Other Classwork #2

Obsessive-Compulsive Disorder

Final Paper

Ashanti S. Nedrick

The City College of New York

May 16th, 2023

What is Obsessive-Compulsive Disorder

 Obsessive-compulsive disorder (OCD) is a frequent, constant, and long-lasting mental health condition in which a person experiences uncontrollable, recurrent thoughts and activities that they feel compelled to repeat. OCD is a common condition that impacts adults, adolescents, and children worldwide. OCD is more likely to develop in people with first-degree relatives (such as a parent, sibling, or kid) who have it, according to twin and family studies (NIMH,2022). If the first-degree relative experienced OCD as a kid or adolescent, the risk is increased. The relationship between genetics and OCD is still being investigated by studies, which might aid in OCD diagnosis and therapy. Some research has shown a link involving childhood trauma and symptoms of obsessive-compulsive disorder. To properly comprehend this connection, more study is required. PANDAS, or pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, are conditions where children may experience OCD or OCD-like symptoms after contracting a streptococcal infection such as strep throat but more research is needed more studies on OCD (NIMH,2022).

History on OCD

  The development of concepts pertaining to religion, health, and psychology throughout OCD’s history can be seen as aspects that are experienced at a broad social level. Priests and other theorists created particular guidelines for the therapy of OCD throughout the era known as the Enlightenment which began in the 1600s, along with not attempting to repress disturbing 

 

thoughts, keeping busy with everyday activities, and maintaining social contact with others (Admin, 2019). During this time, autobiographical and self-help writings by contemporary philosophers began to form the basis of a kind of behavioral therapy for OCD. During the 1700s, people saw a movement in OCD treatment away from religion and toward medicine, despite the fact that doctors had few effective OCD treatment options at the time. This demonstrated a tendency in society’s consciousness away from an unwavering faith in the preeminent spiritual systems and toward rationalism and positivism. Bloodletting, laxatives, and enemas were among the regular medical procedures that were employed at the time to treat a wide range of medical disorders. OCD patients had a generally unpleasant time period in their lives since the medical practice was unprepared to handle psychiatric problems and there was an increase in the hospitalization of OCD patients in insane asylums. Throughout the 1700s and 1800s, hospitalization was a pattern that grew in importance as OCD was perceived as a form of insanity during this time (Admin, 2019). OCD patients were less frequently institutionalized as the medical world came to the conclusion in the late 1800s that OCD is not a form of insanity. In the early 1900s, the psychoanalytic paradigm, made popular by Freud, began to emerge. This paradigm evolved to interpret OCD metaphorically, as reflections of conflicts in patients’ issues and problems for them. Talk therapy was recommended by psychologists following Freud as the best course of action for OCD. The church’s beliefs, which continued to place a strong focus on “morals or ethics,” conflicted with the psychodynamic approach to OCD and the Freudian understanding of the connection with fundamental primordial problems. Discussions and treatments on OCD have evolved over time, reflecting changes in social awareness as well as 

 

philosophical and cultural advances at the social level. The way psychiatric disorders like OCD are treated has changed along with society’s prevailing attitudes seeing it first as an anxiety disorder. The evolution of social views on religion, medicine, science, and the nature of people are all reflected in the history of OCD as well as the past of mental disorders in general.

Symptoms

OCD typically develops slowly. Minor symptoms may appear to be typical habits. A death in the family, abuse, or a traumatic experience that significantly impacts you can set them off (NIMH,2022). If anyone in the family suffers from OCD or another mental illness like depression or anxiety, the likelihood of someone developing it increases. Compulsions and obsessive behaviors are the two basic types of OCD symptoms, though they may differ from individual to individual. According to The National Institute of Mental Health, Obsessional symptoms, compulsive symptoms, or both may be present in OCD patients (NIMH,2022). Some symptoms of obsessions can be fear of germs, contamination, unwanted thoughts (could be sexual or violent), fear of harm, the need to have things in order (symmetrical), and also constant doubt or worries. People can also experience compulsions that can be a response to an obsessive thought such as excessive cleaning, excessive hand washing, pulling out hair, peeling skin, ordering or arranging things in a particular way, repeatedly checking on things, compulsive counting and etc. It is possible for symptoms to intensify, fade over time, or come and go. People who have OCD may attempt to assist themselves by avoiding circumstances that set off their 

 

obsessions or they may turn to medicines or alcohol to help them relax. Some adults and the majority of children may not be aware that their behavior is abnormal, despite the fact that most OCD sufferers are aware that everything they engage in makes no sense. Usually, parents or educators can identify a child’s OCD symptoms. Everywhere across the world, OCD is a widespread illness that impacts adults, adolescents, and children. The majority of cases receive a diagnosis by the age of 19, with boys often developing the disease earlier than girls but it can also develop after the age of 35. OCD can begin at various moments. To some, it may do so in early infancy, while for other people, it may do so as late as old age. But in the majority of instances, OCD symptoms initially appear between the ages of 10 and 12 (early childhood to early adolescence) and between the late teens (about 18 years) and early adulthood (approximately 25 years) (BarlowD, 2023). Anxiety, depression, impatience, avoidance behaviors, and problems concentrating are some more OCD symptoms that may exist. It’s crucial to remember that not every individual with OCD is going to experience all of the symptoms, and certain individuals may have distinctive signs at various points in life.

Potential Causes of OCD

It’s unknown what causes OCD exactly. The condition is probably caused by a mix of elements, including both the environment and the genes. OCD typically starts with a specific issue, such as an obsession with germs or exposure, but it can also begin for no apparent reason. About 1.2 percent of girls and 0.4 percent of males have OCD at some time in their lives, with the illness often beginning in adolescence or early adulthood, but it can occasionally occur later in life 

 

(BarlowD, 2023). Although the exact etiology of OCD is unknown, environmental, genetic, and neurological abnormalities may all be associated with it. According to studies, 1% of all females will experience OCD at some time in their lives, compared to 0.5% of males who will experience the illness (BarlowD, 2023). Some other potential causes could be neurological functions, having a family history of OCD in the family, specific infections, events that cause stress, mental illnesses that accommodate anxiety or depression, or alcohol and substance abuse.

Treatments

There are multiple treatment options for patients with OCD such as medication, therapy, and prevention options as well. Medication, therapy, or both are mostly used to treat OCD. Some people with OCD show symptoms despite the fact that most individuals benefit from treatment. OCD symptoms can be alleviated with the support of selective serotonin reuptake inhibitors (SSRIs). SSRI medications help with the symptoms by increasing the brain’s serotonin levels, which may benefit people in a way that helps manage mood and decrease anxiety levels. SSRIs can take up to 8 to 12 weeks to begin effectiveness in the medical treatment of OCD compared to the treatment of anxiety, and some patients may show more rapid improvement while taking them. According to research, some people may benefit from taking antipsychotic medication as well for more severe cases if symptoms do not improve with SRIs (NIMH,2022). Research has also shown that exposure and response prevention (EX/RP), another kind of CBT can be helpful in decreasing compulsive tendencies in OCD, even among people who did not respond well to 

 

SRI medication. EX/RP involves spending time in the exact situation that sets off compulsions but afterward preventing oneself from engaging in the typical resulting compulsion. I think it’s very important to understand that finding an OCD treatment that works for them can be challenging to find because a treatment that is good for 1 person may not be effective for someone else. A specialist in mental health can help to come up with a treatment plan that is best for someone with OCD.

OCD in the DSM

The DSM has a long history in the DSM in which its category and diagnosis have changed over time. From the DSM-IV-TR to the DSM-5-TR, there were major changes for obsessive-compulsive disorder (OCD) and related illnesses including the establishment of their own diagnostic category. OCD was a part of a category called “anxiety disorders” in which other disorders were a part of this category such as panic disorders and phobias. OCD was then removed from anxiety disorders to then be categorized into its own disorder. An article by Boston Anxiety Treatment states “In 2013, the DSM classification of anxiety disorders by the American Psychiatric Association removed OCD from the list of anxiety disorders to become a separate diagnosis. The reasons were that there are significant differences in the brain function and chemistry that occurs for OCD and anxiety disorders” (Barlow, 2023).  OCD and anxiety disorders are both included within the category known as “neurotic, stress-related, and 

 

somatoform disorders.” Since the two different illnesses display differently and may require different treatments depending on the individual, they correspond to genetic aspects. 

The Removal of OCD from the DSM

The 2013 DSM-5 maintained OCD’s classification as an independent disease but added a new category for it called “Obsessive-Compulsive and Related Disorders.” Along with OCD, this classification also covers conditions including trichotillomania (hair-pulling disorder), body dysmorphic disorder, and hoarding disorder (BarlowD, 2023). Research that revealed these illnesses had distinctive clinical characteristics and treatment requirements that were different from other disorders led to the decision to develop this category. OCD stems from obsessions and compulsions rather than worry, and results in anxiety disorders, which is one of the arguments used to support the removal of OCD. The removal of OCD into its own disorder was a good decision because some diagnoses of anxiety are not the same for OCD. As well as recurring behaviors or compulsions carried out in reaction to these obsessions, OCD is additionally defined by recurrent, unsettling ideas or thoughts. These obsessions and compulsions can seriously impair your daily activities and relationships as well. OCD sometimes involves anxiety, but the condition can also be identified by other characteristics, including the existence of obsessions and compulsions as well as being unable to resist engaging in repetitive tasks. Additionally, OCD accommodates treatments differently than the majority of anxiety disorders, with exposure and response prevention therapy being the most successful approach. It’s a lot more than just having 

 

uncontrollable obsessions or compulsions. Additionally, it goes beyond the damage that OCD may do to your life quality or mental health. The issue with OCD is that it never reveals itself when you’re in need of it most and always pops up when you least expect it. Research has shown that patients with OCD are prone to also suffer from anxiety and sadness, which adds to the complexity of the situation (BarlowD, 2023). The fact that OCD is largely a biological illness with roots in variations in brain chemistry implies that medicine alone is not a sufficient form of treatment. The DSM-III, which was released in 1980, was the first diagnostic manual to classify OCD as an anxiety illness. On the other hand, OCD was granted its own category apart from anxiety disorders in the DSM-IV, which was released in 1994. This choice was made in light of mounting evidence that OCD differed from other anxiety disorders in both its characteristics and how it responded to therapy.

 

Work Cited