulsive disorder includes therapy, psycho-education, and medication. When medication is required for the treatment of OCD, Online Consultation for medication with the “Best Psychiatrist near me” would be of great help. The most effective type of therapy for OCD is known as Cognitive Behavioral Therapy (CBT) with Exposure Response Prevention and Dialectical behavioral therapy DBT. CBT teaches people that there is a link between their thoughts, moods, and actions and that changing their thoughts to be less anxious and more realistic can improve their moods and actions. Feel free to seek Online Counselling from the Top Psychologist in India at TalktoAngel for OCD.

References:

1. Westwell-Roper C, Stewart SE. Challenges in the diagnosis and treatment of the pediatric obsessive-compulsive disorder. Indian J Psychiatry 2019;61:S119-30. 10.4103/psychiatry.IndianJPsychiatry_524_18 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

2. Veale D, Roberts A. Obsessive-compulsive disorder. BMJ 2014;348:g2183-g. [PubMed]

Contributed by: Dr (Prof) R K Suri & Ms. Swati Yadav