If your loved one has obsessive-compulsive disorder (OCD), they may not be able to break free of their symptoms on their own. You can help by getting them the treatment they need. Here’s how.
Obsessive-compulsive disorder (OCD) is a mental health condition noted for its intrusive thoughts and repetitive rituals employed to banish those thoughts. It can be annoying at best, and completely debilitating at worst. OCD is more than just a passing problem for most people who develop it. According to the Harvard Medical School National Comorbidity Survey (NCSSC), the overall occurrence of OCD among US adults was 2.3%. Of those, 14.6% had mild impairment, 34.8% moderate impairment, and over one half (50.6%) serious impairment. At Aura Psychiatry, PLLC, Farheen Makani, PMHNP-BC and the staff have extensive experience treating people with all forms of OCD at their San Antonio, Texas, office. Each person’s symptoms are unquestionably unique, but the disorder can be broken into several general categories that make understanding and treating OCD possible and effective. Here’s how to help a loved one with OCD. Understanding OCD To help someone with OCD, it’s first important to understand the nature of the problem. Obsessive-compulsive disorder is composed of two parts: intrusive ideas, thoughts, or sensations (obsessions); and repetitive behaviors (compulsions) performed to eliminate the obsessions and make the world “right.” Everyone has distressing thoughts or repetitive behaviors from time to time, but they generally don’t disrupt daily life. For people who have OCD, though, the obsessions are persistent, and the behaviors must be rigidly performed. Failure to perform the behaviors, or not performing them the exact way “necessary,” causes overwhelming distress, even panic. Most people living with OCD know their obsessions aren’t realistic, but their brain chemistry compels them to perform the rituals anyway. A diagnosis of OCD requires the presence of obsessions and/or compulsions that are time-consuming (greater than an hour a day), cause significant distress, and interfere with work, school, or social functioning. Some of the most common categories of obsessions include:
Fear of germs beyond healthy measures
Fear of being “contaminated” by people or the environment
Disturbing sexual thoughts or images
Overwhelming concern with order, symmetry, or precision
Intrusive, recurrent thoughts of sounds, images, words, or numbers
Fear of losing or discarding something important
General categories of compulsions include:
Excessive or ritualized hand washing, showering, brushing teeth, or toileting (even to the extent of rubbing the skin raw)
Repeated cleaning of objects (tables, chairs, door handles)
Arranging and rearranging things in specific ways
Repeatedly checking locks, switches, or appliances
Repeatedly counting to a certain number
It’s possible to have multiple types of obsessions and compulsions at the same time, such as organizing objects while counting their number, then cleaning them off and starting again. Many people with OCD feel embarrassment or shame about their condition, so they get very good at hiding their rituals from other people. This unfortunately allows the disorder to progress to an advanced state before anyone realizes they need help. Treating OCD OCD isn’t curable, but it can be controlled with various types of medication and/or some form of psychotherapy. Medication Selective serotonin reuptake inhibitors (SSRIs), a class of drugs commonly used to treat depression, can also be effective at treating OCD, although a higher dose generally is required. If patients don’t respond to one SSRI, they sometimes respond to another, so it’s worth trying different medications to find which works best. Other psychiatric medications, like serotonin and norepinephrine reuptake inhibitors (SNRIs) and some antipsychotics, can also be effective. It may take 6-12 weeks before the medication reaches a therapeutic level, so if you don’t see a result right away, don’t give up. Psychotherapy Two types of psychotherapy are effective for OCD: cognitive-behavioral therapy (CBT) and exposure and response prevention (ERP). CBT is based on several principles, including:
Mental health problems stem, in part, from faulty or unhelpful ways of thinking.
Mental health problems stem, in part, from learned patterns of unhelpful behaviors.
People living with mental health problems can learn better ways of coping with them, relieving symptoms.
CBT treatment therefore strives to change the unhelpful thinking patterns leading to ritualized behaviors. During ERP treatment sessions, patients are exposed to the images or situations that reflect their obsessions; it’s understood this initially leads to increased anxiety, so it’s important this be done under therapeutic supervision. While exposed, patients are instructed to avoid engaging in their usual compulsive behaviors (response prevention) for as long as possible. When people remain in a fearful situation without anything terrible occurring, it helps them understand their fearful thoughts are just thoughts, not reality. It also helps them learn they can address their obsessions without needing to perform ritualistic behaviors. As a result, with continued exposure, their anxiety decreases over time. If your loved one is showing signs of OCD, you need to get them medical help to overcome it. To get started, call Aura Psychiatry, PLLC at 469-599-2872 to set up a consultation, or book online with us today.