Telehealth for obsessive compulsive disorders
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Obsessive-compulsive disorder is a form of anxiety disorder that typically develops in late childhood or early adolescence. It consists of both obsessions and compulsions. Obsessions are a form of recurrent anxiety with compulsions being repetitive rituals or behaviours that are used to control or neutralise these obsessive worries. These compulsions can be very time consuming and take up time that would otherwise be used for daily activities such as school or work. People with OCD are typically aware of their behaviour and can feel shame that leads to keeping these behaviours secret.
Obsessive compulsive disorder is different to obsessive compulsive personality disorder which is a personality disorder marked by a rigid need for orderliness, neatness and perfectionism.
Symptoms of Obsessive Compulsive Disorder
Obsessions. These are recurring thoughts or topics that continue to persist despite efforts to ignore or confront them. Some common obsessions include:
- Fear of illness or contamination from germs.
- Fear of hurting others or yourself. A specific example is fear of hurting someone in a car accident.
- Having things arranged in a certain pattern or order
- Sexual or pornographic images
- Religious or spiritual matters
Compulsions are behaviours that can occur because a person feels that they must do the behaviour or because the activity gives them a sense of control and negates the anxiety caused by obsessive thoughts. Some common forms of compulsion are:
- Excessive cleanings such as frequent hand washing or cleaning
- Overwhelming need to place objects in a certain position or pattern
- Repeatedly counting objects or items
- Repeatedly checking that certain things are in the right state, e.g. checking that the oven or a light is turned off
- Picking at your skin
- Hoarding random objects
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Causes of Obsessive Compulsive Disorder
OCD is thought to develop from a combination of genetic and environmental factors however current research is not conclusive. As is the case for multiple health disorders it is likely that multiple factors increase a person’s risk. Factors include:
- Genetics may give a person an increased likelihood of developing OCD
- Biological factors such as structural, chemical or functional differences in the brain
- Environmental influences such as a major stressful event like developing a serious illness or potentially learning behaviours from a relative
Diagnosis of Obsessive Compulsive Disorder
A psychologist, psychiatrist or other licensed mental health professional is required to diagnose OCD. Using a manual such as the Diagnostic and Statistical Manual of Mental Disorders (DSM), a diagnosis will be made through an assessment of feelings, thoughts and behaviours.
To be diagnosed with OCD a person must have either or both obsessions or compulsions that:
- Takes up a significant part of your day (1 hour or more)
- Is recognised as excessive
- Interferes with normal daily activities
- Causes significant distress
Treatment of Obsessive Compulsive Disorder
OCD is most commonly treated with psychological therapies such as cognitive behaviour therapy – a method that slowly alters thinking patterns into healthier behaviours – and exposure and response prevention – a method that slowly and safely uses images, thoughts or objects of obsession to desensitise a person to their compulsions and worry. In some cases medication may also be used to assist in the treatment of OCD.