Obsessive compulsive disorder

- [Voiceover] Right before you leave the house, you might double-check that you've turned off the stove, right? So it doesn't burn the house down or something. This is a totally normal thing to do. Someone with Obsessive-Compulsive Disorder might feel the need to triple or even quadruple-check it, or even do other things, or have to perform a specific series of things or a routine before they can leave. Obsessive-Compulsive Disorder, or OCD, is a type of anxiety disorder, where you have these frequent and upsetting thoughts that are basically unwanted and intrusive, so they just sort of force their way into your brain, and so you tend to obsess over them, and we end up calling these thoughts obsessions. And these produce some sort of anxiety, and in this attempt to try and control these intrusive obsessions and anxiety, you feel this overwhelming urge, or you feel compelled to repeat certain rituals or behaviors, which we call compulsions, and so the two components to Obsessive-Compulsive Disorder are obsessions and compulsions, that makes sense. And for someone with OCD, these thoughts and rituals cause serious distress to their daily life and can also interfere with their daily activities and social interactions. So, when looking at people with OCD, there are several more common types of obsessions and compulsions, and it's important to note that the obsessions and compulsions usually come together, but there can also be just obsessions or just compulsions. All right, first there's cleaning, and this compulsion is very commonly associated with OCD and is brought about by this obsession with germs and contamination. To control these germs and apparent contamination, someone might spend hours washing both themselves and their surroundings. Now, another type of compulsion is repeating, and this involves saying a phrase or a name or doing some behavior several times in a row. With this compulsion, there's this obsession that if they don't do these repetitions, then something bad'll happen. As an example, they might have to turn on and off a light switch multiple times before entering a room. Checking is another compulsion, and patients will constantly check and re-check something to make sure that it's safe because they have this obsession or fear of hurting themselves or others. An example might be checking several times that the door is locked, or checking that the gas stove is off. Ordering and arranging is this compulsion to order objects in a certain way or make sure that they're symmetrical in some way, or to always have to have things perfect or just so. An example might be needing to have the books on a bookshelf organized by color. They become obsessed with this order and feel that it reduces discomfort and anxiety. Finally, mental rituals are these prayers or phrases that are performed to try and neutralize or get rid of these intrusive thoughts, or to try to prevent this dreaded future event. So if they have this bad thought, they might try and use this specific phrase or prayer to replace this bad thought. Okay, so now, if someone has one of these obsessions or compulsions, they may meet the criteria for OCD. In order to figure this out, a mental health professional will look at the Diagnostic and Statistical Manual for Mental Disorders, the 5th edition, or more fondly known as the DSM-5. For it to be an obsession, the first criteria is that they have to have this recurrent and persistent unwanted thoughts that cause a lot of anxiety and distress. Secondly, the patient has to have tried to suppress or ignore these thoughts, and then for it to be a compulsion, the first criteria is that either repetitive behaviors like ordering or checking, or mental acts like praying or counting, are done in a response to an obsession. And then secondly, the compulsions are done to reduce anxiety or prevent some sort of distress and are clearly excessive. Again, someone doesn't need to have both obsessions and compulsions for a diagnosis of OCD and may have only one or the other, but why might someone have one of these obsessions or compulsions? What causes someone to develop OCD? Well, what we do know is that OCD tends to run in families, and the cause is now thought to be largely biological, as opposed to completely environmental. Ultimately, though, we still don't really know what the exact cause of OCD is. Usually, though, it starts for many people in their childhood or teen years, most being diagnosed by about age 20, and affects about two million Americans, and it's equally as common with men as with women. Once OCD's been diagnosed, we're going to look to treatment, which is either psychotherapy, specifically cognitive behavior therapy, medications, or both. One particularly effective cognitive behavior therapy that they'll probably try is called exposure and response therapy. With this therapy, the patient is exposed to the situations that might be causing some sort of anxiety or causing them to follow through with their compulsions. Through this exposure, the patient might be able to reduce the resulting compulsive rituals and find that the anxiety that comes from the obsessions actually lessons without the rituals. This treatment, though, is only effective if the patient adheres to the procedures. Some patients don't agree to participate because they don't want to experience the anxiety. On the other hand, some patients are given medications. Serotonin reuptake inhibitors, or SRIs, can be effective in treating about half the patients that take them. Although very helpful, they'll often leave residual symptoms, though, or side effects, that might need to be treated with other medications or psychotherapy. Patients that have gotten treatment, though, via these methods are shown to have an increased quality of life and are usually able to get back to their normal routine, including school, work, and relationships.