Obsessive-Compulsive Disorder
Obsessive Compulsive Disorder (OCD) is an anxiety disorder characterized by recurrent, obsessive or unwanted thoughts followed by repetitive, compulsive behaviors. Those with OCD typically are quite rigid in their thinking and behavior, and seek consistency and avoid spontaneity (which is perceived to be dangerous). Uncontrollable thoughts are usually considered by the person to be socially unacceptable, such as bizarre sexual thoughts, or thoughts of hurting someone. The person then engages in compulsive behaviors (such as counting, touching something repetitiously, and other ritualistic behaviors) in an attempt to control the obsessive thoughts. With severe OCD, the engagement of multiple compulsive behaviors can be extremely debilitating and may result in major disruptions in the person’s life. OCD affects over 2 million adults in the United States.
There has been significant controversy over whether Obsessive-Compulsive Disorder has a genetic basis. Recent studies have shown that there is familial transmission of OCD, but there are different forms that confuse research results. There is also an association of Obsessive Compulsive Disorder with Tourette's Syndrome, further suggesting a hereditary component. OCD has also been associated with low levels of Serotonin, a chemical neurotransmitter in the brain. Environmental factors, including a history of psychological trauma, stress overload, poor self-esteem or personality issues may predispose a person to the development of OCD. Chronic insomnia, overworking, substance abuse, medical problems, and difficulties with family or other interpersonal relationships can all contribute to the onset and severity of OCD symptoms. Women with OCD may experience new onset or a worsening of symptoms during and after pregnancy, including obsessive thoughts about their new baby.
How is Obsessive-Compulsive Disorder diagnosed?
The diagnosis of Obsessive-Compulsive disorder is based on specific criteria. A history of obsessions or compulsions, with awareness that these thoughts or behaviors are disruptive to life is foremost in establishing a diagnosis. There are precise definitions of obsessions and compulsions that a psychologist or psychiatrist can use to assess an individual for OCD. The initial evaluation may include interviewing not only the Client but his or her family. OCD is characterized by symptoms which significantly interfere with work, school, relationships, or daily functioning. Symptoms cause significant distress, and the person with OCD knows that the thoughts and behaviors are unreasonable and uncontrollable. A family history of someone with Obsessive Compulsive Disorder or other anxiety disorder further supports the diagnosis.
What is the Prognosis for Obsessive-Compulsive Disorder?
Obsessive-Compulsive Disorder can be effectively managed with psychotherapy and, when necessary, medication. Sleep and stress management and psycho-education can significantly improve the wellness of someone with OCD. Medications appropriate for OCD include newer antidepressants and selective anti-anxiety drugs. Benzodiazepines (valium, ambien, klonopin) can be addicting and counterproductive when taken improperly.
What is it like to have Obsessive-Compulsive Disorder?
Famous footballer David Beckham admits he suffers from Obsessive-Compulsive Disorder. "I've got this obsessive compulsive disorder where I have to have everything in a straight line or everything has to be in pairs. I'll put my Pepsi cans in the fridge and if there's one too many then I'll put it in another cupboard somewhere... I'll go into a hotel room and before I can relax, I have to move all the leaflets and all the books and put them in a drawer. Everything has to be perfect." Asked if he wanted to stop his obsessive behaviour, he said: "I would like to. I've tried and can't stop." Beckham said that his teammates at his former club, Manchester United, would deliberately rearrange his clothes in hotel rooms or move magazines around to infuriate him.
What factors can slow recovery?
Obsessive-Compulsive Disorder can be quite debilitating, especially when associated with depression, other anxiety disorders, self-medication or substance abuse. Persons with OCD may be reluctant or afraid to seek treatment. When substance abuse (especially alcohol, marijuana or cocaine) complicates OCD it significantly interferes with effective psychological and medical treatment. Persons with OCD may isolate themselves, and they often have problems relating to family or loved ones, lacking an effective social support structure that is important to help with their recovery.
How Can Friends and Family Help?
It is important for friends or loved ones to realize that a person suffering from Obsessive Compulsive Disorder needs help, and that they are not just a "perfectionist" or "control freak." OCD rituals can entangle family members, causing them distress, and involving them in the web of the disorder. Thus, it is important that family and loved ones educate themselves about OCD to understand when the person needs help the most and how to provide a calm, supportive environment for them without antagonizing and destabilizing them. Family members can convince a person with Obsessive Compulsive Disorder that there are effective treatments available and that they need to seek help. They can also assist in monitoring medications and transporting the person to a treatment center, in addition to providing valuable emotional and financial support.
When Should a Client enter a treatment center?
When a person with Obsessive Compulsive Disorder cannot control their thoughts or behaviors, which are interfering with daily school or work life or personal and family relationships, an intensive treatment program is an appropriate option. Routine outpatient therapy such as once per week psychotherapy or medication may be ineffective at managing serious symptoms of OCD. A treatment facility, like PCH Treatment Center, offers immersive treatment that addresses the underlying deep issues that are causing the person with OCD and his family and loved ones distress and unhappiness.
How does PCH Treatment Center treat Obsessive-Compulsive Disorder?
When a person with Obsessive Compulsive Disorder arrives at PCH Treatment Center, a thorough initial assessment is performed. A doctoral level psychologist is assigned to each Client, specific to their needs and psychological issues. In the initial evaluation, we endeavor to accurately diagnosis their psychological problems, discarding useless diagnoses or stigmatizing labels. A thorough history of symptoms, behaviors, medications, medical problems and family history is obtained. The foundation at PCH Treatment Center is psychotherapy. Each Client receives four individual psychotherapy sessions per week, complemented by Somatic Experiencing. In our weekly case conferences, each Client's progress is carefully monitored, and the clinical team contributes to their care plan. Our staff psychiatrist, Dr. William Wirshing evaluates each Client after admission. He verifies the medication regimen and endeavors to minimize the number and amount of medicines each Client is taking. PCH Treatment Center places great emphasis on holistic healing, and Dr. Wirshing supports this philosophy in his work with Clients. Holistic therapies such as yoga, meditation, acupuncture and massage therapy are important for recovery and healing. Family therapy groups are also available which incorporate family members or significant others into the Client’s treatment environment.
