What is the meaning of OCD? OCD stands for obsessive-compulsive disorder. Like phobias, OCD is an anxiety disorder with two main components: obsession and compulsion. People who are suffering from this disorder struggle with uncontrollable thoughts of performing specific actions repeatedly.
- First, we are going to delve into the OCD meaning and define obsessions and compulsions.
- Next, we will look at the causes of OCD.
- Then, we are going to look at OCD symptoms.
- Later, we will look at types of OCD.
- Finally, we will talk about OCD treatment, including OCD medication.
OCD Meaning
OCD, otherwise known as obsessive-compulsive disorder, is a fairly prevalent anxiety disorder, with some sources saying that around 1 in 50 people in the UK struggles with OCD during their lives. OCD is characterised by two main behaviours – obsessions and compulsions.
Obsessions are uncontrollable, recurring, and intrusive thoughts. The main characteristic of obsessions is that they are not grounded in reality.
For someone with OCD, the obsessions are life-consuming, stressful, and persistent. However, someone without OCD will view these obsessions as trivial and unproblematic.
Someone with OCD may believe that germs and bacteria are all around them, which drives up their anxiety levels, making them feel constantly uncomfortable.
You may have come across someone who has OCD concerning germs. They wash their hands, use hand sanitiser, and wipe down surfaces all the time to avoid coming in contact with germs. The germs are their obsessions, so then what is their constant cleaning?
Compulsions are the need to perform specific actions to feel better about obsessive thoughts.
People with OCD do compulsions because they will be incredibly anxious if they do not. Even though compulsions help people reduce their anxiety at the moment, they do not help people with OCD in the long run.
Keeping with the same example from above, cleaning and hand washing are this person’s compulsions. They incessantly clean their hands and surfaces they interact with because it helps alleviate their anxiety.
OCD Causes
There are two main theories of the cause of OCD; genetic and neural.
There is empirical evidence from twin studies (on identical and fraternal twins) that if any family member has a history of OCD, the next generation can genetically inherit it.
According to a study presented by Lewis (1936), approximately 37% of people with OCD had family members with similar anxiety disorders.
Another twin study by Carey and Gottesman (1981) showed that 87% of identical twins inherited OCD symptoms compared to a rate of 47% in fraternal twins of obsessive symptoms, which is strong evidence for the genetic cause of OCD.
However, the genetic component may not be the sole cause of OCD. If this were the case, we would expect to see the results indicating 100%.
Instead, the interaction between genetic and environmental factors may best explain OCD causes.
A neural explanation of OCD uses neurotransmitters and brain structures to explain OCD. These neurotransmitters convey messages through the nervous system. Lower levels of serotonin and elevated levels of dopamine may cause OCD.
High dopamine levels affect concentration, which explains why it can be difficult for OCD patients to distract themselves from their obsessive thoughts. However, lower serotonin levels are responsible for a bad mood that can cause obsessive thoughts.
The brain’s orbitofrontal cortex, a part of the prefrontal cortex (PFC), is thought to be responsible for decision-making and converting information from our senses into thoughts in the brain.
People with OCD have an overactive orbitofrontal cortex, leading to increased sensory information conversion into thoughts and actions, leading to obsessive compulsions. This increase in orbitofrontal cortex activity also hinders the person from stopping performing the action.
However, it is difficult to establish a confirmed cause-and-effect relationship in this case because it is unclear whether OCD causes this effect on the brain or vice versa.
OCD can worsen if the patient experiences any trauma, like the death of a loved one. Too much stress or abuse may increase the patient’s underlying insecurities, worsening the disorder.
OCD Symptoms
OCD can look different depending on the person. Not everyone with OCD will have the same obsessions and compulsions. People can have obsessions and compulsions that are unique to themselves or some that are more common such as cleaning, counting, and hoarding.
To be diagnosed with OCD, someone has to experience obsessions, compulsions, or both behaviours. Obsessive symptoms could be fear of contamination, fear of losing things, immoral and intrusive sexual thoughts or images, thoughts of causing violence, fixation on strict adherence to religious practices, or excessive focus on superstition (judging actions as good or bad luck).
Fig. 1. OCD symptoms include stress response when triggered.
While people can experience these same thoughts, they have to impact someone’s daily life to be diagnosed with OCD.
Other examples of OCD symptoms include:
- Excessive washing and cleaning.
- Repeated counting to reduce the likelihood of making a mistake.
- Excessive arranging and ordering of items.
- Engaging in many religious acts to avoid punishment for sins.
- Double-check things repeatedly, such as locks or lights, and hoard stuff because it is bad luck to throw them away.
Types of OCD
When referring to types of OCD, we mean common ways that OCD can manifest itself. As mentioned earlier, some people have unique forms of OCD, but typically the obsession and compulsion symptoms can fall into one of five categories.
Some people with OCD have obsessions with cleanliness or are scared of contamination. They believe that they (or someone they know) will be harmed if they are contaminated.
To alleviate the stress of contamination, people with OCD will avoid touching anything, such as light switches, door handles, bannisters, or public toilets, and will often wash their hands or clean surfaces.
This type of OCD is known as contamination.
The checking compulsion can come in the form of triple checking if the lights, stove, water, or car are turned off (or if a candle is blown out).
While people without OCD can worry about whether they forgot to turn off their lights, this compulsion stems from the obsession with preventing damage, theft, and accidents. People with OCD will check several times if they have turned off their cars to avoid a disaster.
People who have ordering obsessions need to have objects ordered. Often, this can be the need for items to be arranged symmetrically or parallel.
People with ordering OCD can be viewed as perfectionists, but they are not making items perfect because they need them to be but because they have to be.
Fig. 2. People with ordering OCD often have to have items perfectly spaced out.
While people with OCD all have intrusive thoughts about their obsessions, these are different. People with OCD will think about their obsessions if they do not do their compulsions, but people with intrusive thinking OCD will obsess over sexual or violent behaviours. However, intrusive thinking usually does not come with compulsions.
There is a current debate on whether hoarding is a type of OCD or its own diagnosis. Regardless, it has qualities shared with OCD. People who hoard obsess over the need to be prepared for any situation.
Why should they throw it away if they could use it in the future?
OCD Treatment
Psychotherapy is one option for treating OCD. One of the suggested treatments for OCD is cognitive-behavioural therapy (CBT). CBT focuses on improving how patients think and respond to situations.
CBT is a type of therapy that is a suggested treatment for a wide variety of psychological disorders.
Another option for therapy is exposure and response prevention (ERP). ERP focuses on teaching patients how to respond to stimuli that could trigger their compulsion. A therapist will gradually expose the patient and work with them on responding to the situation. Since this therapy is more tailored to OCD symptoms, it has shown great results.
Cognitive therapies are typically first recommended when someone is diagnosed with OCD. They are non-invasive, drug-free, and can have very successful outcomes. However, if therapy alone is unsuccessful, it can be combined with medication.
OCD Medication
According to empirical studies, antidepressants such as SSRIs (selective serotonin reuptake inhibitors) and SRIs (serotonin reuptake inhibitors) effectively treat OCD symptoms. These two categories of OCD medication increase serotonin levels, supporting the neural explanation of OCD.
These OCD medication work by blocking the reuptake of serotonin; this means that more serotonin is available in the synapse, and this combats the issue of the potential cause of OCD; low serotonin levels.
However, any medication that regulates neurotransmitters other than serotonin indicates insignificant results.
According to Kotapati et al., 2019 in a systematic article review, cognitive behavioural therapy was more effective in reducing OCD patients with the help of SSRI.
In addition, Soomro et al. (2008) examined 17 studies comparinSSRIsRI to placebo. They concluded that SSRIs reduce OCD symptoms better than placebo.
OCD - Key takeaways
- OCD meaning is an anxiety disorder that consists of two main components: obsession and compulsion.
- Obsessions are uncontrollable, recurring, and intrusive thoughts; they are not grounded in reality.
- Compulsions are the need to perform specific actions to feel better about obsessive thoughts.
- There are various types of OCD, but they all share some common symptoms: contamination, intrusive thoughts, double-checking, and arranging or ordering things.
- There are two main explanations for OCD causes, including genetic and neural.
- Neural explanations focus on the roles of serotonin and dopamine.
- Psychotherapies, such as cognitive-behavioural therapy and exposure and prevention response are used for OCD treatment.
- OCD medication examples include SSRIs, which have been empirically proven to reduce OCD symptoms.
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