Understanding OCD: An Overview of Symptoms, Causes, and Available Treatments

Obsessive-Compulsive Disorder (OCD) is a mental health disorder that affects millions of people worldwide. Often misdiagnosed as generalized anxiety disorder, OCD can go decades without proper treatment leading to worsening symptoms and feelings of hopelessness. Luckily, with proper identification and treatment, people with OCD feel confident and able to manage their symptoms without impact on daily life. Today, we will learn more about this often misunderstood disorder through gaining awareness of its symptoms, causes, and treatment options.

Overview of OCD Symptoms

OCD is characterized by intrusive thoughts, images, or impulses known as obsessions. These kick off our body’s stress response leading us to engage in behaviors or mental acts to help us feel temporary relief known as compulsions. Engaging in compulsions helps us feel better in the moment, but as soon as the obsession returns, we feel we must repeat the compulsion again. This continued pattern becomes ritualistic and can dominate our lives.

Common OCD symptoms include:

• Checking rituals: The fear of harm or danger drives people to repeatedly check if doors are locked, appliances are turned off, or other potential hazards are avoided. Some take pictures to remind themselves that they checked.
• Symmetry and order: A compulsion to arrange objects symmetrically or in a specific order to achieve a sense of control. A person will feel like the anxiety will not go away until this is done.
• Intrusive thoughts: Disturbing thoughts, often of a violent or sexual nature, that cause significant distress and guilt. These thoughts are not things we want to do but instead have a fear that we might do. Someone often seeks reassurance from others to make sure they have not done something wrong.
• Hoarding: Persistent difficulty parting with possessions, leading to excessive clutter and a sense of emotional attachment to objects. A person may struggle throwing something away out of fear of needing it in the future and no longer having it.
• Contamination fears: Excessive concerns about germs, dirt, or contamination, leading to compulsive cleaning and washing. Someone might avoid public restrooms, not touch their face or clothing with dirty hands, or avoid spaces considered unclean.

Learn more about OCD subtypes by checking out our “OCD” tab on our website: www.calmocd.com

Common co-occurring disorders include:

• Depression: Depression is commonly seen in those with OCD because the symptoms of OCD can feel devastating to so many areas of life. Studies have repeatedly shown that roughly a quarter of those with OCD also experience major depressive disorder following the initial presentation of OCD symptoms.
• Eating Disorders: Research demonstrates that someone with an eating disorder is more likely to also develop OCD. While the diagnoses are different, both disorders experience fear and worries which drive behavior patterns and limit our experience with the world around us.
• Panic Disorders: Up to one fifth of people with OCD may also experience a panic disorder. Panic disorder is described as intense fear that also includes physical manifestations of anxiety including heart palpitations, shortness of breath, chest pain, dizziness, and abdominal distress.
• Substance Use: People with OCD are at a higher risk of developing a substance use disorder than those without OCD due to the difficulty managing the emotions associated with OCD. Substances can often feel like an escape from the trap someone feels when OCD goes untreated, leading to increased feelings of hopelessness and distress.

Causes of OCD

Like most mental health disorders, the exact cause of OCD is not well understood. Current researchers believe OCD comes from a combination of genetic, neurobiological, and environmental factors. Studies of the brain show that there are certain abnormalities seen in the structure and function of the brain, specifically the circuits involving the frontal lobes and the basal ganglia. Family history of OCD and anxiety disorders also increase the risk of OCD development. Life events, such as trauma, stress, or life changes can also make OCD symptoms much worse.

Available Treatments for OCD

OCD is very treatable with the right interventions. There are various research based interventions for OCD that show the best outcomes following treatment:

• Cognitive-Behavioral Therapy (CBT): CBT includes many of the treatment models discussed below in more detail and is considered the most effective evidence-based approach to treatment of OCD. It also addresses cognitive challenging strategies to allow us to more effectively respond to triggers in ways that support our desired outcomes. CBT separates our thoughts, emotions, behaviors, and physical responses into separate parts allowing us to target areas in chance our perception and our lives. Effective OCD treatment focuses on changing the behaviors we engage in following the thoughts, emotions, and physical responses someone experiences with an obsession in order to break the OCD cycle.
• Exposure and Response Prevention (ERP): ERP is a specialized treatment intervention within CBT. It is where a person experiences the exposure of the triggering event and no longer engages in the compulsions. Inhibitory learning, the most effective treatment in ERP, focuses response prevention when we feel the urge to engage in a compulsion to break the OCD cycle and create lasting change. Previous ERP treatment focused on anxiety as the target of treatment when in reality we have very little control over how strongly we feel an emotion but complete control over what we do while feeling it. This approach increases confidence and makes a person feel in control again.
• Acceptance and Commitment Therapy (ACT): ACT focuses on seeing the uncomfortable thoughts and emotions that come with OCD as a part of our human experience rather than something that should be viewed as problematic. It incorporates the principles that fear is not something that is bad and should be avoided as much of society believes. This change in thinking allows for improvement in behavioral functioning without needing to experience any change in the frequency or intensity of triggering events or obsessions. ACT highlights the important differences between what we think or feel compared to the actions we take and empowers us to control our actions to make change.
• Inference-based Cognitive Behavioral Therapy (I-CBT): I-CBT is uniquely used to treat OCD and focuses on resolving faulty reasoning leading to obsessional doubts. It can be thought of as reason-focused treatment rather than cognitive-challenging treatment making it very different from traditional CBT models. Exposure therapy is not incorporated into I-CBT approaches unless recommended by the clinician.
• Dialectical Behavioral Therapy (DBT): DBT is broken down into four pillars: distress tolerance, mindfulness, emotion regulation, and interpersonal effectiveness. Treatment with DBT focuses on allowing ourselves to experience powerful emotions associated with our triggering events without feeling overtaken by the emotion and responding with compulsions to eliminate the discomfort we feel. DBT can allow someone to implement the response prevention skills learned in OCD treatment because of their increased ability to tolerate uncertainty.
• Family Therapy utilizing SPACE: Involving family members in the treatment process can strengthen support systems and improve understanding and communication within the family unit. Loved ones are often unknowingly reinforcing compulsions for the person with OCD, so family therapy allows for identification of family accommodation and change behavior. The Supportive Parenting for Anxious Childhood Emotions (SPACE) program is an evidence-based intervention to support the family of someone with OCD who is any age.
• Medication: Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed medication for people with OCD. SSRIs regulate serotonin, a neurotransmitter in the brain, which can help alleviate some of the symptoms. Medication alone is not often effective on its own and is recommended in addition to CBT.
• Support Groups: OCD support groups provide individuals with a sense of community and understanding. Sharing experiences with others who can relate to their struggles can be immensely therapeutic.

Getting Started in OCD Treatment

OCD can significantly impact someone’s life, and getting treatment with someone knowledgeable in OCD is essential. If you think you may have OCD, reach out to an OCD specialist with specific training in ERP if you are not currently in therapy or talk to your therapist about screening for OCD. CalmOCD is an in-person treatment provider in Scottsdale and Tucson, along with virtual treatment throughout Arizona, Colorado, Florida, Illinois, Minnesota, Nevada, and Utah specifically focuses on treating individuals with OCD with the most effective and up-to-date research available. We provide individual, customized therapy services for ages 5 and older, family-integrated therapy, and in-person groups. We also provide screening tools and education to therapists so they can properly treat their clients.

Therapists at CalmOCD are uniquely qualified and specialized in the treatment of OCD allowing an individual to be treated with the therapeutic intervention best suited for their symptoms and learning style. We focus on increasing confidence and rebuilding hope so commonly lost in those suffering from intense symptoms of OCD.

If you or someone you know is struggling with OCD symptoms, it is crucial to reach out. Call CalmOCD today to get started.