What is OCD?

Thrive Psychology Clinic > Blog > What is OCD?

August 17, 2021 / By thadmin2

Obsessive-Compulsive Disorder (OCD) is a chronic mental disorder that can affect people of all ages, and it occurs when a person is caught up in a continuous cycle of obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, images or urges that trigger intensely distressing feelings. Meanwhile, Compulsions are behaviors an individual engages in in attempts to eliminate the obsessions and decrease his or her level of distress (IOCDF, 2014). According to a study conducted by the Institute of Mental Health (IMH) in 2010, 1 in 33 adults in Singapore has developed OCD at some point in their life. However, OCD does not only affect adults; IMH sees on average 100 to 200 children and youth a year regarding OCD.

It is normal for everyone to experience some form of obsessive thoughts or compulsions in their lifetime, albeit to varying degrees of intensity. However, the obsessions and compulsions in OCD are typically so extreme that it obstructs their daily life functioning. For individuals with OCD, obsessive thoughts are persistent, while compulsive behaviors are rigid and often develop into rituals, whereby not performing the behaviors/rituals commonly causes great distress (Rivera, 2020). Common misconceptions of OCD are that OCD always involves cleanliness or hand washing, or that the disorder is only observed in “germaphobes”. While the disorder can manifest differently in each individual, here are some common obsessions and compulsions that underlie OCD (Hasan, 2017): 

Obsessions: 

  • They, or someone else, might get hurt, sick or die 
  • Something is unclean
  • Something is placed not in order, or not in an exact way 
  • Fear of losing control and harming self/other

Compulsions: 

  • Repeated hand washing and cleaning 
  • Often erasing things, re-writing, re-doing, or re-reading 
  • Having things in a specific order 
  • Repeatedly checking in on loved ones to make sure they’re safe

OCD is a chronic illness that often persists into adulthood. Though that may be the case, empirically tested therapies have been proven to alleviate the symptoms of OCD and allow an individual to achieve a good level of daily functioning.

 

How does OCD develop? 

 

OCD is a complex mental disorder whose causes are still not fully understood, however research suggests it could be caused by a host of factors surrounding genetics, neurobiology or learned behaviors (OCDUK, 2018). 

Genes are the building blocks of the body, it gives the body a set of instructions on many things, including its appearance and how it behaves in certain environments (Higuera, 2017). Genes are passed on from parent to child, and research has shown that OCD may also be passed down from parent to child (Nestad, Grados & Samuels, 2010). Though research has shown that there is a possibility of inheriting OCD from one’s parents, it is still unclear which specific set of genes are responsible for causing OCD (Valentine, 2021). Furthermore, the environment plays a large role alongside one’s genetic vulnerability, as certain environmental factors such as one’s stressful experiences, may contribute to the development of OCD (Owen, 2020).

Neurobiology refers to the structure of the brain, and it has been shown that individuals suffering from OCD typically display structural and functional abnormalities in the brain (Grant, 2020). These abnormalities can cause a “communication error” in the reward centre of the brain, tricking the brain into thinking that compulsive rituals will alleviate the distress caused by one’s obsessions. 

OCD can also be explained from a behavioral perspective. Engaging in one’s compulsive behaviours serves as a coping mechanism or avoidance technique to help individuals alleviate their feelings of anxiety and fear caused by their obsessive thoughts. These compulsions can also develop into time-consuming rituals, which are associated with helping them reduce their anxiety but are often unhelpful in eliminating their obsessions. This in turn results in the maintenance of the obsessions and subsequent compulsions, and a vicious cycle is formed (Mayo Clinic, 2020).

Despite the many theories surrounding OCD, its root causes are still not fully understood. It is also possible that many underlying factors interact with one another to trigger the development of OCD. 

 

How OCD can affect your child and how to detect it

 

OCD can put a significant strain on children’s academics due to the debilitating influence of their obsessions. As a result, they often do not have enough attention or mental capacity to focus on their schoolwork. In response to these obsessions, they may also have fixed patterns/rituals when performing certain tasks, and any disruptions to this pattern causes great distress and anxiety. OCD can also affect their sleep cycle as they might not go to bed unless they have finished a specific ritual or routine (Riley’s Children, 2017). 

Parents should be vigilant and observe for any repeated habits or behaviors as it can help to identify the early onset of OCD and curb the intensity of symptoms in adulthood. Some signs that may be attributed to OCD include (Hasan 2017): 

  • Having trouble concentrating on schoolwork, or enjoying activities 
  • Taking much too long to do everyday tasks, like getting dressed, organising a backpack
  • Getting upset and losing their temper if they can not make something perfect or if something is out of place 

Identifying OCD in adulthood is generally easier compared to childhood, as adults understand that their obsessions and compulsions are not logical, whereas children may not have the well-developed capacity to understand the irrationality of their thoughts and behaviors yet (Kelly, 2021). Consequently, children may not be able to verbalise and process their intrusive thoughts adequately and appropriately, causing symptoms to go unnoticed and delays in seeking treatment (IMH, 2021). 

Sometimes, even if children understand that their actions are irrational, they may be too ashamed to speak out about it, or they may attempt to mask their rituals to avoid being judged by family or friends. 

It is also important for parents to understand that different children will exhibit different forms of signs and symptoms of OCD. Being attentive to your child’s behavior is paramount in identifying OCD early. If you believe that your child has OCD, do seek a psychologist for an accurate diagnosis and proper treatment plan. 

 

Tips for parents for overcoming OCD  

 

Overcoming OCD can be extremely challenging, hence the support from parents is monumental in helping your child overcome the odds. 

Here are some tips for parents: 

  1. Set Limits: Though it may be difficult to see your child in distress, it is even more difficult for your child to overcome OCD without such limits. You can try to adjust their routines bit by bit, by setting progressive limits on the duration or frequency of their  routine such as hand-washing or changing their clothes. Gradually reducing the duration or frequency in small steps is crucial to avoid causing a “meltdown” or significant distress experienced by your child, as they gradually get used to the consistency which helps reduce their levels of anxiety overtime. 
  2. Being Firm: Being firm with your child does not mean punishing or being harsh on them, but rather explaining to them clearly how you are prioritising their well-being that is being compromised by their OCD. This also means that being consistent and following through with the limits you set is extremely important. However, do remember to also be empathetic and explain your rules in a calm manner, as getting loud or angry could potentially serve as another stressor for your child. 
  3. Be aware not to accommodate their OCD tendencies: What this means is to not be caught up in your child’s rituals. They might ask you to wash the plates again, or change your plans because of their OCD. It is imperative to not get involved in their rituals as it reinforces their vicious cycle of OCD and supports their mindset that what they do is right. 
  4. Praise them: Tackling OCD is challenging, especially for more severe cases. Small gradual improvements can go a long way in winning their fight against OCD. Praise can be as simple as “Good job, I’m proud of your progress”, which lets them know that their efforts are recognised and rewarded. Apart from praise, you can also provide other forms of incentives such as letting them play their favorite game. 

 

Ultimately, it is also advisable to work with a therapist to come up with a suitable therapy plan if the OCD becomes too severe. 

 

Treatment Provided at Thrive Psychology Clinic

 

OCD is a lifelong disorder that can be debilitating if left untreated. Various forms of treatment such as Cognitive Behaviour Therapy (CBT) and Exposure Therapy have been proven to be successful in curbing the symptoms of OCD. While there is no one-size-fits-all cookie cutter strategy to treat OCD, here at Thrive Psychology Clinic we ensure that each client obtains a specially curated form of therapy that is catered to their specific needs and would best benefit them. 

At Thrive Psychology Clinic, we are committed to providing effective and efficient support for every adolescent, child or adult in their mental health. If you believe that your child may be struggling with mental health issues, feel free to contact us via email: info@thrivepsychology.com.sg or call: 6962 9753 and we will be happy to assist you.

 

References:

  • American Psychiatric Association. (2018). What is obsessive-compulsive disorder? https://www.psychiatry.org/patients-families/ocd/what-is-obsessive-compulsive-disorder
  • Grant, J. E. (2020). Exploring the neurobiology of OCD: Clinical implications. Psychiatric Times. https://www.psychiatrictimes.com/view/exploring-neurobiology-ocd-clinical-implications
  • Hasan. (2017). Obsessive-compulsive disorder. Nemours KidsHealth – the Web’s most visited  site about children’s health. https://kidshealth.org/en/parents/ocd.html
  • Higuera, V. (2018). Genes: Function, makeup, Human Genome Project, and research.  Medical and health information. https://www.medicalnewstoday.com/articles/12057
  • Institute of Mental Health. (2018). Obsessive compulsive disorder (OCD) in kids.  https://www.imh.com.sg/wellness/page.aspx?id=2297
  • International OCD Foundation. (2014, April 28). What is OCD? https://iocdf.org/about-ocd/
  • Mayo Clinic. (2020). Obsessive-compulsive disorder (OCD) – Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/sy ptoms-causes/syc-20354432
  • Nestadt, G., Grados, M., & Samuels, J. F. (2010). Genetics of obsessive-compulsive disorder. The Psychiatric clinics of North America, 33(1), 141–158. https://doi.org/10.1016/j.psc.2009.11.001
  • OCD-UK. (2018). What causes OCD? https://www.ocduk.org/ocd/what-causes-ocd/
  • Owen, K. (2020). Why genes are only a piece of the OCD puzzle. Verywell Mind. https://www.verywellmind.com/ocd-and-genetics-2510481
  • Owen, K. (2021). How to recognize signs of OCD in children. Verywell Mind. https://www.verywellmind.com/parenting-children-with-ocd-2510563
  • Riley Children’s Health. (2019). How does OCD affect children in the classroom?  https://www.rileychildrens.org/connections/how-does-ocd-affect-children-in-the-classroom
  • Ryback, R. (2016). 4 myths about OCD. Psychology Today. https://www.psychologytoday.com/sg/blog/the-truisms-wellness/201605/4-myths-about-ocd
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