Obsessive Compulsive Disorder

Breaking Free

Obsessive-compulsive, or OCD, is a frequently-used term in today’s society. We may tend to associate OCD with individuals who are very neat, well-organized, structured (maybe to the point of rigidity), and concerned with cleanliness. This may or may not be problematic for the individual or for those around him/her.

Many individuals simply have an obsessive-compulsive style. In these cases, they are likely to be sharply focused and detail-oriented. They may display high levels of concentration, which can be sustained for long periods of time. Actions are typically well thought-out and deliberate, often including specific rituals related to counting, organizing, or securing. Those with an obsessive-compulsive style excel at highly technical jobs that require sustained focus and concentration, such as accountant, air traffic controller, engineer, scientist, or computer software developer.

However, some individuals may be found to have an Obsessive-Compulsive Disorder. In these cases:

  • Focus and concentration become obsessions that are marked by recurrent and persistent thoughts, urges, or images, that are intrusive and unwanted, and that cause anxiety or distress.
  • Organized activity and perseverance become compulsions that may be displayed as: (1) repetitive behaviors, such as hand-washing, checking, hoarding, organizing, or as: (2) mental acts, such as counting, repeating words or phrases, or making mental lists. With compulsions, a person feels driven to perform the behaviors or mental acts in order to prevent or to reduce anxiety or distress.

When the obsessions or compulsions take more than one hour per day, or cause significant distress or impairment, this may constitute a “disorder” or a mental illness. Relief, through treatment, is often needed.

The most likely to be successful treatment options include:

  • Exposure and Response Prevention (ERP) therapy, which:  (1) teaches the individual to purposefully expose him/herself to the thoughts, urges, or images, that are intrusive and unwanted, and that cause anxiety or distress, then (2) requires the individual to deliberately choose not to engage in the compulsive behavior. ERP equips the individual with effective coping strategies that do not involve compulsive behaviors.
  • Medication may be prescribed by a psychiatrist or by your Primary Care Physician
    • SSRIs—have been found to ease symptoms of depressed mood and anxiety, and may decrease obsessions and/or compulsions
    • Anxiolytics—Relieve anxiety and tension, and may promote sleep, but should only be used for very short-term relief

About 70% of people are likely to benefit from ERP and/or medication for their OCD.

Additional means of treatment that are found to be effective include:

  • Acceptance and Commitment Therapy (ACT) encourages individuals to accept their thoughts and feelings, and offers multiple strategies to reduce the anxiety and distress.
  • Psychotherapy is helpful in those cases in which the obsessions and/or compulsions are related to significant life experiences. Significant, distressing experiences are explored, processed, and resolved, utilizing insight-oriented techniques and cognitive behavioral strategies.

Finally, an Integrative/Functional medicine psychiatrist will seek to discover and treat the root cause of OCD, typically recommending dietary interventions, nutritional supplements, exercise, meditation, and proper sleep hygiene. 

© 2020                                                                      Christine Muehlenweg, Ph.D.