Obsessive-Compulsive Disorder (OCD) is a mental illness that presents with bothersome intrusive thoughts that produce a feeling of discomfort. To reduce this discomfort, people afflicted with OCD often react compulsively with rituals.  However, these actions—or “rituals”—either don’t have a true connection to the thing they are meant to stop or are overdone.

There isn’t enough data on OCD in the Philippines; however, about 2% of the population is estimated to have the disorder. Onset usually happens at age 19, and often exist with other psychiatric diagnoses most commonly anxiety disorders. Although more females are affected, males generally present with the signs and symptoms earlier.

Researchers have discovered a connection between some parts of the brain, including the thalamus, caudate, anterior cingulate cortex, and orbitofrontal cortex, and developing OCD. It is believed that these areas must have extremely high levels of activity.

Patients with OCD frequently experience preoccupations or persistent intrusive thoughts that interfere with their lives or take up more time than they would want. Examples include the following:

• fear of contamination or germs;
• unwanted taboo ideas involving harm, sex, or religion;
• aggressive thoughts, either against oneself or others.

They engage in repetitive practices like:

• excessive washing of hands or cleaning;
• putting items in a specific, orderly arrangement;
• check things repeatedly, such as ensuring the oven is off, or the door is secured.

In this manner, their minds are put at peace. Additionally, they exhibit inflexible behaviors, violent outbursts, and coercive conduct, such as readily incited rage.

According to DSM V, to clinically diagnose OCD, patients must be consumed by the obsession or compulsions or that they cause significant daily stress for more than 1 hour per day.

Doctors also use Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) to screen for OCD. It requires the patient to rank the following, based on the severity, on a scale of 0-40 (40 as the most severe): 

• The interference of and time occupied by obsessive thoughts and compulsions;
• The distress of and degree of control over obsessive thoughts;
• Resistance against obsessions;
• The time occupied by compulsive behavior;
• The distress associated with compulsive behavior;
• Resistance against and degree of control over compulsive behavior;

Treatment

Medication and therapy are the options for treating OCD. Selective Serotonin Reuptake Inhibitors and Tricyclic antidepressants can help reduce OCD symptoms. Cognitive behavioral therapy with exposure and response prevention is also an effective therapy. This approach involves exposing the patient to their fears and requiring them to resist the urge to perform a compulsion.

Always ask your physician if you want to discontinue the medication. Stopping a drug abruptly may aggravate OCD symptoms, and withdrawal is also possible.

Report any side effects to your doctor so they can adjust the medication plan.

It is also essential to provide necessary and relevant medical information to your doctor so he can treat you as a whole and not just the psychological symptoms.

Finally, consider joining a support group, which may offer comfort and coping techniques while reducing feelings of loneliness. They provide an opportunity to connect with others while providing information and guidance to family members and friends.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Brock H, Hany M. Obsessive-Compulsive Disorder. [Updated 2022 Aug 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK553162/

https://www.nhs.uk/mental-health/conditions/obsessive-compulsive-disorder-ocd/treatment/

https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd#part_2230