Obsessive-compulsive disorder, or OCD, impacts approximately 1 in 40 U.S. adults and 1 in 100 children. When severe anxiety disorder like OCD goes untreated, it can significantly impair a person’s day-to-day functioning and quality of life. People with this condition will be afflicted with intrusive, stressful thoughts, and images. To find relief, they will develop certain rituals or compulsions, to alleviate these irrational obsessions. Fortunately, OCD is a treatable condition, and there are several options available to OCD sufferers, including transcranial magnetic stimulation.
What is OCD?
OCD is an anxiety-driven mental health disorder that afflicts people from all backgrounds and age groups. Slightly more women are diagnosed with OCD than men, and having a close blood relative increases the chances of someone developing OCD. People with this condition experience a variety of obsessions that get caught up in a cycle of compulsions. This cycle causes the OCD sufferer to fall into an endless loop of rituals that are often excessive and irrational. People with OCD sometimes understand that what they are doing isn’t based on logical reasoning, but they are unable to stop themselves without the proper treatment.
When someone with OCD experiences an obsession, they often feel tense, panicked, and anxious. Performing a compulsion, or OCD ritual helps alleviate these feelings, but the reality of the matter is that routines only reduce these feelings in the short-term. Eventually, the obsession comes back full-force, and the cycle repeats.
While many people will have intrusive thoughts or develop rituals, these routines don’t disrupt their life and cause them distress. The difference with OCD is the person can’t alleviate their pain without engaging in the compulsion. The cycle of obsessions and compulsions will take up a lot of someone’s time, distract them, and prevent them from performing their daily activities and responsibilities.
What are obsessions in OCD?
Obsessions in OCD typically precipitate compulsions or rituals. Obsessions are images, urges, or thoughts that recur and make the person feel out-of-control. People with OCD will find these obsessions disturbing and stressful and are unable to control them. Often, people with OCD know their obsessions aren’t logical. Unfortunately, these urges and thoughts come with deep, visceral feelings of disgust and fear, so much so that the only way they can prevent or alleviate the feelings is with compulsions. Obsessions are intrusive, anxiety-ridden and are easily triggered to the point of significantly impairing a person’s ability to function.
What are OCD compulsions?
Everyone, at some point in their life, will worry about something or appear “obsessed.” They may fear getting sick, having their car break down, or losing their job. But the difference between a “normal” fear or obsession and OCD obsessions is the pattern of disruption and extreme anxiety that accompanies distressing thoughts. As a result, people with OCD will create rituals or compulsions to deal with these obsessions and find relief.
The second part of the OCD equation is compulsions, which are repetitive actions, either physical or mental that someone performs as a way to make their obsessions go away. OCD sufferers come to rely on these compulsions as a temporary mechanism of escaping from intrusive, painful thoughts and urges. Unfortunately, performing compulsions will disrupt a person’s ability to function in their daily life.
It’s essential to understand what a compulsion is not. Having a particular bedtime routine, schedule, or religious practice does not mean a person has OCD and is performing a compulsion. Being a stickler for details doesn’t mean someone has OCD, either. The issue is that people with OCD won’t be able to stop the compulsion. Not being able to perform an OCD compulsion or ritual results in severe anxiety and distress. Also, people with OCD would usually rather not perform the compulsion, but fear the consequences of not doing so.
What are some examples of compulsions in OCD?
OCD compulsions are triggered by obsessions that a person finds distressing. For example, many obsessions have themes, like a fear of germs, or fear of being in a car accident. For someone with OCD, these thoughts and fears are impossible to stop without performing some sort of ritual.
In instances where someone is terrified of germs and contamination, they may wash their hands a total of three times before their fear is alleviated, until the next time the obsession enters their thoughts. People who have an obsession with getting into a crash on their way to work may walk through their front door a certain way and a specific number of times before they can leave the house.
These compulsions can eat up precious time, and the person with OCD may feel embarrassed when others are present while they perform a ritual. Compulsions can also be mental acts. For example, a person with OCD may count in their head to a “safe” or even number when they are presented with an obsession.
How are OCD compulsions treated?
OCD may be a distressing, chronic condition, but it is treatable. Since OCD is rooted in anxiety, many people with this condition find relief with SSRI medications that are commonly used to treat anxiety disorders. Medication alone is rarely adequate to alleviate symptoms. Combining drugs with cognitive behavioral therapy is ideal for OCD patients. With therapy, OCD patients can learn how to cope with triggers and stop disruptive compulsions and habits from occurring.
Sometimes, medications and therapy aren’t enough. But that doesn’t mean all hope for OCD treatment is lost. Transcranial magnetic stimulation (TMS) can help alleviate the anxious, obsessive thoughts that OCD patients struggle with. TMS is non-invasive, and it doesn’t come with the range of potential side effects that are common in OCD medications. Combining TMS with therapy is something worth exploring for people who haven’t found relief with medications.
A 2020 Psychiatric Times article says obsessive compulsive disorder (OCD) affects 4 million people in the United States, and the degree of impairment it causes often goes underestimated. However, treatments are available, and as many as half of the individuals with OCD don’t respond to traditional therapies or have severe side effects that make them intolerable. Even those who treatments help may still have symptoms. Researchers are searching for more effective therapies.
OCD Facts and Statistics
- OCD affects 2.2 million adults (1% of the population) in the United States.
- The same percentage of males and females are diagnosed with OCD.
- 1 in 4 cases of OCD occurs by the age of 14.
- 1 in 3 adults with OCD experienced symptoms in childhood.
- Parents may enable compulsions while trying to help.
- Anxiety disorders, depression, and ADHD may accompany OCD in children.
- Up to 50% of people with OCD had symptoms in childhood, often unnoticed.
- Researchers estimate that fewer than 1 in 10 individuals with OCD get help.
First-Line Options for OCD
Obsessive compulsive disorder is a mental condition that causes recurring thoughts and images or obsessions. To relieve the stress caused by the obsessions, individuals develop compulsions or the need to repeat certain actions. The goal of treatment is to reduce the anxiety caused by the obsessive-compulsive behavior.
Traditional OCD treatment includes a combination of three therapies:
- Cognitive behavioral therapy (CBT)
- CBT is a short-term, structured talk therapy that addresses present problems rather than focusing on the past.
- Exposure-response prevention (ERP)
- ERP is a process that allows patients to work with their therapist to expose their fears a little at a time, reducing the anxiety that feeds the obsessive thoughts and compulsions. ERP is effective if patients complete it, but almost half drop out before they finish.
- SSRIs (antidepressants)
- The first choice of medication for treating OCD is a selective serotonin reuptake inhibitor (SSRI), an antidepressant that works in up to 70% of patients but may cause serious side effects.
Other Treatment Options for OCD Compulsions
When first-line therapies don’t work, doctors may change SSRIs, increase the dose, or switch to older drugs that work but have even more side effects. It can take months or years to find the right medication. If nothing else is effective, a surgeon may implant electrodes that stimulate the area of the brain thought to cause obsessive thinking. Still, the procedure is invasive and involves greater risk and expense than other treatments.
In 2018, the FDA approved transcranial magnetic stimulation (TMS) for treating OCD compulsions that had not responded to other kinds of therapy. The FDA first approved TMS to treat major depression in 2008, followed by its approval for specific types of migraine headaches in 2013.
OCD Treatment Southern California
Updated March 27, 2021