OCD (Obsessive Compulsive Disorder): Diagnosis & Treatment

What Is Obsessive-Compulsive Disorder (OCD)?

According to the International OCD Foundation, an obsessive-compulsive disorder definition must include information on obsessions and compulsions, separately and together. Obsessions are thoughts, urges, and images that cause you to feel severe stress.

To get rid of obsessions, some people engage in specific behaviors to cope and ease stress, even if it is only temporary relief. The combination of obsessions and compulsions forms OCD.

OCD is a type of anxiety disorder, but they have very different characteristics. General anxiety is when you have real-life issues, and you worry excessively about them. OCD obsessions are not typically realistic; they can be fears that something may happen in the future.

Thoughts are followed by the strong need to participate in behaviors in hopes they will eliminate fears. People with generalized anxiety do not have compulsive behaviors.

Common Misconceptions About OCD

Many misconceptions exist regarding obsessive-compulsive disorder’s meaning which leads to the continuance of stigmas, producing barriers for people getting the help they need. Dispelling the myths is crucial.

Myth: OCD Only Involves Excessive Cleaning or Organization

While excessive cleaning and the need for organization are OCD symptoms, they are followed by fears and anxiety that something awful will occur, like contamination or infection. These two symptoms do not exist in everyone with OCD. They are not the only symptoms, either.

OCD may also involve obsessions and compulsions related to relationships, intimacy, violence, duties, and more.

Myth: Everyone Has “a Little” OCD

While symptoms may vary for each person with OCD, it is rare for someone to have a small amount of OCD. This statement is often said in a joking tone, but nothing is funny about having OCD.

Myth: People with OCD Don’t Have Any Willpower

If someone with OCD only needed the willpower to stop the intense, severely debilitating symptoms, they would find it. OCD is their response to extreme stressors.

Quitting their compulsive behaviors without the proper coping skills can worsen their symptoms. It takes specific skills taught by a licensed mental health professional to cope with obsessions and compulsions.

Myth: There is No Treatment for OCD

Multiple treatments exist for those with obsessive-compulsive disorder. They are evidence-based, helping many people with OCD live a happy and healthy lifestyle, including working, attending school, and having a great home and social life.

Integrative OCD treatment can include medicine, behavioral therapies, mindfulness-based therapies, and neuromodulation.

Recognizing OCD Symptoms and Different Types of OCD

OCD symptoms can vary for each person, and obsessive symptoms will be different than compulsive symptoms. In addition, symptoms can range from mild to severe. Examples of symptoms may include the following.

Obsessions

Obsessions are the thoughts that seem to take over the mind. They are unwanted, but it feels impossible to get rid of them. Some people experience:

Fear of contamination or germs
Fear of losing control
Thinking things must be in a specific order
Inappropriate thoughts involving taboo subjects like sex or harm
Aggressive thoughts about other people

Someone with these OCD symptoms may feel overwhelmed and have a high amount of stress. Obsessions can become severe and often only disappear when an action or compulsive behavior follows them.

Compulsions

Obsessive thoughts trigger compulsions, which are behaviors that ease symptoms. Behaviors are often repetitive and ritualistic, such as:

Excessive hand washing or cleaning
Arranging objects in a specific way
Checking things multiple times, like turning a light switch on and off
Counting objects repeatedly
Repeating statements or words over and over

Most people with OCD know their thoughts and behaviors are excessive or extreme. However, they can’t stop them. They typically spend hours daily dealing with their OCD.

Types of OCD

According to the American Psychiatric Association, OCD has multiple related disorders, all of which can be debilitating. Some disorders involve harming the body in some way, while others involve intrusive thoughts and fears.

Contamination OCD

Contamination OCD is the fear of germs that triggers cleanliness compulsions. People with this disorder must engage in activities to eliminate their worries and chances of catching an infection from the germs they think they have encountered.

Relationship OCD

Relationship OCD involves having intrusive thoughts and doubts about romantic relationships. Obsessive thoughts become repetitive and uncontrollable, straining the relationship. Thoughts are negative, causing doubt that you deserve the relationship or that your partner loves you.

You may need constant reassurance, feel anxious about the relationship ending, or compare your relationship to others and focus on flaws.

Hoarding OCD

Hoarding refers to a behavior stemming from someone’s need to keep an object rather than throw it away or give it away. The thought of losing the item creates severe stress. The more items they keep, the more clutter builds throughout their home or living space, making it unsafe.

Body Dysmorphic OCD

Body dysmorphic disorder is when someone becomes obsessed with the flaws they see in their body or with their image. However, the flaws usually do not exist in reality. The person has a distorted view. This can trigger someone getting numerous surgeries to erase the supposed flaws, developing an eating disorder, and other unhealthy consequences.

Hair Pulling OCD

Trichotillomania or hair-pulling OCD is when someone repeatedly pulls out their hair, usually from the scalp, eyebrows, and eyelids. It leads to significant hair loss, so much so that someone with this disorder may avoid work, school, or social activities out of embarrassment.

Skin Picking OCD

Excoriation or skin-picking OCD is when someone can’t stop picking their skin, leading to open wounds or lesions. Like trichotillomania, this disorder can make some feel embarrassed and cause them to avoid going out in public. They may stop going to work or school and hanging out with friends. They experience extreme distress.

How OCD is Diagnosed: Tests and Evaluations

Physicians and licensed mental health providers utilize the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM5) to diagnose OCD. You must meet the following criteria for diagnosis.

Obsessions

Someone has recurring and persistent thoughts, urges, or images that are intrusive, unwanted, and cause marked distress. They try to suppress the thoughts, urges, or images by replacing them with compulsive actions.

Compulsions

People must respond to their thoughts, urges, or images with rigid, repetitive behaviors. They feel driven to perform the behaviors because they believe doing so will reduce their anxiety or stress. Some feel they must perform behaviors to prevent something terrible from happening.

Additional Criteria

Obsessions take up much of a person’s time and interfere with their ability to work, attend school, fulfill duties at home, and socialize. Also, OCD symptoms are not a result of a physical or mental condition.

OCD Testing and Evaluation

OCD doesn’t appear in blood samples or other traditional tests. That’s why OCD tests play a significant role in identifying symptoms. Doctors must use assessments that gather information that may or may not support an OCD diagnosis, including the following:

The Yale-Brown Obsessive Compulsive Scale (YBOCS)
The Children’s Yale-Brown Obsessive Compulsive Scale (CYBOCS)
The Child Obsessive-Compulsive Impact Scale (COCIS)
Family Accommodation Scale (FAS)
The DSM5
Obsessive-compulsive inventories
Self-reported data

Doctors may also ask for reports from family, friends, coworkers, teachers, and others who interact with you regularly for their input on your symptoms. You and your supporters must provide honest feedback for the most accurate diagnosis.

It is crucial to allow your doctor to perform OCD tests and diagnose you. Avoid trying to diagnose yourself. Your symptoms may appear as obsessive-compulsive disorder (OCD) but may be from an underlying physical or mental health condition. Part of getting an accurate diagnosis may include ruling out other disorders.

Also, self-diagnosis can lead to not getting the proper treatment and symptoms worsening over time.

Effective OCD Treatment: Therapy and Medication Options

The most effective obsessive-compulsive disorder treatment is an integrative approach that utilizes various therapies to address all issues caused by your symptoms. Available OCD treatment options include the following.

Psychotherapies

Psychotherapies to treat OCD include cognitive-behavioral therapy (CBT) and exposure and response prevention (ERP).

CBT is a highly effective approach that helps you recognize and change negative thought patterns and unrealistic thoughts. You learn to replace negative thoughts with positive ones, reducing the need to engage in compulsive behaviors.

ERP is a form of CBT and is the gold standard among treatment methods for OCD. It involves slowly exposing you to something that makes you anxious, then guiding you through it, helping you avoid the need for compulsive actions.

Pharmacotherapies

OCD medications often enhance the CBT experience. However, not everyone will need medication. Those who do are often prescribed the following, each of which is evidence-based for effectiveness in treating OCD:

Selective Serotonin Reuptake Inhibitors (SSRIs, antidepressants)
Tricyclic antidepressants (TCAs)
Antipsychotics
Glutamatergic agents

A combination of OCD medications may prove more effective. It can take several trials before determining which medicines work the best and at which doses.

Neuromodulation Therapies

Neuromodulation therapies allow doctors to alter the functioning of your central nervous system. It involves technology that delivers stimulation to certain parts of your body to stimulate nerves. Using either electrodes, chemicals, or magnetics can improve how your brain communicates with the rest of your body.

Examples of neuromodulation with evidence that it works for OCD include:

Transcranial magnetic stimulation (TMS)
Stereotactic ablation
Deep brain stimulation

You and your treatment team will create an OCD treatment plan based on your needs. A combination of therapy, OCD medication, neuromodulation, and other treatments often gives you a higher chance for optimal results.

Finding the Right OCD Therapy: How to Get Help

Finding the right OCD therapy means working with a doctor and therapist with specialized training in OCD. Professional guidance is essential to managing OCD. They can teach you specific skills to help you reduce symptoms and improve how you perform daily tasks, whether at work, school, or home.

How to Find Obsessive-Compulsive Disorder (OCD) Therapy Near Me

Local and online therapy for OCD options exist in your area. You can search online for “OCD therapy near me,” or you can contact a local treatment center or provider. You must also search for reviews of the specialist, ask friends or coworkers for referrals, ask the provider for references, and prepare a list of questions to ask them directly.

Questions like the following can help you make an informed decision:

Do you have a master’s degree or higher in the mental health field?
How much experience do you have working with people with OCD?
What techniques do you use in therapy for OCD? They must mention ERP therapy ocd.
How long do sessions last?
What do we do in sessions?
How many sessions does it take to see improvements?
Are sessions in person, online, or both?

If you have other questions, add them to the list. While consulting with a therapist, please consider how they make you feel. This should be a contributing factor in making your decision. You don’t have to choose the first therapist you find. You want the one that best meets your needs and preferences.

Steps to Start Therapy To Treat OCD

The first step to starting OCD therapy is to remind yourself it is a good idea to ask for help. You deserve help, and you are not alone. Many others are in therapy to treat OCD right now. Second, contact an OCD therapist online or by phone.

Most providers have websites with chat access and contact information. Finally, make yourself a priority. Attend appointments, engage in self-care, continue learning about OCD, and build a support system of family and friends.