Treatment for Obsessive-Compulsive Disorder All

Treatment for Obsessive-Compulsive Disorder

All mental disorders can have serious -- and sometimes even devastating -- consequences for the individuals who are affected by it. But at least most kinds of mental illness do not subject the patient to casual, daily ridicule in the way that Obsessive-Compulsive Disorder -- or OCD -- does. There are countless jokes -- on everything from sit-coms to sportscasts -- about people washing their hands a la Lady Macbeth in an obsessive way. People make continual references to being obsessive or compulsive about one thing or another all the time in a way that to someone who actually struggles with OCD can feel slighting and incredibly dismissive. Those who have this condition, far from finding it a joke, can in fact find it crippling and are often deeply ashamed of their thoughts and behaviors. The bright side of this condition is that there are sound and highly effective treatments for the condition and that advances continue to be made in the treatment of OCD.

I would like to begin this paper, which focuses on the treatments that are available to individuals with OCD, with a brief overview of the condition and its variants. It is important to note initially that OCD is an entirely different condition than Obsessive-Compulsive Personal Disorder, which has an entirely different etiology and treatment. OCD is a mental disorder with two different but related components. These are intrusive thoughts, the "obsessive" part of the disorder, and repetitive behaviors, the "compulsive" part of the disorder.

Both of these symptoms cause anxiety, and the anxiety increases dramatically if the individual tries to resist either compulsions or obsessions (Rachman, 2003, p. 21). Generally, the obsessions and compulsions that a person has are related to each other. For example, if a person has obsessions about cleanliness (a common obsession), then that person is likely to have compulsions around the issue of cleanliness as well -- for example he or she might continually clean the kitchen, bleaching the cabinets over and scrubbing the floor with a toothbrush. If this individual tries to stop cleaning all the time (or even to stop thinking about cleaning all the time), then that person's anxiety levels are likely to get higher and higher. The result is that in almost all cases when an individual has not received treatment that person will decide that the anxiety is too much to bear and allow the obsessions and compulsions unfettered access.

While cleanliness is certainly a common obsession for people with OCD, there are other common obsessions and associated compulsions, including hoarding and focus on religious and sexual issues. Most people with OCD feel ashamed of their feelings and recognize that their actions are irrational. Most people with OCD would like to stop their behaviors and their thoughts. They simply do not know how to do so, and this fact can lead to secondary mental disorders such as depression (Wilson & Veale, 2005, p. 61).

Given the ways in which people with OCD can suffer from the condition, it is fortunate that there are effective treatments for the condition. Individuals vary in how effective different treatments are for them, but there are generally recognizable treatments that help most people.

The first service that must be offered to people with OCD is accurate assessment. People with the condition are generally quite aware of the fact that they are different in some fundamental way from other people but they are often unaware of exactly what is "wrong" with them. This may be especially true because of the casual way (described above) in which people in general use the terms "obsessive" and "compulsive" and talk about having OCD. Thus having an accurate diagnosis, learning that what one has is formally called Obsessive-Compulsive Disorder. A general practitioner can provide such a diagnosis if she or he has been trained in basic psychological conditions. The fact that OCD is so common is in many ways a tragedy given the fact that its consequences can be so terrible. The reverse of this is that because it is so common most doctors have had patients with this disorder and so will (one hopes!) be able to help the patient identify his or her disorder. This diagnosis will help put the patient on the right path to proper treatment. Given that some individuals with OCD also can benefit from treatment with drugs (including a number of anti-depressants), physicians can often be an important part of the team treating an individual with OCD.

An individual is perhaps somewhat more aware that their problem is psychological -- perhaps because she or he has a relative who has been diagnosed, which is entirely likely given that OCD has a genetic component -- might go to a psychologist or psychiatrist for a diagnosis (Abramowitz, 2009, p. 29). Locally, there are good resources for an individual seeking a diagnosis from a mental health professional. One good option is through the Alberta Mental Health Board. The Grey Nuns Community Hospital in Edmonton offers outpatient psychiatric assessment and treatment, including treatment specifically aimed at individuals with OCD (http://www.albertahealthservices.ca/services.asp?pid=saf&rid=4528

The Centennial Centre in Ponoka is also a good choice for an individual seeking treatment for OCD given that its staff has substantial experience in treating a range of mental illnesses. The centre focuses more on brain injuries than on mental illnesses such as OCD; however, it offers treatment for all conditions and specializes in treating individuals with diagnoses of more than one condition.

http://www.albertahealthservices.ca/services.asp?pid=saf&rid=4528

As noted above, individuals with OCD often have other mental illnesses such as depression and so would benefit from a joint-diagnosis approach.

The most effective treatment for OCD is Cognitive Behavioral Therapy supplemented with a technique called Exposure and Response Prevention (ERP). Many clinics and individual mental health professionals offer Cognitive Behavioral Therapy (or CBT), but it is most useful for an individual with OCD to find a mental health professional who has specific experience using CBT with individuals with OCD. It is especially helpful if the professional has experience with ERP (Canadian Mental Health Association, http://www.cmha.calgary.ab.ca/mentalhealth/Types_of_Mental_Illness/OCD.aspx).