Obsessive-Compulsive Disorder and Its Treatment

Abstract

Obsessive-compulsive disorder occurs in many forms that encompass checking, hoarding, mental contamination, and intrusive thoughts. Indications of the disorder may arise in children and adolescents and become worse with age. Despite widespread research on obsessive-compulsive disorder, the definite cause of the condition is yet to be recognized. Regarding the association of objects with sentiments of fear being established, people with an obsessive-compulsive disorder start to avoid items and the ensuing dread, instead of dealing with or tackling the fright. The use of drugs, which include citalopram, fluvoxamine, and sertraline, is a treatment plan for short-term goals. The development of selective serotonin reuptake inhibitors widens the range of treatment options.

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Introduction

Obsessive-compulsive disorder refers to an anxiety problem that holds patients in continuous sequences of recurring thoughts and actions. The name of the disorder is attributed to the person having it being overwhelmed by repetitive and stressful thoughts and fears that uncontrollably take much of their time (obsession). Moreover, the arising anxiety creates a pressing need to undertake never-ending rituals (compulsion). Such rituals are carried out in an effort of avoiding obsessive thoughts and perhaps eliminating them. However, they only make anxiety disappear for a short time before the person is again required to act on it with the recurrence of obsessive thoughts (de la Cruz et al., 2016). Although people with obsessive-compulsive disorder are aware that obsessions and compulsions are not realistic, they have no way of stopping them, and there is a need for effective treatment.

Types

There are numerous forms of obsessive-compulsive disorder, which include symmetry and orderliness, checking, mental contamination, hoarding, and intrusive thoughts. Checking results in the need to assess things for leakages, destruction, or damage constantly, for instance, endlessly monitoring car doors, alarms, gates, or taps to mention a few. It may also involve feeling that a person and others close to the one having obsessive-compulsive disorder might be suffering. This may involve checking more than a hundred times in a short time irrespective of any commitment (Krebs & Heyman, 2015). It might entail continually confirming the genuineness of memories. People with the disorder may repetitively confirm letters and electronic mails because of the fear of having made errors or accidentally upsetting the recipient.

Mental contamination arises when a person with the disorder has an endless and domineering need to clean due to the feeling that the objects they hold are dirty. This emanates from the fear that the person or object might become sick or be contaminated if repeated cleaning is not done (Krebs & Heyman, 2015). The behavior may manifest in the form of excessive brushing of teeth, showering repetitively in a day, frequent cleaning of some rooms in a house, or staying away from a group of people to avoid contracting germs. Hoarding leads to the inability to dispose of used or worthless items.

Intrusive thoughts denote aggressive, appalling, and obsessive reflections that usually entail hurting others physically or sexually. The thinking may result in obsessions with relationships, murder, suicide, the dread of being pedophile, or being overwhelmed by superstitions. Symmetry and orderliness make people with obsessive-compulsive disorder be obsessed about things being arranged excellently to avoid harm or embarrassment (Najafi et al., 2017). This could make such people constantly arrange and rejig books on shelves in an attempt to make them look neat and perfectly ordered.

Symptoms and Signs

The obsessive-compulsive disorder differs from other mental health disorders because of the occurrence of obsessions and compulsions, which lead to striking distress, are prolonged, and slow down people’s normal operations. The signs of obsessive-compulsive disorder may arise in children and adolescents with the condition often starting gradually and becoming worse with age (de la Cruz et al., 2016). Symptoms of the disorder may either be severe or gentle with some individuals having just obsessive thoughts devoid of the involvement of compulsive behavior. Most people who have obsessive-compulsive disorder successfully conceal the symptoms to avoid being embarrassed or stigmatized. Nevertheless, close friends and members of the family discern most of the physical indications. Repeated washing of hands, showering, and cleaning of objects in a particular manner are common compulsions in the disorder.

Causes

Regardless of extensive research on obsessive-compulsive disorder, the actual cause of the condition is yet to be established. The disorder is believed to have a neurological origin with some researchers affirming that the brain operates differently in people with the condition. Most studies show that a defect or imbalance in neurotransmitters is a major source of obsessive-compulsive disorder (Najafi et al., 2017). The condition is evenly common among male and female adults. However, an obsessive-compulsive disorder that starts in childhood is more prevalent in boys when compared to girls, and the characteristic period of onset is later for females than their male counterparts. The disorder is believed to be caused by a combination of behavioral, cognitive, hereditary, neurological, and environmental aspects.

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Obsessive-compulsive disorder may run in a family and maybe deemed a familial problem. It can span generations and make close family members of a person with the condition considerably more probable of developing symptoms of the disorder. A wide pool of studies has established that signs and symptoms of the disorder are moderately likely to be inherited, and genetic aspects contribute about 35% variation in scores measuring the condition (Najafi et al., 2017). Sadly, no single gene is yet to be named the cause of the obsessive-compulsive disorder. The behavioral theory proposes that people with the disorder link certain items or situations with fear. Such people learn to avoid supposed objects or are inclined to carrying out rituals to assist in the alleviation of fear. The ensuing fear, evasion, or ritual sequence might start in the course of extreme distress, for instance, while commencing a new job or immediately following the termination of a serious relationship that has lasted for years.

Environmental factors have also been connected with the development of the obsessive-compulsive disorder in people who are likely to have the condition. Some environmental stressors include different infectious agents and childhood experiences (de la Cruz et al., 2016). When a mother with the disorder washes compulsively, her children may learn it and end up taking it as a normal practice or a necessary action that should be done hence developing the condition. Furthermore, childhood sexual or physical abuse, over and above other traumatic occurrences results in increased risk for obsessive-compulsive disorder.

Diagnosis

The DSM-5 diagnostic measures for obsessive-compulsive disorder encompass the existence of either compulsions or obsessions, or both. Apart from the occurrence of obsessions and compulsions being time-consuming, they cause medically noteworthy agony or impairment in work-related, social, or other vital areas of life (Krebs & Heyman, 2015). Symptoms of the disorder are not linked to the physiological impact of narcotic drugs or medicines for other conditions. Additionally, the resulting disturbance cannot be suitably explained by other mental health disorders. It is only when the criteria for compulsions or obsessions are met that a proper diagnosis of obsessive-compulsive disorder is given. It is important to note that several other neurological and psychiatric conditions, for instance, anxiety and depression, have similar indications to obsessive-compulsive disorder and might arise alongside it.

Treatment

The use of drugs is a treatment plan for short-term goals with the development of selective serotonin reuptake inhibitors broadening the scope of options. They encompass citalopram, clomipramine, fluoxetine, fluvoxamine, and sertraline, which may also be prescribed for other conditions such as depression and anxiety (Oliver et al., 2015). Drugs function through augmenting the level of neurotransmitter serotonin within a person’s brain. They are used in higher doses in the treatment of obsessive-compulsive disorder than other conditions and may take even three months before results are noticed. Cognitive-behavioral therapy is a treatment plan for long-term goals and centers on the evocation of the person’s cognitions that are pertinent to the condition while assisting the patient to modify them (Jacobson, Newman, & Goldfried, 2016). Therapists help patients to develop healthy and successful approaches of reacting to obsessive thoughts devoid of turning to compulsive behavior. This assists in the prevention of relapse when treatment is accomplished.

Conclusion

Obsessive-compulsive disorder is an anxiety condition that leaves patients in constant sequences of persistent thoughts and behaviors. Despite people with the disorder being aware that obsessions and compulsions are impractical, they are unable to stop them, hence the need for effective treatment. People with the obsessive-compulsive disorder do not choose to hold such thoughts and this may give them severe distress. The occurrence of grief makes such people unable to follow through on their thoughts soberly. Obsessive-compulsive disorder is believed to be caused by behavioral, genetic, cognitive, neurological, and environmental aspects. Cognitive-behavioral therapy is a treatment plan for long-term goals.

References

de la Cruz, L. F., Kolvenbach, S., Vidal-Ribas, P., Jassi, A., Llorens, M., Patel, N.,… Mataix-Cols, D. (2016). Illness perception, help-seeking attitudes, and knowledge related to obsessive-compulsive disorder across different ethnic groups: A community survey. Social Psychiatry and Psychiatric Epidemiology, 51(3), 455-464.

Jacobson, N. C., Newman, M. G., & Goldfried, M. R. (2016). Clinical feedback about empirically supported treatments for obsessive‐compulsive disorder. Behavior Therapy, 47(1), 75-90.

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Krebs, G., & Heyman, I. (2015). Obsessive-compulsive disorder in children and adolescents. Archives of Disease in Childhood, 100(5), 495-499.

Najafi, K., Fakour, Y., Zarrabi, H., Heidarzadeh, A., Khalkhali, M., Yeganeh, T.,… Pakdaman, M. (2017). Efficacy of transcranial direct current stimulation in the treatment: Resistant patients who suffer from severe obsessive-compulsive disorder. Indian Journal of Psychological Medicine, 39(5), 573-577.

Oliver, G., Dean, O., Camfield, D., Blair-West, S., Ng, C., Berk, M., & Sarris, J. (2015). N-acetyl cysteine in the treatment of obsessive compulsive and related disorders: A systematic review. Clinical Psychopharmacology and Neuroscience, 13(1), 12-18.

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