Only a tiny fraction of people suffering from Obsessive compulsive disorder ever seek OCD treatment. The main reason being that people with OCD are ashamed of their obsessions and compulsions, fearing that they may be deemed as crazy or weird. Even though people with OCD may know they are behaving irrationally, they are not able to curb or stop their obsessive behaviors.
Many years ago, it was believed that OCD behavior was caused by bad parenting or personality quirks. However, it is now established that OCD is caused by a variety of factors:
Genetic factors, imbalances at serotonergic system and life experiences play an important role in the development of obsessive compulsive disorder.
The role of genetics is confirmed by studies showing that twins have a higher incidence of the illness. Family history is also known to play an important role in the development of OCD, a previous incidence of psychiatric disorder in the family increases the individual’s likelihood of developing OCD.
Neurochemical imbalance also plays an important role in OCD. Patients are known to have decreased serotonergic activity but increased dopaminergic activity. This explains why selective serotonin uptake inhibitors (SSRI antidepressants) and neuroleptics that work on dopaminergic system are effective in treating obsessive compulsive disorder.
OCD is a difficult condition to live with, not only for the patient but also for his/her relatives. The irrational behavior and rituals of the patients can make life hard for the relatives. Logical explanations don’t help the patient, even if repeated over and over again.
Patients tend to be stubborn in their obsessions and compulsions that are seen as nonsense by healthy people. Sometimes friends or parents of the sufferer may feel irritated and harshly criticize the patient, such a situation would only adds to the pressure on the obsessive compulsive disorder patient. There are famous treatment techniques which have been widely used in USA for treating patients suffering from OCD.
The best option available is to seek professional help.
The patient may opt for therapy or medications. Most of the talk therapies appears useless as a treatment, cognitive behavior therapy, on the other hand, has success when used alone or along with medication.
Cognitive Behavior Therapy:
CBT teaches the person methods to discover the irrationality of his/her beliefs or behaviors. Therapeutic interventions are based on the therapist’s ability to teach the patient skills to distinguish between being rational and irrational thoughts.
Cognitive therapy teaches methods to identify negative thought patterns and helps the patients develop an objective and effective pattern of thinking. It also provides short term relief from worry that causes distress to the sufferer.
CBT helps the person to identify the emotional differences between what’s rational versus what’s irrational. This way the patient is gradually trained to identify their urges and take control over them.
Many patients with OCD tend to carry a lot of guilt and self blame and look upon themselves as being psychologically weak individuals. CBT helps them develop a positive self-image and take control over the situation by showing them how the mechanisms of OCD works.
It also helps the patient develop greater levels of tolerance toward anxiety by developing a greater understanding of the thought patterns involved in OCD and looking upon it as something that can be managed.
Cognitive behaviour therapy has proven to be the most helpful amongst various types of therapies. Psycho-dynamic and dynamic therapies have shown limited effectiveness on OCD. Beside these treatment options, obsessive compulsive disorder is generally a treatment resistant illness.
Behavior therapy also involves “Exposure and Response Prevention” where a patient is exposed to the feared idea or object, but (s)he is discouraged from responding in the usual manner. For example, someone having an irrational fear of dogs is made to touch a dog initially, and gradually being able to take the dog for a walk without unnecessary fears.
A person who washes hands excessively can be asked to touch something (s)he thinks is dirty and then not being allowed to wash the hands for several hours. Someone who walks around several times checking windows and doors to make sure everything is locked up tight, may only be allowed to do it one time only. With repeated therapy the levels of anxiety are known to decrease and obsessive reactions tend to stay decreased for extended periods of time.
Medications for OCD:
The first line of treatment of treatment for OCD is through antidepressants. Selective serotonin uptake inhibitors (SSRIs) and neuroleptics in some cases combined with cognitive behaviour therapy have shown great response.
The serotonergic antidepressants commonly used in OCD are fluoxetine, paroxetine, sertraline, citalopram and escitalopram. These well known SSRIs have less side effects than other antidepressants and also have less withdrawal symptoms. Other antidepressants used in treatment are drugs such as Effexor, and Wellbutrin. These drugs are frequently used to supplement OCD medications.
These medications increase the amount of the neurochemical serotonin in the brain. (serotonin levels are known to be low in OCD.) As their name implies, the SSRIs work by selectively inhibiting (blocking) serotonin reuptake in the brain.
The SSRIs work by keeping serotonin present in high concentrations in the synapses. These drugs do this by preventing the reuptake of serotonin back into the nerve cell that is transmitting an impulse. The reuptake of serotonin is responsible for turning off the production of new serotonin. Therefore, the serotonin message keeps on coming through. It is thought that this, in turn, helps arouse (activate) cells that have been deactivated by OCD, thereby relieving the symptoms of the condition.
Clomipramine, a tricyclic antidepressant has also shown great effectiveness in the OCD treatment .
Alternative remedies for OCD:
Inositol in large amounts is known to help OCD.
St john’s wort was previously thought to be effective as it works on serotonergic system and has a significant value in treating depression but recent studies showed minimal or no benefit. Also you can check the effective treatment techniques for OCD here.
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