Obsessive-compulsive disorder is a type of mental health condition. Under the ICD 11, Obsessive-compulsive disorder is classified under Obsessive Compulsive and related disorders. The prevalence of OCD in India is thought to be between 0.8% and 1%. There are two aspects to the condition described in the name: obsessions or compulsions, or, most commonly, both. People suffering from OCD may have only obsessions or compulsions or have both. So, the central feature is a person having repeated thoughts that they cannot avoid or resist and repeated behaviours in response to those thoughts.
Obsessions are thoughts. These thoughts are repetitive and persistent. They can also take the form of images or impulses/urges that are intrusive and unwelcome thoughts.Obsessive thoughts are commonly associated with anxiety. The hallmark is that it is distressing to the individual. This is known as being ego-dystonic (not welcome or liked by the individual). The individual attempts to ignore or suppress obsessions or to neutralise them by performing compulsions. Obsessive thoughts can come into the mind of the person affected, even if the person tries to resist them. It usually concerns doubts and not being 100% certain. It can also have other forms, but they are all distressing.
It requires a person to perform a particular behaviour ritual or think of an opposite “neutralising thought “to reduce anxiety and uncomfortable feelings. The relief from anxiety is, however, short-lived, and usually, the thoughts don’t go away in response to the behaviours. Sometimes, people may only have obsessive thoughts and no associated behaviours. These neutralising, anxiety-reducing behaviours are known as compulsions.
Compulsions are repetitive behaviours, including repetitive mental acts that the individual feels driven to perform in response to an obsession, according to rigid rules, or to achieve a sense of ‘completeness’. For obsessive-compulsive disorder to be diagnosed, obsessions and compulsions must be time-consuming (e.g. taking more than an hour per day) or result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.
People suffering from OCD may have only obsessions or compulsions or have both. So, the central feature is a person having repeated thoughts that they cannot avoid or resist and repeated behaviours in response to those thoughts. Some examples of obsessive thoughts include having repeated thoughts of contamination and dirt, not being 100% certain if one has locked the door or having distressing thoughts of wanting to scream or behave aggressively, thoughts of loved ones dead, and always being conscious about swallowing and breathing are some examples of obsessive thoughts.
In some people with OCD, pure compulsions will be present without the obsessive thoughts. So, when one has repetitive thoughts in the form of doubts if they have locked the door and are anxious as they are not 100% certain, it will result in compulsive rituals in the form of repeatedly checking doors.
Some examples of compulsive rituals include repetitive counting, checking and washing in response to obsessive thoughts. Sometimes, some people may need to check on their near and dear repeatedly or seek reassurance as they may have obsessive thoughts that the person may have died. Sometimes, instead of checking, they may have to have an idea in the head of them looking healthy to “neutralise” the thought of the loved one dying.
Washing hands for hours at a stretch and not feeling that one has washed the hands “enough “is an example of a compulsive ritual in response to thoughts of fear of dirt and contamination. Sometimes OCD may present with co-morbid depression or anxiety, and the signs of depression or anxiety could be the main presenting feature. Sometimes, obsessive thoughts and compulsions can cause low mood. Obsessive-compulsive disorder is a mental health condition that is diagnosed and treated by psychiatrists with medications and Cognitive Behaviour Therapy.
Sleep difficulties can occur in Obsessive-compulsive disorder due to obsessive thoughts or the need to be awake for the compulsions. Sometimes, when a person is sleepless, it makes the OCD worse. Anxiety disorders can co-exist with OCD. Obsessional thoughts can be distressing and anxiety-provoking. Sometimes, when compulsions are resisted, that can lead to anxiety and panic attacks as well. OCD treatment is widely available, and these blogs aim to promote awareness and provide the correct information.
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