Obsessive Compulsive Disorder

What is it?

Obsessive (ub-ses-iv) compulsive (kum-pul-siv) disorder or "OCD" is an anxiety disorder. An obsession is an unwanted thought that stays in your mind most of the time. You cannot stop or control this thought. A compulsion is something you do and cannot stop doing because of the obsessive thought. You may become very anxious if you try to stop the compulsion. OCD may affect how you feel about yourself and life. But, OCD can be treated.

Causes:

OCD may be caused by a problem in how the brain works. It may also be caused by chemical changes in the body. The following things increase your risk of getting OCD.

  • Stress.

  • Important significant changes in your life, such as a marriage, death, or job change.

  • Using street drugs or abusing alcohol.

  • Rarely, you could get OCD after an illness, such as strep throat.

  • Being very sad now or in the past.

  • Being very anxious now or in the past.

  • A family member with OCD or some other mood disorder.

Signs and Symptoms:

  • OCD signs may start in childhood, or any time before 30 years old. The signs of OCD may be better or worse at times and may last many years. With OCD, instead of asking for help, you try to hide your thoughts or behaviors. You may not want to see or talk to anyone. When you try to stop thinking a thought or doing an action you get very nervous. You may not be able to do your normal activities. You feel that what you are thinking and doing is wrong, but you still need to do it.

  • With OCD, you may have a thought that you cannot get out of your mind, such as wanting to exercise. You may have a behavior that you cannot stop, such as washing your hands over and over. You may have an obsession or compulsion about keeping your body or everything around you clean. You may have a habit of counting everything. You may not be able to throw anything away. You may pull gray hairs out and have trouble stopping. Or, you may check many times to see if something is locked.

Care:

Psychiatric assessment:

Caregivers will ask if you have a history of psychological trauma, such as physical, sexual, or mental abuse. They will ask if you were given the care that you needed. Caregivers will ask you if you have been a victim of a crime or natural disaster, or if you have a serious injury or disease. They will ask you if you have seen other people being harmed, such as in combat. You will be asked if you drink alcohol or use drugs at present or in the past. Caregivers will ask you if you want to hurt or kill yourself or others. How you answer these questions can help caregivers decide on treatment. To help during treatment, caregivers will ask you about such things as how you feel about it and your hobbies and goals. Caregivers will also ask you about the people in your life who support you.

Treatment includes meeting with your caregiver and you may also need medicine. The following are possible treatments you may receive.
  • Medicines:

    • Anti-Anxiety Medicine: This medicine may be given to help you feel less nervous. It may be given by IV, as a shot, or by mouth.

    • Anti-Depressants: OCD can cause you to feel depressed so you may need anti-depressant medicine. This medicine is given to lessen or to prevent the symptoms of depression. It is given by mouth.

    • Anti-Psychotics (si-kaw-tiks): This medicine is usually given to decrease the symptoms of psychosis or severe (very bad) agitation. Anti-psychotics are given as a shot, by mouth, or as a suppository in the anus (rear-end).

  • Care Settings:

    • Partial Care Program: This is when you come to the unit every day during the day or evening. After you are treated each day, you then go home. You may need a partial care program just after they've been treated in the hospital. Or, caregivers may suggest this type of program to keep you from needing to go into the hospital.

    • Intensive Outpatient Program: This is when you come to the hospital or clinic for 1 to 3 hours of treatment. This program is usually 2 to 5 times a week for a short period of time. The treatment is less intense than in a partial care program.

    • Outpatient Program: This is when you meet with your therapist once a week or less. Appointments are one hour long or shorter. You could meet one-to-one with your therapist. Or, you might meet with your therapist in a group. You may have few or many scheduled appointments over time.

  • Caregivers:

    • Psychiatrist (si-ki-uh-trist): This is a medical doctor who works in the area of mental health. The psychiatrist is in charge of ordering your medicine. You may work closely with this doctor and other caregivers.

    • Therapist: This is a caregiver that works closely with you during treatment. This person may be a doctor, psychologist (si-kall-o-jist), nurse, mental health counselor, or social worker.

  • Types of Therapeutic Sessions:

    • Couples Therapy: You and your significant other meet with a caregiver to talk about how to cope with your illness. Your significant other may be your spouse (husband or wife) or a boyfriend or girlfriend.

    • Family Meetings: Your caregivers will meet with you and your family. You will talk about how to cope with your illness.

    • Group Therapy: A series of meetings that you attend with other patients and staff. During these meetings, patients and staff talk together about ways to cope with illness.

    • Individual Therapy: A time for you to meet alone with your therapist. During this time you and your therapist may talk about how to cope with your illness.

  • Types of Therapy Approaches:

    • Behavioral Modification: teaches you how to change your behavior (actions). You will look at the reasons for your behavior and the results of your actions. With behavior "mod" therapy, you learn that certain behaviors have good or bad results. These results may make you feel either good or bad about yourself. Good behavior makes most people feel good about themselves. Good behaviors are often rewarded.

    • Cognitive Therapy helps to make you aware of how you see things. You may have trouble seeing the good in things around you. Then you are more likely to feel depressed, sad or angry. Cognitive therapy teaches you to learn how you see things in a more positive way.

    • Exposure/Desensitization (d-sen-tuh-ti-za-shun) Therapy. Exposure therapy helps you to face your fears in a safe setting with caregivers there to support and help you. After you have practiced ways to decrease your fear and anxiety you are better able to handle your fears when alone. Desensitization is when caregivers help you practice facing a fear a little at a time. This is taught in a supportive and safe setting.

    • Relaxation is another way to focus your attention on something other than your feelings. For instance, good smells may change your mood and help you relax. Good smells may also help your brain make special chemicals called endorphins (n-door-fins). Endorphins are a natural body chemical that can decrease bad feelings and pain. For example, listening to music or taking a bath with aromatherapy (uh-ro-muh-thair-uh-p) oils. Candles, massage oils, and scented bubble baths are ways that smells can be used.

Patient Rights:

  • Release of Information Form: This is a legal paper that lets caregivers share information with those listed on this form. You have to sign this form before any information can be released to persons outside the hospital.

  • Right to Privacy: Information that you share with your caregivers is private among caregivers. They will not share information with others without your permission.

Coping:

  • Accepting that you have OCD is hard. You and those close to you may feel angry, sad, or frightened. These are normal feelings. Talk to your caregivers, family, and friends about your feelings. Write down questions you have about OCD and how it is treated. This way you will be able to ask them during your next visit to the caregiver.

  • Ask your health care provider if they know about books that you can read. Reading about your illness might help you better understand it.

  • You may also want to join a support group. This is a group of people who also have OCD. Ask your caregiver for the names and numbers of support groups in your town. You can also call or write one of the following national organizations for more information.
  • National Alliance on Mental Illness
    3803 N. Fairfax Dr., Suite 100
    Arlington , VA 22203
    Phone: 1- 703 - 524-7600
    Phone: 1- 800 - 950-6264
    Web Address: http://www.nami.org
  • National Institute of Mental Health (NIMH), Public Information & Communication Branch
    6001 Executive Boulevard, Room 8184, MSC 9663
    Bethesda , MD 20892-9663
    Phone: 1- 301 - 443-4513
    Phone: 1- 866 - 615-6464
    Web Address: http://www.nimh.nih.gov/
  • Obsessive Compulsive Foundation, Inc.
    676 State Street
    New Haven , CT 06511
    Phone: 1- 203 - 401-2070
    Web Address: http://www.ocfoundation.org

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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