People get ideas about mental illness from movies or TV shows, and popular culture often simplifies or even completely misrepresents what it is really like to live with mental illness.
Obsessive-compulsive disorder (OCD) is no different. Many people associate their knowledge and understanding of OCD with popular TV shows, like The Big Bang Theory and Monk. Consequently, OCD may be one of the most misunderstood mental health conditions.
1. OCD defined.
Let’s start with a clear definition of OCD. The National Institute of Mental Health describes OCD as “a common, chronic, and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over.”
These obsessions can focus on anything, and compulsions are often directly related to the obsessions. For example, if a patient is obsessing over a loved one’s safety, he or she may feel the urge to text them every 10 minutes to make sure that loved one is okay.
2. OCD isn’t only centered on cleanliness.
Some people mistakenly believe that if someone has OCD, they will be extremely neat and tidy. While some obsessions and compulsions focus on cleanliness (e.g., compulsive hand-washing in those who obsess over germs), many do not. Every person suffering from OCD experiences obsessions that are unique to them. Furthermore, the fact that someone seems to care quite a bit about keeping their home or apartment clean doesn’t mean they have OCD.
3. OCD is treatable.
OCD can significantly impact both the lives of those affected and their families, but help is available. First-line treatments are a specific type of cognitive behavioral therapy known as exposure-response prevention (ERP) therapy and medication.
In ERP therapy, patients, under the direction of a certified therapist, confront specific triggers that induce obsessive thoughts and work to reduce anxiety surrounding these triggers so that they do not feel the urge to perform the associated compulsion.
Along with ERP therapy, selective serotonin reuptake inhibitors (SSRIs) are considered a first-line treatment option and have been effectively helping patients with OCD for nearly three decades.
4. Sometimes these treatments don’t work, but there are other options.
While ERP and SSRIs are effective in a large proportion of patients, there are some patients for whom these first-line treatment options don’t work. Fortunately, there are other options available. One of these options is deep transcranial magnetic stimulation (deep TMS). The treatment is non-invasive and has been shown to have very few side effects. Deep TMS treatment involves sitting under a helmet that delivers electromagnetic pulses to specific parts of the brain, which neuroscientists have been shown are associated with OCD. Patients who undergo deep TMS treatment go to their psychiatrist each day for six weeks.
Study results show that patients who underwent this treatment saw a 30 percent reduction in symptom severity, and even 10 weeks after the treatment ended, patients showed further reduction in symptom severity (Tendler, Zohar, Carmi, Roth, & Zangen, 2018). While deep TMS is often not the first choice of treatment, it is effective and can potentially help patients who haven’t found success with other options.
5. Scientists are still learning about OCD.
Since the first SSRI was approved in 1989, the psychiatry community has made significant strides in effectively treating OCD, thanks to the efforts of researchers all over the world. Because of this research, the side effects associated with medications are improving, and new technologies, such as deep TMS, are being discovered. The more we understand about this disorder, the more effective and personalized we can make our treatments.
So, while OCD is considered extremely treatable today, therapies will be even more effective in the future as we begin to better understand how and why individuals with OCD are affected.
6. People with OCD can lead happy lives.
Treatment options are available, even for patients who might not be comfortable taking medication. Patients don’t need to be debilitated by their symptoms, and there are many options to help them overcome their obsessions and shift their focus to living a rewarding and healthy life.
Tendler, A., Zohar, J., Carmi, L., Roth, Y., & Zangen, A. (2018). O14. Deep TMS of the Medial Prefrontal and Anterior Cingulate Cortices for OCD: A Double-Blinded Multi-Center Study. Biological Psychiatry, 83(9, Supplement), S113–S114. https://doi.org/10.1016/j.biopsych.2018.02.299