Treatment for OCD

Author: J. Flowers Health Staff

What is OCD?

Obsessive compulsive disorder (OCD) is a mental disorder characterized by the combination of obsessions and compulsions. While obsessions are unwanted and intrusive thoughts and urges, compulsions are behaviors that the individual will engage in to pacify the obsessions. With the combination of both of these, the individual generally experiences a high level of anxiety and distress due to the OCD symptoms, however, there are medications and there is more than one OCD treatment available.

Addiction vs OCD

Although addiction is separate from obsessive compulsive disorder, there are some relationships between both conditions. For example, when evaluating the relationship between addiction vs compulsion, it is important to establish a difference between the two. Addiction is defined as the dependence that an individual develops on a particular substance or addictive behavior. Compulsions, on the other hand, are intense urges that an individual feels towards a certain behavior.

Compulsions may influence addiction because the intense urges that are generally a side effect of addiction can cause intrusive feelings that incite a behavior.²As for addiction vs obsession, the ritualistic components of obsession look like an addiction. However, addiction is typically behavior that is performed as a mental escape, and obsessions do not result in any type of pleasure.³

Obsession vs Compulsion

When exploring OCD, both obsessions and compulsions must be present for the disorder to be diagnosed. Because the obsessions generally precede the compulsions and because the compulsions are used to neutralize the obsessions, both must be present for OCD to be diagnosed properly.

Defining OCD

How Common is OCD?

OCD can impact both children and adults. The International OCD Foundation estimates that about 1 in 100 adults who live in the United States currently live with OCD. Furthermore, 2 to 3 million adults are suffering from this disorder and could benefit from OCD treatment.

At least 1 in 200 (approximately 500,000) children and teens live with OCD. As a comparison, this number is nearly the same percentage of children men teens who suffer from diabetes.

How Is OCD Diagnosed?

OCD must be diagnosed by a medical professional or mental health professional. Generally, these clinicians will use the ICD-10 or DSM-5 criteria. Both diagnostic guidelines hold that obsessions and compulsions must be present and must cause the individual high levels of distress and anxiety.

In addition, the obsessions and compulsions must not be related to any other disorder, including substance use, generalized anxiety, and depressive episodes. The obsessions and compulsions must be present for an extended period.

OCD Triggers

Triggers are people, objects, places, and events that influence or cause an emotional response. For individuals with OCD, triggers are often related to their obsessions. For example, if an individual with OCD needs to have all their items perfectly lined up and in a specified location, and someone moves one of the items, it may cause that individual extreme levels of anxiety. They will also likely feel the need to participate in the compulsive behavior to fix the object.

Who Suffers from OCD?

OCD Symptoms in Children

Because children can have OCD, it is important to watch for these symptoms to emerge. Typically, OCD in children will develop between the ages of 8 and 12 and some or all of these symptoms may be present at various levels of severity.

Frequent irrational fears and worries

Referring to disturbing thoughts and feelings that the child feels they cannot control

Unusual or illogical behaviors of a child cannot explain

Anxiety or tantrums that occur when something is out of order

Desire to place things in a particular order

Rituals such as circling the room before leaving

Trouble focusing on schoolwork or homework

Checking and rechecking

Abnormal amounts of worry that something bad is going to happen

Trouble making new friends and keeping friendships

Anger when a compulsive behavior is interrupted

Depressed mood or anxiety.³

OCD Symptoms in Adults

In adults, there will be symptoms of both obsessions and compulsions. These symptoms can be observed by watching their behavior or discussing via an interview. It is also important to keep in mind that the symptoms of OCD can vary in severity and should be addressed if they are thought to be causing excess amounts of worry, changes in behavior, or prevent the individual from participating in daily life activities.

Obsessions are unwanted and intrusive thoughts that can cause the individual stress or anxiety. Typically, obsession symptoms will have a theme and can be characterized by any of the following:

Fear of contamination

Struggles with doubt and uncertainty

A need to have everything orderly and symmetrical

Thoughts regarding losing control and harming oneself and others

Pervasive and unwanted thoughts such as aggression, sexual, or religious topics

Avoidance of any triggering situations or objects

Increased invisible stress when something isn't orderly or right

Compulsions typically resemble repetitive behaviors that can be ritualized in some cases. These behaviors are meant to counteract obsessive thoughts and urges. For example, compulsions may have themes and could include some of the following behaviors:

Washing one’s hands until the skin becomes raw

Repeatedly checking and locking doors to make sure they are locked

Repeatedly checking a stove to ensure it's turned off

Counting behaviors

Repeating a prayer, word, or phrase

Always placing objects in a symmetrical or certain way⁴

Treating a Dual Diagnosis of OCD and Addiction

OCD and addiction can be co-morbid. The individual may turn to substances to cope with the intense levels of anxiety that that individual feels daily, particularly when social isolation results from OCD. That person may feel shame and loneliness because of the way that their OCD affects them.

Because some types of OCD also make an individual less likely to see their loved ones, loneliness can become a problem. When treating OCD and addiction as dual diagnoses, the disorders must be treated at the same time. OCD and addiction are likely entwined, and only treating one disorder while ignoring the other one will be detrimental to that client’s healing and progress.⁵

Cognitive-behavioral therapy (CBT) is one type of OCD treatment that has shown to be effective in treating addiction and OCD. Because CBT focuses on coping mechanisms and how to properly manage unwanted thoughts and feelings, this treatment is a great option for all types of people. Furthermore, antidepressant medication can be used alongside CBT methods.⁶

What is Dual Diagnosis?

According to the Alcohol and Drug Foundation, dual diagnosis is the term used to describe a condition in which the person is experiencing both mental health challenges as well as substance use. Often referred to as co-morbidity and co-occurring, both of these disorders harm the individual’s life and should be treated together instead of separately.⁷

OCD Treatments for Symptoms

Luckily, there are many treatment options for those with OCD. For example, medication, psychotherapy, and the use of brain imaging technology have all been used for treatment.

Medication

Medication, such as anti-depressants like serotonin reuptake inhibitors (SRIs), can be used to treat OCD symptoms and compulsive behaviors. Since a symptom of OCD is often depression or anxiety, these medications can be used to treat OCD. However, you should discuss these medications with your medical doctor so that you can monitor the progress made by using the medication.

Additionally, it is beneficial to attend therapeutic sessions whether with a rehabilitation center, inpatient program, outpatient program, or psychotherapy. While the drugs themselves may lessen the symptoms of OCD, individuals must learn coping mechanisms to manage obsessions and compulsive behavior.⁸

Psychotherapy

Psychotherapy and other psychological treatments can aid in OCD treatment. Particularly, cognitive-behavioral therapy (CBT) is a successful treatment method because it works to help individuals manage unwanted thoughts and feelings.

Additionally, the use of exposure and response prevention (ERP) helps individuals face obsessive thoughts, cope with such experiences, and learn how to handle triggers. Generally, psychotherapy and ERP are performed by licensed medical professionals or mental health professionals.⁸

Self-Help Strategies

Along with the use of medication and formal OCD treatment options, self-help strategies are beneficial in helping the individual cope and manage the stress of their daily lives. While many of these self-help strategies revolve around stress management and healthy lifestyle choices, individuals may also choose to attend support groups so that they can talk to other people who experience the same challenges from OCD and addiction.

Some common self-help strategies that can be useful in managing OCD symptoms include:

Using self-help resources such as books and others that are based on cognitive behavioral therapy
Looking to peers for support
Joining OCD support groups
Using coping mechanisms, stress management, relaxation techniques, and mindfulness
Getting enough sleep
Daily physical activity
Eating a healthy diet⁹

Brain Mapping

Because of advancements in technology and brain imaging, the use of brain mapping can treat many different mental health disorders including anxiety, depression, and OCD.

What is Brain Mapping?

Brain mapping refers to the technique of evaluating, examining, and testing the brain for normal and abnormal behavior. Because the brain functions off of electrical impulses, scientists can use the information to discern whether or not an individual has differences in their brain. For example, individuals with OCD typically have abnormal activity in the cingulate gyrus in the brain.¹⁰

How Can Brain Mapping Help in OCD Treatment?

Brain mapping aids OCD treatment because it allows professionals and doctors to know exactly what is going on in the client’s brain. Because we know that there are abnormal speeds of electricity in the cingulate gyrus of an individual with OCD, doctors can use this information to track the progress of intervention and see what the brain’s normal functioning should be.

In the OCD brain, there is a significantly elevated response in the cingulate gyrus. Because researchers can see this physical difference in the brain, they can work to monitor the levels of excitement in the brain.¹⁰

Neurofeedback Therapy for OCD Treatment

Neurofeedback therapy is a type of therapy that trains the brain to respond differently to the world around it. As mentioned above, individuals with OCD have an elevated response in the cingulate gyrus in their brains. Because neurofeedback therapy focuses on training the brain to respond differently, both brain mapping and neurofeedback therapy can be used together to manage and treat OCD symptoms.

This type of therapy involves connecting the individual to a computer that measures brain waves. While the process is like biofeedback, neurofeedback measures brain waves. Traditional methods have measured heart rate and blood pressure.

Additionally, neurofeedback therapy helps individuals develop healthier brain waves and thus have healthier responses to the world around them. Furthermore, studies have shown that OCD symptoms are associated with certain brain waves and can be trained. This method, in turn, can help manage unwanted obsessions and compulsions to have a successful OCD treatment.¹¹