Obsessive-Compulsive Disorder (OCD): Symptoms, Triggers & Treatment | Mass General Brigham

Summary

Dr. Sabina Wilhelm, a leading expert in OCD at Mass General Hospital, provides a comprehensive overview of Obsessive-Compulsive Disorder (OCD). She explains that OCD involves recurring, distressing thoughts (obsessions) and repetitive behaviors (compulsions). The video outlines common obsessions like contamination fears or concerns about harm, and compulsions such as hand washing or checking. Dr. Wilhelm discusses OCD’s causes, its prevalence, treatment options like Cognitive Behavioral Therapy (CBT) and medication, and how the disorder differs from simply wanting to be organized. The video also highlights the importance of seeking treatment, with a strong emphasis on hope and effective interventions.

Takeaways

• 😀 OCD (Obsessive Compulsive Disorder) is a psychiatric disorder involving obsessions (recurrent thoughts, images) and compulsions (repetitive behaviors or mental acts).
• 😀 Obsessions in OCD can cause significant anxiety and distress, prompting individuals to engage in compulsive behaviors to alleviate that discomfort.
• 😀 Common obsessions include fears of contamination, losing something, making mistakes, or concerns about symmetry, violent, sexual, or religious thoughts.
• 😀 Common compulsions include hand-washing, checking, repeating actions, and mental compulsions like praying or reviewing thoughts.
• 😀 OCD triggers vary widely, ranging from objects (e.g., doorknobs) to interactions with people, potentially leading to intrusive thoughts and compulsive actions.
• 😀 OCD affects about 1-2% of the population, with peaks in childhood and early adulthood; most individuals develop symptoms before age 25.
• 😀 Genetics, biological factors, psychological traits (e.g., perfectionism), and environmental factors (e.g., stress or trauma) are thought to contribute to the development of OCD.
• 😀 The two gold standard treatments for OCD are Cognitive Behavioral Therapy (CBT) with Exposure and Response Prevention, and pharmacotherapy (typically serotonin reuptake inhibitors).
• 😀 CBT for OCD usually involves 16-20 sessions, with a 60-80% success rate. It includes learning to manage thoughts, exposure to feared situations, and preventing compulsive behaviors.
• 😀 While 20% of people may relapse after successful CBT, relapse can often be managed by revisiting strategies or consulting a therapist for booster sessions.
• 😀 OCD differs from being a 'neat freak' or wanting to perform well; real OCD involves distressing obsessions and compulsions that cause significant suffering, unlike a preference for cleanliness or order.
• 😀 OCD is diagnosed through a clinical interview, and there is no specific brain scan or blood test to confirm it. Several disorders share similarities with OCD, such as body dysmorphic disorder, trichotillomania, and hoarding disorder.

Q & A

What is obsessive-compulsive disorder (OCD)?

OCD is a psychiatric disorder where individuals experience recurrent obsessions (intrusive thoughts or images) and compulsions (repetitive behaviors or mental rituals) that they perform to relieve anxiety caused by the obsessions.

What are some common examples of obsessions in OCD?

Common obsessions in OCD include fears of contamination, fears of making a mistake, concerns with symmetry or exactness, and intrusive violent, sexual, or religious thoughts that are considered inappropriate by the individual.

What are compulsions, and how do they relate to OCD?

Compulsions are repetitive behaviors or mental actions that a person feels compelled to perform in response to an obsession. For example, washing hands repeatedly to reduce the fear of contamination or checking things repeatedly to ensure they were done correctly.

How do triggers contribute to OCD symptoms?

Triggers are situations, objects, or events that precede and provoke the onset of OCD symptoms. For instance, touching a doorknob might trigger an obsession about contamination, leading the individual to compulsively wash their hands.

How common is OCD and when does it typically begin?

OCD affects about 1-2% of the population, with two peaks of onset: childhood and early adulthood. Most individuals develop OCD before the age of 25.

What are some potential causes of OCD?

The exact cause of OCD is unknown, but it is believed that a combination of genetic factors, brain activity imbalances, personality traits like perfectionism, and environmental triggers such as stress or trauma may contribute to the development of the disorder.

What are the two gold standard treatments for OCD?

The two gold standard treatments for OCD are Cognitive Behavioral Therapy (CBT), which focuses on exposure and response prevention, and pharmacotherapy, typically involving serotonin reuptake inhibitors (SRIs).

How effective is Cognitive Behavioral Therapy (CBT) for OCD?

CBT is effective for many individuals, with about 60-80% of patients responding positively to the treatment. It involves exposure to feared situations and preventing compulsive responses, typically over 16-20 sessions.

Can individuals relapse after treatment for OCD?

Yes, about 20% of people may relapse after initial success with CBT. However, they can often regain progress by revisiting coping strategies or seeking additional therapy sessions.

How is OCD diagnosed?

OCD is diagnosed through a diagnostic interview with a mental health professional, who will inquire about the individual’s obsessions and compulsions. There is no need for brain scans or blood tests to diagnose the disorder.

What are some common comorbidities associated with OCD?

OCD often co-occurs with other conditions, such as depression, anxiety disorders, eating disorders, and body dysmorphic disorder. Related disorders include trichotillomania (hair-pulling), excoriation (skin picking), and hoarding disorder.

Is there hope for individuals with OCD, and what resources are available?

Yes, there is hope. OCD is treatable, and effective therapies are available. Resources like the International OCD Foundation provide valuable information and support for those affected by OCD and their families.