OCD AND RELATED DISORDERS

Also known as OCD “...a common, chronic, and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and/or behaviours (compulsions) that [they] feel the urge to repeat over and over.” 

(National Institute of Mental Health)

“Symptoms may come and go, ease over time, or worsen.” (NIMH)

2.3%  Of people have OCD, 1 in 40 adults and 1 in 100 children in the U.S. (Anxiety and Depression Association of America)

1.8% Of women have OCD and 0.5%Of men have OCD

90% Of people with OCD struggle with a coexisting disorder at some point in their lives. Mainly ADHD and bipolar disorder.

Some types of OCD: Relationship, Contamination, Purity, Responsibility, Sexual Orientation, “Just Right”

 
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“Recurrent, persistent, intrusive, and unwanted thoughts, images, or urges that cause anxiety or distress” (Verywell Mind)

Examples...

  • Intrusive thoughts about

    • Germs or contamination

    • Sex, religion, or harm

    • Self image or relationships

    • Symmetry

    Obsessions

    “Repetitive behaviors or mental acts a person with OCD is driven to perform in response to an obsession or a rigid set of rules that govern them.” (Verywell Mind)

    Examples...

    • Compulsion: excessive actions such as

      • Cleaning or hand-washing

      • Arranging things in a particular, precise, or perfect way

      • Repeatedly checking on things

      • Counting, repetition​

    Compulsions

     

    OCD TREATMENTS

    Certain psychiatric medications can help control the obsessions and compulsions of OCD. Most commonly, antidepressants are tried first.

    Antidepressants approved by the U.S. Food and Drug Administration (FDA) to treat OCD include:

    • Clomipramine (Anafranil) for adults and children 10 years and older

    • Fluoxetine (Prozac) for adults and children 7 years and older

    • Fluvoxamine for adults and children 8 years and older

    • Paroxetine (Paxil, Pexeva) for adults only

    • Sertraline (Zoloft) for adults and children 6 years and older

    However, your doctor may prescribe other antidepressants and psychiatric medications.

    • Intensive outpatient and residential treatment programs. Comprehensive treatment programs that emphasize ERP therapy principles may be helpful for people with OCD who struggle with being able to function because of the severity of their symptoms. These programs typically last several weeks. 


    • Deep brain stimulation (DBS). DBS is approved by the FDA to treat OCD in adults age 18 years and older who don't respond to traditional treatment approaches. DBS involves implanting electrodes within certain areas of your brain. These electrodes produce electrical impulses that may help regulate abnormal impulses.


    Transcranial magnetic stimulation (TMS). The FDA approved a specific device (BrainsWay Deep Transcranial Magnetic Stimulation) to treat OCD in adults ages 22 to 68 years, when traditional treatment approaches have not been effective. TMS is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of OCD. During a TMS session, an electromagnetic coil is placed against your scalp near your forehead. The electromagnet delivers a magnetic pulse that stimulates nerve cells in your 


    Behavioral therapy that gradually exposes a patient to a situation or factor that causes them extreme distress. The goal of the therapy is to prove to the patient that what they fear is not harmful so that anxiety, avoidance, and distress is reduced the next time they are unintentionally exposed and to improve ease in one’s life. This is done when a person has a phobia, OCD, anxiety, or other problematic fears  that needs management. Learn more about exposure therapy below.

     
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    Self Care Suggestions

    Exercise, Reduce caffeine, Sleep, Reduce nicotine and alcohol intake, Meditation, Educate yourself, Mindfulness, Peer support, etc.

    How to Help a Friend

    Provide a calm, supportive environment

    Be empathetic, open,  and communicative

    Praise attempts to ignore urges

    Communicate directly and positively

    Find the humor

    Don’t tell someone with OCD to stop their rituals

    Don’t go along with the OCD rituals

    Be present

    Keep an eye on your own mental health​

     

    TESTIMONIALS FROM PEOPLE WITH OCD

    Trigger Warning for Intrusive Thoughts

     
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    “If I don’t flip this lightswitch 39 times, my entire family will get sick and die because of me”

    “I fear I’ll impulsively gouge one of my eyes out with my fingers.”

    “They will die without my care, they will die. Even if maintaining this relationship is harmful for me. They need me.”

    “I am a woman dating a woman. On occasion, I worry that I am totally wrong a out my seuality and just “leading her on”

    "Every time I go to work, I worry I unknownly have Covid-19 and I have infected my clients."

    "I'm afraid of killing my brother and father in my sleep. Even if I don't want to."

    STIGMA AROUND OCD

    Misconception vs. Reality

    Perfectionism

    “OCD is just perfectionism”


    There are actually many different types of OCD and ways it may manifest such as tics, repetitive behaviors such as checking or deep cleaning, and intrusive thoughts about sex or responsiblity or contamination. 

    Learn more on slide 21.


    Germophobia

    “Everyone with OCD is the same”


    Once again, there are so many ways OCD can present. Not all people with OCD like to stay organized. OCD isn’t always visible. Do not romanticize OCD.


    OCD IS NOT DESIRABLE.

     

    RESOURCES

    Project Calendula is intended to be a prelude for your mental health journey by guiding your education and advocacy. We are not a mental health service. 

    If you or someone you know are in crisis, please call the National Suicide Prevention Lifeline (U.S.): 800-273-8255. If you or someone you know are struggling, please visit the resources at the bottom of this section to find a mental health professional near you.


    Please visit any of the following websites for further information on mental illness education. 

    RECOVERY VILLAGE

    For an overview on OCD and examples of how it may present with related resources, visit Recovery Village below.

    INTERNATIONAL OCD FOUNDATION

    For an overview on causes, symptoms, treatment and more related articles visit IOCDF below.

    HELP GUIDE

    For information on treatment and self-help for OCD visit Help Guide below.

     

    OBSESSIVE COMPULSIVE PERSONALITY DISORDER

    “...a mental condition in which a person is preoccupied with rules, orderliness, and control.” (Medline Plus)


    Signs and Symptoms

    Perfectionism

    Emotional withdrawal

    Over-devotion to work

    Not being able to throw things away

    Lack of flexibility

    Lack of generosity

    Not wanting to allow other people to do things

    Not willing to show affection

    Preoccupation with details, rules, and lists

    1 in 100 of people struggle with OCPD

     
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    OCD


    • Anxiety Disorder

    • Unwanted Thoughts

    • Often Begins in Childhood

    • High Achiever

    • Sense of Urgency About Actions

    OCPD


    • Personality Disorder

    • Believe Thoughts are Correct

    • Often Begins in Teens or Early 20s

    • High Achiever

    • Sense of Urgency About Actions

     

    BODY FOCUSED REPETITIVE BEHAVIOR

    Also known as BFRB is “a general term for a group of related disorders that includes hair pulling, skin picking, and nail biting… These behaviors are not habits or tics; rather, they are complex disorders that cause people to repeatedly touch their hair and body in ways that result in physical damage”. (The TLC Foundation)

    22%  Of students were BFRB positive (US National Library of Medicine)

    13.3% Of the students were engaged in trichotillomania

    13.9% Of the overall subjects who tested positive were female

    9.0% Of the students were engaged in onychophagia

     
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    Trichotillomania

    Also known as hair-pulling disorder:


    • Eyebrows

    • Eyelashes

    • Scalp

    • Other parts of the body

    • Results in bald patches

    Excoriation

    Also known as skin-picking disorder:


    • Touch

    • Rub

    • Scratch

    • Pick at / Dig

    • Results in discoloration, scarring, and even severe tissue damage

    Onychophagia

    Also known as nail-biting disorder:


    • Bite nails past nail beds

    • Chew on cuticles until they bleed

    • Results in soreness and infection

     

    TREATMENT FOR BFRB

    Outreach:

    Professional help from a BFRB trained mental health professional should result in helpful treatment

    Other therapy models are less effective with BFRB because they “are not specific enough to the person’s unique manifestation of BFRB-related thoughts and behaviors


    Medication:

    There are currently no approved medication that can prevent or diminish BFRB which is why seeking help from a trained mental health professional who is specifically focused on BFRB is a very viable and recommended option

     

    STIGMA AROUND BFRB

    Misconception vs. Reality

    “It’s just a Tic”

    This is harmful language because it does not distinguish between an inconvenience and a debilitating condition. It is simply a misnomer and can confuse people as to what tics really are and how they should be addressed, versus what BFRB is and how it should be addressed or treated respectively.


    “It’s cute”

    This comment might be made to try and lift the spirits of someone someone struggling with a BFRB but it really minimises the reality of the situation and can make someone struggling with it feel lesser-than and even more self-conscious than before.


    “Just Stop”

    This diminishes the actually gravity and pain that comes with BFRB. Like any other disorder, it is not controllable or maintainable. Making comments like these spreads misinformation, can result in severe self-consciousness, and implies that the person struggling is not doing enough to help themselves.