Obsessive Compulsive Disorder (OCD) is often (inaccurately) depicted in the media. It is also a diagnosis whose name people throw around willy-nilly, joking that they have OCD because they like this one thing a certain way, etc. OCD, however, is a serious, difficult condition to live with. I have written about two books that I read which depict OCD honestly. One is the fiction book Turtles All the Way Down by John Green, the other is the non-fiction book The Man Who Couldn’t Stop by David Adam.
Unlike the previous versions of the DSM, the DSM-5, does not classify OCD as an anxiety disorder.
For an individual to be diagnosed with OCD, they must meet the following criteria (taken from BeyondOCD.org).
- Presence of obsessions, compulsions, or both
- Obsessions are defined as:
- Recurrent and persistent thoughts, urges, or impulses that are experienced at times as intrusive and unwanted, and cause marked anxiety or distress.
- The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action.
- Compulsions as defined as:
- Repetitive behaviors (e.g. checking a door is locked) or mental acts (e.g. counting steps) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.
- The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way to what they are designed to neutralize or prevent, or are clearly excessive.
- Obsessions are defined as:
- The obsessions or compulsions are time-consuming or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- The obsessive-compulsive symptoms are not attributed to the physiological effects of a substance or another medical condition.
- The disturbance is not better explained by another mental disorder.
Everyone experiences OCD differently, the video below shows how one young woman is affected by her OCD.
Treatment for OCD involves medication, psychotherapy, or a combination of the two. According to the NIH SSRI’s have been found to be effective in the treatment of OCD. SSRI’s include medications such as sertraline (Zoloft), and fluoxetine (Prozac). If these medications are not effective for an individual, antipsychotic medications have been found to be a helpful treatment, these medications include drugs such as risperidone (Risperdal) and Haloperidol (Haldol). Atypical antipsychotics may also be prescribed, such as quetiapine (Seroquel) and olanzapine (Zyprexa).
Cognitive Behavioral Therapy (CBT) has been found to be helpful in treating OCD. Within CBT is a type of therapy called Exposure Therapy (ERP), in this type of therapy people with OCD are placed in situations that exposes them to their obsessions and are asked to restrain from engaging in the obssessions that help ease their symptoms. In The Man Who Couldn’t Stop, David Adam talks about his experience with this type of therapy. By facing their fears, people participating in ERP slowly become habituated to their distressing events which can make it easier to comfortably function in daily life. It is important to make sure that your mental health practitioner is familiar and comfortable with using ERP if it is something you feel would be helpful.
As with many (if not all) mental illnesses, OCD can require maintenance throughout the life of a diagnosed individual. I do not live with OCD, nor does anyone close to me. If you have OCD and feel I have left out something important, please let me know.