OCD is an abbreviation for obsessive compulsive disorder (OCD). It is a mental illness that causes repeated unwanted thoughts or sensations (Obsessions) or the urge to do something over and over again (Compulsions). It is a common, chronic and long-lasting disorder in which a person has an uncontrollable, reoccurring thought/s.

Obsessions are involuntary thoughts, images or impulses that occur over and over again in your mind, you don’t have these ideas but you can’t stop them. Unfortunately these obsessive thoughts are often disturbing and distracting.

Compulsions are behaviors and rituals that you feel driven to act out again and again. Usually compulsions are performed in an attempt to make obsessions go way. For example, if you are afraid of contamination, you might develop elaborated cleaning rituals. However, the relief never lasts. In fact the obsessive thoughts usually comeback stronger. And the compulsive rituals and behaviors often end up causing Anxiety as they become more demanding and time consuming.

Most of the people with OCD fall into one of the following categories:

1. Washers: are afraid of contamination. They usually have cleaning or hand-washing compulsions.
2. Checkers: repeatedly check things (oven turn off, door locked, etc.) that they associate with harm or danger.
3. Doubters and Sinners: are afraid that if everything isn’t or done just right something terrible will happen or they will be punished.
4. Counter and arrangers: are obsessed with order and symmetry they may have superstitions about certain numbers colors or arrangement.
   
   

OCD signs and symptoms

Just because you have obsessive thoughts or perform compulsive behaviors does not mean that you have obsessive compulsive disorder. With OCD these thoughts and behaviors cause tremendous distress, take up a lot of time (at least one hour per day) and interfere with your daily life and relationships. Most people with obsessive compulsive disorder have both obsessions and compulsions but some people experience just one or the other. Here are some sign and symptoms:

1. Fear of contamination or dirt.

2. Doubting and having difficulty tolerating uncertainty.

3. Needing things orderly and symmetrical
4. Aggressive or horrific thoughts about losing control and harming yourself or others.

5. Unwanted thoughts, including aggression, or sexual or religious subject.

 OCD self-help

Tip 1:   Identify your triggers

The first step to managing OCD is to recognize the triggers – the thoughts or situations that bring on your obsessions and compulsions. Record lists of the triggers you experience each day and the obsessions they provoke. Rate the intensity of fear or anxiety you experienced in each situation and then compulsions or mental strategies you used to ease your anxiety.

For example:  if you have fear of being contaminated by germs,touching railing at the mall might generate a fear intensity of 3, whereas touching the restroom floor in the mall might generate a 10 and requires 15 minutes of hand washing to ease your anxiety. Keeping track of your triggers can help you anticipate your urges and by anticipating your compulsive urges, you can help to ease them before they arise. For example “ if your compulsive behaviors involves checking that doors are locked , windows closed or appliances turned off try to lock the door or turn off the appliances with extra attention the first time.

Create a solid mental picture and then make a mental note. Tell yourself, “the window is now closed “or “I can see that the oven is turned off. So when the urge to check arises later, you will find it easier to re-label it just as an obsessive thought. Identifying and recording your triggers also provides an important tool for learning to resist your OCD compulsions.

Tip 2: Learn to resist OCD compulsions

It might seem smart to avoid the situations that trigger your obsessive thoughts, but the more you avoid them, the scarier they feel. Conversely, by repeatedly exposing yourself to your OCD triggers you can learn to resist the urge to complete your compulsive rituals. This is known an exposure and response prevention (ERP) and is a main stay of professional therapy for OCD. ERP requires you to repeatedly expose yourself to the source of your obsession and then refrain from the compulsive behavior you usually perform to reduce your anxiety. If you are compulsive hand washer for e.g. that could mean touching the door handle in washroom and then not allowing yourself to wash your hands as you sit with the anxiety, the urge to wash your hands will gradually begin to go away on its own. In this way you will learn that you don’t need the rituals to get rid of your anxiety and that have some control over your obsessive thoughts and compulsive behaviors.

Tackling your biggest fears straight off might be too extreme. So ERP exercises starts with you confronting lesser fears and then working your way up the “fear ladder”. Confront those situations that generate a low fear intensity and once you are able to tolerate the anxiety you can move on to the next more difficult exposure challenge.

TIP 3: Create a tape of your OCD obsessions or intrusive thoughts

– Focus on one specific thoughts or obsession and record it to tape recorder or smartphone.

– Recount the obsessive phrase, sentence or story exactly as it comes into your mind.

– Play the tape back to yourself, over for a 45 minute period each day, until listening to the obsession no longer causes you to feel highly distressed.

By continuously confronting your worries or obsessions you will gradually become less anxious. You can then repeat the exercise for a different obsession.

TIP 4: Reach out for support

 OCD can get worse when you feel powerless and alone so it’s important to build a strong support system.

TREATMENTS

The two main treatments for OCD are “Psychotherapy” and “Medications”. Often treatment is most effective with a combination of these.

In treatment resistant cases, other options may be offered.

1. Intensive outpatient and residential treatment programs.
2. Deep brain stimulation (DBS)
3. Transcranial magnetic stimulation (TMS)

Therapy for OCD is usually a type of Cognitive Behavioral Therapy (CBT) with exposure and response prevention.