Obsessive-compulsive disorder (OCD) is defined by the occurrence of obsessive thoughts and compulsive behaviors performed in an effort to neutralize such thoughts. Obsessions are persistent and recurrent intrusive thoughts, imagery or even impulses which seem disturbing, uncontrollable and inappropriate. People who suffer from obsessions, they try to neutralize it with a repetitive compulsive behavior. Compulsions are overt behavior which is repeatedly acted upon to an extent that it is performed unnecessary number of times. It involves lengthy rituals like washing your hands multiple times, praying incessantly, saying certain things or words or counting. (Association, 2013)
A person feels like he/she is on a motor, driven in a specific manner, at a specific time for a fixed duration of time. They are aware of their actions and the reality that is distinction from other psychotic disorders. We all go through minor obsessive thoughts like checking our stoves a few times or checking the lock before going outside. But what is separating OCD from these daily instances is that in OCD, people don’t check things for only few times, they do it for many a times a day, every day at the same time. It is a recurrent behavior that is rooted in their intrusive obsessive thoughts.
The treatment of OCD was once proposed to be quite difficult but with combinations and different studies conducted on the efficacy of all kinds of treatment, there are medications and therapeutic techniques which provide improved results.
- Neurosurgical treatment approach: This type of treatment has just emerged with effective response rate in severe cases of OCD. It is especially meant for those intense patients who have not responded to other forms of treatment like behavior therapy or medications. Though active research is still going on this issue but the prior reports show that techniques like Deep Trans-cranial Magnetic Stimulation seems to improve the occurrence of the obsessive symptoms. (Roth, 2020)
- Medications: Although medications are not the most effective for other anxiety disorders, it is reported that they work wonders for OCD patients. Drugs like clomipramine (Anafranil) and fluoxetine (Prozac) reduce the intensity of symptoms up to at least 25-30 percent of the occurrence in approximately 60 percent of the sample. Also there are some antipsychotic drugs which are effective for the reduction of the symptoms. But the only limitation of this approach is that it would not work for long term cases, without behavior therapy as a supportive technique. (Reddy, 2020)
- Behavior therapy: Exposure response prevention (ERP) has been the most effective behavior treatment for OCD patients. It involves an exposure of stimuli which the individual disgust or fear; meaning to provoke their obsessions. Now they can either let them imagine this stimulus or give them a real-life experience. But they refrain the patients to not act upon these obsessions and not do any compulsive behaviors. This would make them see that if they don’t do the compulsive rituals, that obsessive thought will weaken and dissipate naturally down to a 40 to 50 percent on a scale of 100. (Hezel, 2019)
- Cognitive behavior therapy: CBT sets out on its primary goal as the dropout rates of the patients or the improvement in symptoms reduction. It works specifically with medications like d-cycloserine, but without any antidepressants in use. Nowadays there is an emerging technique of Mindfulness-based CBT, which is proven to be effective for those who gave no response or partial response to traditional CBT. It would be more effective if we use both the ERP and CBT for the treatment of OCD. (Külz, 2019)
Lastly, the treatment plan for OCD patients is based on the severity of the OCD symptoms in the patients, there have been studies regarding the effective treatment of many patients with the combined efforts of medications and therapy. There is no fixed intervention technique for such a complex and repetitive disorder.
- Roth, Y., Barnea-Ygael, N., Carmi, L., Storch, E. A., Tendler, A., & Zangen, A. (2020). Deep transcranial magnetic stimulation for obsessive-compulsive disorder is efficacious even in patients who failed multiple medications and CBT. Psychiatry Research, 113179. https://doi.org/10.1016/j.psychres.2020.113179
- Reddy, Y. J., & Arumugham, S. S. (2020). Are current pharmaco-therapeutic strategies effective in treating OCD? https://doi.org/10.1080/14656566.2020.1735355
- Hezel, D. M., & Simpson, H. B. (2019). Exposure and response prevention for obsessive-compulsive disorder: A review and new directions. Indian journal of psychiatry, 61(Suppl 1), S85. https://dx.doi.org/10.4103%2Fpsychiatry.IndianJPsychiatry_516_18
Külz, A. K., Landmann, S., Cludius, B., Rose, N., Heidenreich, T., Jelinek, L., … & Maier, J. G. (2019). Mindfulness-based cognitive therapy (MBCT) in patients with obsessive–compulsive disorder (OCD) and residual symptoms after cognitive behavioral therapy (CBT): a randomized controlled trial. European archives of psychiatry and clinical neuroscience, 269(2), 223-233. https://doi.org/10.1007/s00406-018-0957-4