Obsessive Compulsive Disorder

Genetics are responsible for approximately 45-65% of the risk for developing OCD. 1 in 4 people with OCD has an immediate family member with the disorder. 

Cognitive factors impacting OCD include faulty or dysfunctional beliefs. Examples include perfectionism, intolerance for uncertainty, a sense of inflated responsibility and more. These misinterpretations or intrusive thoughts often lead to the formation of obsessions and compulsions.

The behavioral theory suggests that people with OCD associate certain objects or situations with fear, avoiding those things by performing "rituals."

The environment we live in can have an influence on whether OCD symptoms will develop. Studies indicate that people with OCD have experienced stressful and traumatic life events prior to the onset of the illness.

Having a physical exam by a primary care provider helps rule out other problems that could be causing your symptoms. Your doctor may also run lab tests. Following this exam, your doctor may provide a referral to a behavioral health specialist if necessary.

A behavioral health professional can assess your symptoms and their impact on your daily life. After completing the psychological evaluation, a diagnosis is made by comparing your symptoms to the Diagnostic and Statistical Manual of Mental Disorders, (DSM-V).

Several classes of medication are common in the treatment of OCD, including selective serotonin reuptake inhibitors (SSRIs), anxiolytics and antidepressants. Your doctor may prescribe one or more of these depending upon your symptoms and overall health. 

A variety of psychotherapy approaches are helpful to people with OCD, including:

• Cognitive-behavioral therapy (CBT) – Talk therapy helps people modify negative thoughts, behaviors and emotions that often accompany psychological distress.
• Exposure-response prevention (ERP) therapy – Gradual exposure to the source of anxiety in a safe setting helps reduce psychological distress. With each step, a therapist helps the patient not to panic and works to decrease anxiety, until the item/situation no longer frightens them.
• Behavioral therapy – As a treatment for OCD, behavioral therapy may include symptom substitution (ie., picking the fuzz off of a stuffed animal rather than your eyebrows) or rewards for avoiding repetitive behaviors.
• Group therapy – Therapists also work with groups of OCD patients to help them manage their conditions. 

Sometimes, OCD can resist medications. If you have a case of treatment-resistant OCD, your physician may suggest TMS or transcranial magnetic stimulation. TMS is a non-invasive, FDA-approved treatment for OCD that involves stimulating the brain through repeated magnetic pulses. TMS doesn’t require surgery or sedation, as the electromagnetic coil is placed against your head to give magnetic pulses. The effects of TMS wear off over time, so repeated sessions are recommended.

Another possible solution for treatment-resistant OCD is deep brain stimulation (DBS). In recent years, DBS has been used for treatment-resistant mental disorders including depression, anxiety and OCD. DBS has been used since the mid-1980s to treat movement disorders such as severe tremors or Parkinson's disease.

Integrative medicine or complementary health approaches such as acupuncture, meditation and mindfulness can be an important part of a comprehensive treatment plan for OCD. Many people with OCD also find that these practices help them avoid or control their triggers and manage their symptoms.     

At Mercy, care for patients with OCD is provided in a variety of settings. Patients who are acutely ill and need 24-hour supervised care for their safety may require inpatient care. A full range of evaluation and treatment services are available for comprehensive, individualized inpatient mental health care across Mercy. 

People with OCD may fall back on unhealthy coping strategies that complicate their condition. Some turn to alcohol or drugs out of desperation. The most important step for managing OCD is knowing your triggers. Triggers are thoughts or situations that bring on OCD symptoms. By understanding your triggers, you can begin to control compulsive urges.

Other coping skills include reducing stress with exercise and social contact. Build a support system, and reach out for help when you need it. Living with OCD can be lonely and isolating if you try to manage it alone.