Obsessive Compulsive Disorder (OCD) Theoritical Background

Definition

Obsessive Compulsive Disorder (OCD) is signed with obsession and compulsion. Obsession is a thinking or motivation to do something repeatedly, won’t do it and disturbing, weird, and fear. Compulsion is an insistence to do something that release uncomfortable obsession.

Obsessive-Compulsive Disorder (OCD) is a condition where the individual can not control the thinking of  obsession, the patient with OCD just want to release the anxiety. OCD is anxiety problem where in individual life is controlled by repeat thinking (obsession) and repeatedly behavior (Compulsion) to release the anxiety.

OCD illustration

Patient with OCD  probably tried to fight the disturbing mind, but he or she can not hold the insistence to do repeatedly behavior to make sure everything is okay. 

Causes

The causes of OCD is unknown. OCD has no relation with individual personality, we think that an individual with OCD tend to be proud of  careful, orderly, and attention in unimportant things  behavior. Otherwise, patient with OCD feels pressure with uncontrolled behaviors. He or she will feel shame if the behavior is asked by people around him or her. Patient with OCD tried so hard to reduce obsessive and compulsive behavior.

In these points, there are some causes of OCD that probably have a contribution in obsessive and compulsive behaviors.
 

Genetic

Patient with OCD that has a family members with OCD has risk for OCD in his or her life.

Organic

Organic problem such as like neurology problem in certain brain (to know more about brain functions, click here) part is one of the factors of OCD. Nerves problem may be caused by meningitis and ensefalitis, and those nerves problem will develop to OCD.
 

Personality

People that have an obsessive personality are much more risky to OCD. Their character usually like  obsession in hygiene, obey the rule, difficult in team work, and always want to win.

Experience 

Experience shows how the individual solve the problem with obsessive behavior or something like that. OCD has a relation with depression or history of past anxiety. OCD symptoms usually shows similarity in depression symptoms. For instance, the obsessive behavior in mother with depression try to kill her baby many times.

Risky Individual

Individual who has risk toward OCD are individual that has a problem in family, broken home, neurobiology factors such as like frontal brain lobe, ganglia basal and singulum damage, high level stress intensity, past anxiety history, depression, and sexual confuse.

Sign and Symptoms

OCD sign and symptoms usually agitation about loss and hesitation. OCD patient want to do some ritual or obsession. Most of them can be seen directly, such as washing hand or check the window repeatedly in certain purpose. Another ritual is internal obsession such as counting or saying something to warn the danger.

OCD patient will feel obsession in all things and rituals, These things and rituals is not logic related to uncomfortable feeling and he or she want to do those rituals to release his or her anxiety. For instance patient will feel uncomfortable with pollution, and he or she will feel comfort if he or she put his or her hand is inserted to pants pocket.

Mostly patient know that his or her obsession has no relation with his or her ritual. Patient knows his or her physical and mental behavior is too excessive and tend to weird.

OCD is different with psychosis disease, because psychosis loss of contact with reality. OCD patient is afraid and she or he will do the his or her ritual in silent. If the diagnosis  is clear and the patient knew the medical diagnosis of his or her disease is OCD, it will make depression in patient.

1. The symptoms is signed with repetitive mind and behavior at least four times for one compulsion in a day and still have them  next one to two weeks. The criteria of OCD are:
2. The patient knows about his or her mind and behavior, and he or she believe that his or her behavior is not rational, but he or she still does it to release anxiety.
3. The obsession behavior can not be control even the patient tried.
4. Mind and behavior do not give free, satisfy, and happy feeling, but those behaviors do not release the stress that the patient fells.
5. Obsession (mind) and compulsion (behavior) is repetitive and continuous in many time every day.
6. Obsession and compulsion make internal conflict on patient and spend time (more than an hour a day) or significantly disturb the patient’s normal function and social.
7. Patient with OCD always want to do some rituals, repetitive behavior such as like washing and and check something in certain purpose.

OCD washing hand

The most common obsessive and compulsive behaviors are like washing hand, checking, arranging, collecting and storing, counting, afraid to hard other people, afraid to do something wrong and  well mannered, needing symmetrical and accuracy, and too much confuse feeling.

Patient OCD usually has an intuitive mind without clear repetitive behavior, but the patient may show compulsive behavior as a negative thinking that is always occur before such as germ infection, the patient will always wash his or her hand repeatedly. 

Treatment

Psycotherapy

Psychotherapy for OCD generally is given almost same with other anxiety disorder. There are some factors of OCD that is very hard to . OCD patient will hard to identify the problem (behavior abuse) in persepting his or her behavior as an abnormal behavior abuse.

Patient assumes that he or she is normal although his or her behavior is really make him or her frustration.

For him or her, compulsive behavior is not wrong and he or she just want to make sure everything is in right conditon. Other factors are mistakes in giving information about his or her condition to therapist, it will make the patient won’t to do some therapies.

Cognitive-behavioural therapy (CBT) is used as a therapy for anxiety disorder include OCD. In CBT the OCD patient behavior like washing hand repeatedly will be managed how long the patient wash his or her hand and continuously minimize that behavior. If the patient shows anxiety sign, then the therapist give permission for the patient to wash his or her hand. This therapy is effective to reduce anxiety feeling and minimize the compulsive behavior.

Therapist is not only manage the patient’s time, but also train in breathing, relaxation, and stress management when the patient want to overcome the conflict. This therapy is usually bout three month or more. 

Farmakology

Medical drugs and psychotherapy usually prescribe in combination during the OCD therapy. Medical drugs are only prescribed by the doctor or psychiatrist or social worker. Drug therapy must be controlled because some drugs have bad side effect.

Selective Serotonin Reuptake Inhibitors (SSRIs)

Medical drugs therapy are like selective serotoni reuptake inhibitors (SSRIs) that can change the serotonin level in brain, this SSRIs drugs are  Fluoxetine (Prozac), sertraline (Zoloft), escitalopram (Lexapro), paroxetine (Paxil), dan citalopram (Celexa).

Tricyclics

Trisyclics drugs such as clomipramine (Anafranil). Tricyclics drugs are early drugs that is used for OCD. This drugs dose begins with small dose. The side effect of this drugs are increase the body weight, dry mouth, headache and drowsy.

Monoamine oxidase inhibitors (MAOIs)

The example of this drugs are phenelzine (Nardil), tranylcypromine (Parnate), and isocarboxazid (Marplan). MAOIs prescribetion must forbid cheese, grape, contraception pill, pain killer (Advil, Motrin, Tylenol), anti allergy drugs and supplements. Contradiction with MOAIs drugs cause hypertension.