Recognizing and Managing OCD

You head to the airport, and as you get in line to check your luggage, you wonder if you turned off the stove. This happens to everyone at times. But for people with obsessive-compulsive disorder, or OCD, it can happen every time they leave the house. They may double back to check stoves and light switches again and again, even if it means being late for work—or missing their flight.

A certain amount of second guessing is normal. But the worries and behaviors associated with OCD can disrupt everyday activities, relationships and lives. 

What Is OCD?

Obsessive-compulsive disorder is a surprisingly common, long-lived mental health disorder that involves unwanted, uncontrollable thoughts (obsessions) and/or uncontrollable, repetitive behaviors (compulsions). People with OCD spend at least an hour a day on thoughts and behaviors.

OCD symptoms can cause considerable distress. Compulsive behaviors to relieve anxiety, often triggered by obsessions, disrupt daily activities and interfere with relationships, work, school and home life. Any relief from anxiety is temporary. People with OCD repeat the behaviors to relieve more anxiety, causing more disruption and more distress. OCD becomes a vicious cycle.

OCD affects 1.2% of the US population every year; 1 out of 40 adults (2.3%) will be diagnosed with the disorder sometime during their lives. OCD typically manifests by early adulthood, often by adolescence or childhood. In children, symptoms usually begin around age 10, or slightly earlier in boys. 

“Despite severe functional impairment, only 35% to 40% of individuals with obsessive-compulsive disorder (OCD) seek treatment, and fewer than 10% receive evidence-based treatment.” 

Levy, McLean & Yadin, 2013 

The exact cause of OCD is not yet known, but studies show that having a parent or sibling with OCD increases the chances of developing the disorder. Researchers have also identified parts of the brain that may play a role. It is suspected that these areas do not react in a normal way to serotonin, a neurotransmitter that allows nerve cells to communicate. In addition, differences in brain structure in people with OCD indicate a decreased ability to control behavior and emotion. Some studies have also revealed a link between childhood trauma and OCD, which in turn may be related to disorders such as anxiety, depression and substance use.

Signs of OCD

People with OCD usually have both obsessive thoughts and compulsive behaviors, but it’s possible to have just thoughts OR behaviors. Common obsessions include the following:

  • Fears – of losing something; of misplacing things or forgetting things (like turning off the stove); of germs or contamination (touching something others have touched); of loss of control over behavior.
  • Unwanted thoughts – having taboo or repulsive thoughts about religion, sex or harm (like losing control of your car and injuring others); having aggressive fantasies about others or yourself.
  • Desires – for things to be in perfect order, arranged symmetrically or facing the same way.

Compulsive behaviors may include:

  • Counting – performing an action a certain number of times; for example, tapping the refrigerator door three times before opening it.  
  • Excessive cleaning – for example, washing hands until they are raw.
  • Arranging – ordering objects in a particular way and getting upset when the order is disturbed.
  • Checking – repeated double-checking that the stove is off, lights are off or on, the door is locked.
  • Following strict routines – doing things in the same order, in the same way, every time. 
  • Asking for reassurance – a person with OCD may demand that you confirm, “Yes, it’s clean, really clean.”

Symptoms can be mild and barely noticeable, but in times of greater stress, symptoms can become so severe that they effectively disable a person, taking up all their available time and energy. The stress can be so great that some people turn to alcohol or drugs to calm themselves. 

Children who have OCD may demand food in a certain order, count the number of times they chew, or develop other rituals around eating that must be observed before they eat. These symptoms of OCD can be confused with eating disorders, but eating disorders can co-occur with OCD. Children with OCD may attempt to hide their rituals, or have meltdowns when their rituals or routines are interrupted. They may also experience extreme separation anxiety. 

Managing OCD Symptoms 

If OCD symptoms are affecting your daily life—or you’re wondering whether your child’s time-consuming rituals are normal—it’s time to consult a doctor or mental health professional. They can help determine if thoughts and behaviors constitute OCD.

A health care provider will order a physical exam and a health history to screen for other conditions or illnesses that could be causing symptoms. A mental health professional will perform a complete evaluation, which can also identify these related, but separate, conditions:

  • Hoarding disorder – collecting things that have little value and eventually clutter living space to the point of being unsafe.
  • Trichotillomania – pulling out hair, including eyebrows and eyelashes.
  • Excoriation disorder – compulsively picking at or scratching skin.
  • Body dysmorphic disorder – obsession with physical appearance, examining the body and appearance for extended periods every day, and/or “altering” the body with demanding exercise routines or unnecessary surgery.

Treatment for OCD usually involves psychotherapy (“talk” therapy) or medication, or both. It’s important to screen for other mental health disorders like anxiety, depression and other conditions to develop a comprehensive treatment plan. Therapies commonly used to treat OCD include: 

  • Cognitive behavioral therapy (CBT), which focuses on thoughts, feelings and behaviors, the relationship between them, and on changing disruptive patterns.
  • Exposure and response prevention (ERP) to help reduce compulsive behaviors through controlled exposure to situations that trigger compulsions (for example, objects in disarray) but being prevented from “fixing” the situation (rearranging the objects).
  • Medication, especially SSRI antidepressants

In addition to therapy, it’s important to practice good self-care, get enough sleep, exercise, eat well, and seek support from friends and family. These self-care measures can help manage the anxiety and stress that come with OCD.

Our counselors at Best Day are standing by to help you or your child, starting with proper evaluation and diagnosis of OCD. Together, we can determine a treatment plan that facilitates a return to a freer, more satisfying life, one of greater joy and fulfillment.

How We Can Help You?

Best Day Psychiatry and Counseling is here to help you have a better day and find a better way. We treat a wide range of psychiatric conditions for both children and adults. Contact us today, we’re ready to help:

Charlotte: (980) 867-4440• Durham: (919) 659-8686 • Fayetteville: (910) 323-1543
Fuquay-Varina: (919) 567-0684 • Greenville: (252) 375-3322 • Raleigh: (919) 670-3939
Wilmington: (910) 500-7072 • Winston-Salem: (336) 934-5556