Obsessive-compulsive disorder (OCD) is a surprisingly common yet often misunderstood type of anxiety disorder. According to the National Institute of Mental Health, OCD affects about 2.3% of American adults each year. OCD manifests in a variety of forms but always involves obsessive, anxious thoughts and compulsive behaviors to relieve anxiety. While OCD can be disabling without treatment, therapy and medication provide effective relief for most sufferers. Understanding the psychology behind OCD and learning research-backed coping skills can help you or your loved ones manage this illness.
What is OCD?
OCD is characterized by obsessions and compulsions that feed each other in a vicious cycle. Obsessions are recurring, persistent thoughts, images, or impulses that generate anxiety. Common obsessions include fear of contamination, aggressive or horrific impulses, need for order/symmetry, and excessive doubt. Compulsions are repetitive behaviors or mental rituals performed to decrease anxiety caused by the obsession. For example, excessive hand washing to reduce contamination fears or counting in certain patterns to ease doubts.
Performing compulsions provides temporary relief but reinforces the obsession. The cycle escalates over time as tolerance builds. People with OCD often realize their obsessions are senseless but feel powerless to stop them. Severe OCD can consume hours each day performing rituals, impairing relationships and daily functioning. Around half of people with OCD also have depression.
What Causes OCD?
The exact causes of OCD remain unclear but likely involve:
- Genetics – OCD runs in families, suggesting a hereditary component.
- Brain structure and function – Neuroimaging shows differences in areas regulating fear, decision-making, and impulse control. OCD brains are hyperactive when facing perceived threats.
- Neurotransmitter imbalances – OCD involves too much serotonin and glutamate but too little GABA, which regulates excitability.
- Childhood trauma, infections, or stress may trigger onset of OCD in predisposed individuals, especially if coping skills are lacking. OCD often begins during puberty.
Treatment Options for OCD
While OCD cannot be cured, treatment can successfully manage symptoms for most people. Selecting the right treatment depends on symptom severity. Options include:
- Therapy – Cognitive-behavioral therapy (CBT) with exposure and response prevention (ERP) is the gold standard psychotherapy for OCD. CBT helps reframe thinking patterns while ERP encourages facing fears without performing compulsions to break the obsession-compulsion cycle. Studies demonstrate CBT/ERP relieves OCD symptoms long-term.
- Medication – Selective serotonin reuptake inhibitor (SSRI) antidepressants like Prozac, Zoloft, and Luvox are first-line medications for OCD. SSRIs boost serotonin to strengthen communication between brain cells. Antidepressants won’t cure OCD but can reduce symptoms for 60-70% of people.
- Residential Programs – For severe, treatment-resistant OCD, residential facilities offer intensive CBT/ERP plus medication management. Removing environmental triggers through immersive therapy promotes recovery.
- Brain Stimulation – Experimental techniques like deep-brain stimulation send electrical impulses to modulate problematic brain circuits. Early research is promising. Further studies are needed.
Medication and therapy together have the highest success rates for OCD. Most people need 6-12 weeks of consistent treatment before improvement.
5 Effective Coping Skills for OCD
While enduring OCD treatment, the following self-care habits can help you manage acute distress:
- Stop performing compulsions. As challenging as this is, avoiding compulsions is crucial for breaking the OCD cycle long-term. Start small by resisting a minor compulsion once daily, even if it causes anxiety. Avoid reassurance-seeking from others. Let anxiety diminish naturally without rituals.
- Practice mindful acceptance. Notice obsessive thoughts without reacting or judging them. Say to yourself “I’m having the thought that [obsession],” but don’t engage further. Let the thought pass like a cloud. Release attachment to controlling thoughts.
- Do creative activities. Painting, knitting, cooking, or music engage your mind constructively, providing respite from obsessive rumination. Creative outlets produce endorphins and a sense of flow.
- Exercise and meditate. Physical activity and meditation both calm anxiety effectively. Yoga combines both with mindfulness. Even 10 minutes of walking or meditating can reset your mindset. Make time daily.
- Lean on loved ones. Don’t isolate yourself with OCD. Shame and secrecy exacerbate symptoms. Confide in trusted friends who can offer perspectives untainted by your anxiety. Feel understood.
Create an OCD Action Plan
Finally, make an action plan to motivate and track your progress. Components might include:
- Symptom tracking to identify triggers and patterns
- Treatment goals and appointments
- Coping skill utilization targets, like 15 min meditation daily
- Lifestyle adjustments to reduce stress
- Accountability partner check-ins
- Celebrating small wins!
OCD is challenging but treatable. With professional help and daily commitment, you can overcome OCD and reclaim your life. Don’t lose hope during difficult times. Have faith that recovery is within reach, one step at a time.