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Obsessive-Compulsive Disorder: Diagnostic Criteria, Impact on Person’s Life and Treatment
Obsessive-compulsive disorder, or otherwise popularly known as OCD is one of the most widely spread disorders across the country today. As individuals, we each have small habits that make us feel better, but we can also live without them. For example, we can think of something as lucky or have a regular routine that feels comforting. But for people who experience obsessive-compulsive disorder, these behaviors are much more severe and disruptive and are driven by unwanted and recurring thoughts that the person cannot control. It is not always easy to understand, but this disorder traps people in endless cycles of repetitive thoughts and behaviors and can cause dysfunction in a persons life. This research paper will, therefore, discuss the mental illness known as Obsessive-Compulsive Disorder (OCD) and the impact it has on a person suffering from it. This paper will further discuss the diagnostic criteria of OCD with examples of how these criteria manifest in behavior and the different treatment options for treating it as well.
Definition and Classification of Obsessive-Compulsive Disorder (DSM-V)
OCD stands for Obsessive-compulsive disorder. It is a neuropsychiatric disorder that affects children, adolescents, and adults all over the world. It is a psychological condition which involves primarily two kinds of symptoms where you have obsessions and compulsions. Despite the many research attempts to find the exact cause of OCD, it has proven futile. However, OCD is considered to have a neurological basis with neuroimaging studies showing that the brain functions differently in people with the disorder (CMHA National, 2018). Abnormalities or an imbalance in neurotransmitters, including serotonin or dopamine are thought to be involved in OCD. In certain individuals, OCD could be triggered by a combination of genetic, neurological, behavioral, cognitive and environmental factors (International OCD Foundation, 2018).
Typical Diagnostic Criteria examples of OCD and how these criteria manifest in behavior
Obsessions may involve persistent fears of being prone to danger or injuring someone else, or of a loved one being harmed. People with OCD may have repeated thoughts such as I must have left the door unlocked or other obsessions may have to do with questioning ones sexual identity and constantly attempting to seek reassurance on ones sexuality. Also, fear of loss of impulse control, or a sense that one will act out and do something crazy , resulting in constant contemplation of inflicting harm on others or of self-harm. These thoughts can cause one to avoid sharp objects or knives, areas of perceived danger or possibly social interaction for fear of what may occur.
Compulsions, on the other hand, are repetitive behaviors that an individual feels the driven need to perform or engage in response to an obsession. People with OCD cope with their obsessions by using repetitive ritualized behaviors which may include frequent hand washing, checking things (such as locks or stoves), counting (example: counting certain items over and over again), rearranging objects persistently and repeating words. OCD, as unique as each individual, often centers around certain themes. A general theme about OCD is that obsessions concern situations where there is some degree of uncertainty (what if X happens and I did not do enough to prevent it?) (Clark, 2009). These themes are not limited to the ones we see on TV such as germaphobia. This is a term used to describe a pathological fear of germs and infection. These themes can also involve body dysmorphic disorder, scrupulosity or religious OCD in which people doubt the love they have for their partner or vice versa (EverydayHealth.com, 2018). These obsessions are recurrent and persistent thoughts that are experienced by an individual which trigger intensely disturbing feelings, which in most cases are marked by anxiety or distress.
Compulsive rituals are all about trying to get assurance, support and certainty. Someone with OCD might be afraid to throw anything away and have a strong emotional attachment to many things they own. On the other end of the scale, someone with OCD might turn down a lunch date or other social activities to stick with their cleaning schedule. These obsessions and compulsions are time-consuming and most at times, people with OCD realize that these thoughts do not make sense; however, they are unable to control them. Ignoring or making an effort to stop your obsessions may be accompanied by intense and uncomfortable feelings such as fear, doubt, or a feeling that things have to be done in an exact way. Ultimately, you feel the drive to perform compulsive acts to try to ease the stress. The symptoms of OCD are not attributable to the physiological effects of any substance such as the use of drug, or medication. The content of the obsessions or compulsions is not restricted to the presence of any other disorder. Example, hair pulling in the presence of Trichotillomania or preoccupation with the use of drugs in the presence of a substance abuse disorder (CMHA National, 2018).
Diagnosis of Obsessive-Compulsive Disorder (OCD)
Most people have obsessive thoughts or behaviors at some point in their lives, but this does not place them in the category of suffering from a mental disorder. There may be some challenges in making a diagnosis for OCD since the symptoms of the disorder appear similar to those associated with anxiety disorder, depression, schizophrenia, and a number of other mental illnesses. Diagnosis for this disorder should be done by an interview with a trained professional. When the symptoms get to a point where it gets in the way of functioning or causing a great deal of distress, this is when a trained professional will conclude if the person meets the criteria for diagnosis for the disorder (International OCD Foundation, 2018).
Description of how OCD impacts on a persons life
Dealing with obsessive-compulsive disorder can be very challenging and hard to explain to other people. One may feel ashamed, uncomfortable, or guilty about their experiences, and as a result, these feelings can make it hard to seek help. Because of the nature of OCD, people can spend hours and hours a day having these disturbing thoughts or carrying out these behaviors. Not only do these people experience extremely high anxiety levels, but the disorder also comprises their ability to work and have a normal life. According to the Canadian Mental Health Association, many people describe OCD as something that takes over their life, and this is not easy to deal with. People living with OCD experience a number of detrimental effects due to their condition. Some of the possible outcomes of living with the disorder include; isolation. A person dealing with OCD is under an immense amount of pressure to complete their rituals. The time spent performing these compulsive behaviors is exhausting, and this can cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. This can lead to isolation and loneliness which usually worsens when the individual avoids leaving home because some public situations may trigger the need to do the rituals. The constant thought of thinking one is crazy is also an effect people living with obsessive-compulsive disorder have to deal with. Apart from the stigma mental illness comes with where people are labeled as crazy , people who continuously have these intrusive thoughts that intrude on their everyday life, coupled with strong urges to perform certain behaviors and rituals may begin to think they are crazy if they do not understand the condition (CMHA National, 2018). People with OCD display symptoms such as signs of depression, excessive worry, extreme tension, and the constant feeling that nothing ever goes right. Depression can cause an individual to lose interest in pursuing their life goals, and can, unfortunately, drive a person to attempt suicide if left untreated. According to Everyday Health , over 66% of suicides have depression as a factor (EverydayHealth.com, 2018). Depression not only affects the mind of an individual, but it also affects the individuals body. Some of the physical effects of depression may include inconsistent sleep patterns, loss of appetite, constant fatigue, muscle aches, headaches, back pain and other physical symptoms. OCD can go a long way in affecting the physical health of an individual. Individuals living with OCD experience incredible pressure as they feel a strong urge to perform their rituals and perform them properly. In long-term, this pressure and the exhaustion due to working the rituals for hours each day can lead to skin infections and ulcers. For example, those whose ritual involves hand washing several times per day can develop serious skin lesions and infections. (CMHA National, 2018).
Treatment options used in curing OCD
The best advice to people suffering from OCD is to educate themselves about their condition. As with any persistent illness, understanding the disorder can help one become well-informed about the disorder. This will help you to cope with the illness more effectively. People dealing with OCD or any other mental illness should learn the things that ease or ail their symptoms. This way, they can come up with an effective coping approach. Obsessive-compulsive disorder treatment may not result in a cure, but it can bring some symptoms experienced by the individual under control so that they do not rule their daily lives. Approximately, 1% to 2% of the Canadian population will experience an episode of OCD; a high possibility exists more women experience the disorder than men. The majority of individuals report onset in late adolescence or early adulthood, with very few people experiencing the first onset after 40 years of age. (Clark, 2009). While others may need treatment for the rest of their lives; some individuals may experience significant improvements with treatment, while some may achieve remission. People dealing with the disorder and their family members should be educated about the chronic nature of the disorder and how it is likely to persist if not treated effectively. OCD also affects the entire family of the person who has it. Usually, the family members have difficulty accepting that the person with OCD cannot stop the disruptive behavior. This may arouse feelings such as hurt when a loved one is experiencing distressing symptoms of OCD. Aside from this, families still play a major role in the treatment process of the person with the mental illness. They can learn ways to encourage and support the individual to seek help and follow through with treatment. According to Psychology Works Fact Sheet: Obsessive-Compulsive Disorder , a type of therapy known as the cognitive-behavioral therapy or CBT has proven to be an effective treatment method for helping people with most types of OCD (Clark, 2009). This particular method teaches the individual about how their thoughts, feelings, and behaviors work together and suggest different coping mechanism skills such as problem-solving, managing stress, realistic thinking, and relaxation. This therapy works to manage psychological conditions, such as OCD by changing the way people think and behave. For OCD, some of the common therapies may include an approach called exposure and response prevention (ERP). With this therapy, a person is gradually exposed to situations that provoke obsessive thoughts but is prevented from performing the usual compulsive ritual (Clark, 2009). For instance, if the person is obsessed with cleanliness, they may be asked to touch a dirty cup and then wait for a predetermined length of time before washing their hands. This helps the person to learn new thought patterns and behaviors about their obsession with dirt. Even though this form of therapy involves a lot of effort and practice, it goes a long way in rewarding the person with a better quality of life. The basic idea behind exposure and response prevention is that compulsion allows obsession to exist by interrupting the habituation process. The habituation process is what causes a person to have less interest in a certain event once that person has witnessed the same event many times. For example, if your friends threw a surprise party every day, you would eventually stop being surprised and thrilled. In the same manner, if the compulsion did not exist, the obsession would become less and less thought-provoking until it eventually disappeared (CMHA National, 2018).
Once a compulsion is fulfilled by an obsession, the person feels a temporary relief of anxiety. The relief serves to reinforce the compulsion as a reward, and it becomes a continuous cycle. That is to say, without compulsion, obsession would not occur and vice versa. According to ‘Psychology Works Fact: Sheet Obsessive-Compulsive’ disorder, studies have shown that 76% of individuals who complete treatment (13 to 20 sessions) will show significant and long-lasting reductions in their obsessive and compulsive symptoms (Clark, 2009).
Another remedy for OCD can be with the use of prescription medications. Most medications used to treat OCD affect levels of serotonin, a compound present in blood platelets that acts as a chemical messenger in the human brain. The most effective treatment drugs for OCD are antidepressants such as fluoxetine, paroxetine, fluvoxamine, and sertraline. These medications fall under a category known as selective serotonin reuptake inhibitors (SSRIs). The SSRIs work to increase the levels of serotonin in certain areas in the brain, which is usually low in people with obsessive-compulsive disorders. A nonselective serotonin reuptake inhibitor known as clomipramine is also commonly used (CMHA National, 2018). Some of these medications may have side effects such as vomiting, diarrhea, or appetite changes. Immediately an individual experiences the above symptoms, the issue must be reported to the doctor. A negative effect on the use of drugs for the treatment of a mental illness is the possible addiction or dependence on these drugs. According to research, treatment is said to be the most effective when both the behavior therapy and medication are combined together. (CMHA National, 2018).
Conclusion
Although there has not been a profound cure for OCD, and its exact origins are not exactly known by science or medicine at this time, there is help offered to those who suffer from compulsions, obsessions, and intense anxiety created by unwanted thoughts and inaccurate beliefs. The first step toward treating the disorder is to seek out the help of a therapist or a skilled professional through a medical clinic, mental health facility, or with the help of family members or friends. The effects of OCD can wreak destruction on an individuals life, so, understanding and being knowledgeable about the chronic illness makes one become an expert about the disorder and can help in a long-run with how to cope with the disorder effectively.
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