Obsessive Compulsive Disorder (OCD) is a neurological disorder that affects millions of people around the world. It is characterized by compulsive thoughts and repetitive behaviors that are difficult to control. For those living with OCD, it can be a challenging and grueling journey. Here in the Netherlands, there is information about it on the internet, but for the most part this is about what OCD is. What can be done about it in concrete terms is relatively little information available about depression and is usually in English.
The battle within you
To the outside world, OCD looks like a condition where you wash your hands excessively or continuously check to see if you've turned off the gas. This image is true, but in fact it is only a small part of OCD. OCD is characterized by not being able to deal with uncertainty, which can manifest itself in fear of getting sick or being afraid of having committed a crime without knowing it. There are courses that focus on OCD but often miss the part where the underlying anxiety comes from. Each OCD has a sub-topic, which is different for everyone. It addresses your underlying anxiety, but in fact, everything boils down to the same thing: you perform compulsions for temporary relief. In fact, this will only make things worse. For example, people with OCD can drive home in their car, arrive home, fall into a paralyzing fear of thinking they've hit someone while they've run over a manhole cover. They want to drive back the road to make sure they didn't hit anyone.
I advise people in the area not to say: “this is nonsense, you didn't hit anyone, you really noticed that.” This makes this thought worse, and that may sound strange, but actually the solution is to say: yes, it is possible, but it is not possible either. Someone has to learn to live in uncertainty.
The impact of OCD
The impact of OCD extends to all aspects of daily life. From affecting work performance to disrupting social relationships, OCD can have a crippling effect. It's important to understand that it's not simply about “something someone has in their head” or a habit that can be stopped. OCD is a real condition that requires treatment. It is a compulsive feeling that cannot be stopped; a compulsion is a short-term action to get rid of your anxiety. You can't tell your brain that there is no danger, you have to show it to your brain, in the heat of the moment, while being exposed to fear.
OCD Cycle
- Trigger: an intrusive thought that comes up over and over and that a person doesn't want. That can be a memory, an impulse, or an image or something you experience.
- Perceived threat: the value that your brain assigns to the trigger.
- Anxiety or stress: this causes a person to experience anxiety or stress.
- Urge to eliminate anxiety: your body automatically tries to get rid of that anxiety or stress. This is how our brain is designed; it wants to get rid of your anxiety as quickly as possible.
- Compulsions: this is what a person does to feel a little better, to try to get certainty.
- Temporary lighting: by performing a compulsion, you feel temporarily relieved
- .Confirmation of threat: by performing a compulsion, you train your brain that your OCD cycle works and that's why you repeat it over and over again.
Treatment options
There are a variety of treatment options available for people with OCD. A common approach is cognitive behavioral therapy (CBT), where individuals learn to recognize and change their obsessive thoughts.
Acceptance and commitment therapy (ACT) is a therapy that is about acceptance and behavior. For example, if people can't sleep and focus on not being able to sleep because they have an important appointment the next day, the pressure gets too much. The more you try to fall asleep, the more you focus on not sleeping yet, which is where things go wrong. What you can do is accept that you may not sleep or sleep very briefly, so you don't have to make a compulsion. You can also say: I'm not going to sleep because you're going to read an extra lot, for example, be a bully to your brain. You'll see that if you don't have appointments or are free the next day, the problem is less or non-existent.
Exposure and response prevention (ERP) is a specific form of CBT that involves exposure to anxious situations without performing the compulsive response, gradually decreasing the anxiety response. You are leaving the story in uncertainty. For example, if you have to wash your hands, it's a compulsion, reassuring yourself that you're washing the bacteria off your hands. That is a compulsion out of fear. What you should actually do is not wash your hands and think: maybe there are bacteria on them, but maybe not. Of course, the OCD monster protests heavily, but just like everything in life, that is also decreasing, you have to starve the monster. Another approach is to say: yes, there are probably bacteria on my hands, but I don't care. The answer must be unconditional acceptance. Actually, you should accept yourself unconditionally, even with these obsessive thoughts, because most people with OCD live in shame while suffering.
Repetitive Transcranial Magnetic Stimulation (rTMS) is a non-surgical brain procedure that uses magnetic fields to generate electrical currents in specific areas of the brain.
- Magnetic pulses: rapidly pulsing magnetic fields are generated by a coil that is placed on the scalp.
- Induction of Electric Current: These magnetic pulses generate electrical currents in the nerve cells (neurons) of the brain below the coil.
- Modulation of Brain Activity: The electrical currents influence neuronal activity in the stimulated area. Depending on the frequency and intensity of the pulses, rTMS can increase or decrease brain activity.
rTMS is often used as a treatment for certain psychiatric disorders, particularly depression that does not respond well to limited treatments such as medication and psychotherapy. It is also being studied for other disorders, including obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and some forms of chronic pain. Treatment is usually performed in an inpatient setting and requires multiple sessions over a period of time. The exact mechanism of action of rTMS and the optimal measure for various disorders are still under investigation, but it shows promising results in certain cases.
Medication, such as Selective Serotonin Reuptake Inhibitors (SSRIs), may also be prescribed to reduce symptoms. It is important to work with a healthcare professional to determine the most appropriate treatment.
The journey to recovery
The path to recovery from OCD is unique for each person. It often includes not only therapeutic interventions, but also strong social support. Family, friends, and colleagues play a critical role in supporting someone living with OCD. Understanding the condition is very complicated. You can tell someone with OCD: “You've done it before,” that's where your confidence grows. Don't come along if someone is looking for confirmation. Choose carefully the answers you give. Talking and supporting is crucial.
The importance of self-care
For people with OCD, self-care is essential. It includes setting realistic goals, acknowledging successes, and learning how to deal with relapses. Self-care also includes maintaining a healthy lifestyle with adequate sleep, regular exercise, and balanced diet and exercise. This is certainly no guarantee, so don't think if you've all succeeded, my OCD should be gone, but it's a good basis. The best tools are long-term thinking, always. Accept and be good to yourself. You always do your best, and sometimes it just doesn't work out. Then you'll do it better next time, or you'll do it in two instead of once the next time.
Conclusion
Obsessive compulsive disorder is a challenging condition, but it's important to remember that help is available. It is very important for the people around you that they understand what OCD is and can support you in doing so, so that you are at least not lonely. Learn that you indicate that people with OCD can discuss everything with you without judgment. People with OCD can only do something about the compulsion; they can't change the rest. They have to learn how to deal with uncertainty, and uncertainty is acceptance. With the right treatment, social support, and self-care, it's possible to reduce the impact of OCD and live a life of inner peace and fulfillment.