Causes, symptoms and treatment of OCD: Putting the puzzle together

OCD is used synonymously with ‘Obsession for Cleanliness’, which is not entirely true (Image: Canva)

Is your passion for keeping things neat and clean often referred to as OCD? That may not always align with medical definitions. According to a research published in Pubmed Central, intrusive and obsessive thoughts, and ritualistic compulsions, that disrupt everyday activities are characteristic of the obsessive-compulsive disorder (OCD). The Diagnostic and Statistical Manual of Mental Disorders, (DSM-5) is used to diagnose OCD.

Simply put, OCD is used synonymously with ‘Obsession for Cleanliness’, which is not entirely true. According to medical research, this disorder is explained as four syndromes:

1. Washers: The most common type of OCD is when a person is obsessed with contamination and a compulsion to wash (hands/body) sometimes resulting in consistent skin rubbing and causing superficial damage. They may also become less social as a consequence of this, unwilling to leave their house because of fear of germs. It can be accompanied by anxiety.

2. Checkers: Another syndrome describes an obsession with doubt, which brings along a compulsion of checking. There is a constant doubt of looming calamity due to an action, like not rechecking the stove again, not locking the door, etc. The person also feels guilty because of such doubts, along with the feeling of not being careful enough.

3. Pure obsessions: The third most common syndrome includes intrusive, repetitive impulses, but no compulsion accompanies them. Counter-thoughts are common, and the content of thought is often sexual or aggressive. Some people confess such ideas to a figure of authority in their eyes due to the distress caused.

4. Primary obsessive slowness: An obsession with symmetry also makes it to the list. Such people have marked slowness in their daily functionality due to an obsession with symmetry, where precision matters. For example, they may take a needless amount of time to eat their meal, or spend hours aligning objects until they’re ‘perfect’.

OCD can be a result of several biological factors, including alterations in the activity of the neurotransmitter serotonin, commonly known as the "happy hormone" (Image: Canva)

The Yale-Brown Obsessive Compulsive Scale is used to measure the severity of the symptoms of OCD, providing a range of 0-40. This tool provides a checklist of those symptoms, which includes: aggressive obsessions,  contamination obsessions, sexual obsessions, hoarding/saving obsessions, religious obsessions (scrupulosity), obsession with the need for symmetry or exactness, somatic obsessions, miscellaneous obsessions, cleaning/washing compulsions, checking compulsions, repeating rituals, counting compulsions, ordering/arranging compulsions and collecting compulsions.

Hence, merely being a ‘cleanliness freak’ does not qualify as OCD. It can creep up in a number of forms and lead to intrusive thoughts and behaviours.

Causes of OCD

OCD can be a result of several biological factors, including alterations in the activity of the neurotransmitter serotonin, commonly known as the "happy hormone". Behavioral factors can also contribute to the development of OCD, particularly obsessions. Alongside, continuous exposure to a particular type of stimulus called a "conditioned stimulus," can trigger anxiety.

Treatment of OCD

Fortunately, OCD is no longer an untreatable disorder. It can now be effectively managed with a combination of pharmacotherapy and behavioral therapy. Compulsive behaviors can be treated through a combination of behavioral therapy and cognitive-behavioral therapy. The patient's commitment to these measures is crucial, and gaining insight into the disorder can help them accept the help offered.