Obsessive Compulsive Disorder Treatment Center - Miami, FL
what we treat
What is Generalized Anxiety Disorder?
Obsessive Compulsive Disorder - also known as OCD –is one of the most utilized diagnoses used by society to describe someone who displays certain characteristics or behaviors. How often have you heard, “You’re so OCD!” to describe someone who is very organized and pays attention to detail? Or to describe someone who wants things done a particular way and gets frustrated when it’s not completed in that manner? Yet, these behaviors do not align with the actual symptoms of OCD. In fact, while I was studying for my licensure test and learning about the different diagnoses, I was surprised to find out that the characteristics described above are actually associated with a completely different diagnosis! In actuality, obsessive compulsive personality disorder – not obsessive compulsive disorder - is the diagnosis associated with rigidity, perfectionism, and control (Rowland, Jainer, & Panchal, 2017).
Diagnosing Generalized Anxiety Disorder
So, the question becomes: what symptoms and characteristics are associated with the diagnosis of Obsessive Compulsive Disorder? According to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association [APA], 2013):
OCD is characterized by the presence of obsessions and/or compulsions. Obsessions are recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted, whereas compulsions are repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or according to rules that must be
applied rigidly.
The DSM-5 explains that the obsessions associated with OCD are unwanted and cause a considerable amount of distress for the person experiencing symptoms (American Psychiatric Association, 2013). As a result, the compulsions can arise in response to the obsessions. Thus, compulsions can become behaviors or acts that are performed in order to soothe the distress associated with obsessions, although the compulsions may not necessarily be related to the obsessions in a realistic manner (American Psychiatric Association, 2013). Pittenger, Kelmendi, Bloch, Krystal, & Coric (2005) highlight some examples of obsessions and compulsions:
Common Obsessions of OCD
Some common obsessions of obsessive compulsive disorder include:
- fear of contamination
- fear of harming self or others
- intrusive violent images
- recurrent forbidden or perverse sexual thoughts
- a need to save items of perceived value
- concern with sacrilege or morality
- a need for symmetry
- excessive concern about appearance
Common Compulsions Performed in Response to Obsessions
Some common compulsions performed in response to obsessions include:
- excessive hand washing
- ritualized bathing or grooming
- checking behaviors
- mental rituals
- need to repeat activities
- re-reading text
- hoarding behaviors
- superstitious behaviors
Accordingly, the DSM-5 states that most individuals who are diagnosed with OCD experience both the obsessions and the compulsions (American Psychiatric Association, 2013).
Another criterion necessary in order to be diagnosed with OCD is that “obsessions and compulsions must be time-consuming (e.g., more than 1 hour per day) or cause clinically significant distress or impairment to warrant a diagnosis of OCD” (American Psychiatric Association, 2013, p. 238). This is distinctly important because most, if not all, people experience intrusive thoughts. In my practice as a clinician, I refer to intrusive thoughts as “junk thoughts” that the brain sends out every once in a while.
Furthermore, when diagnosing OCD, it is important to remember that the amount of time someone spends related to their thoughts and/or compulsions can vary from person to person (American Psychiatric Association, 2013). Lastly, in order to diagnose OCD, the symptoms cannot be better explained by any substance, other medical condition, or other mental condition (American Psychiatric Association, 2013).
OCD In the Media
Although OCD is often misused within the media and within society, one of the movies that is a fairly accurate representation is Jack Nicholson’s performance in “As Good as it Gets”.
In the movie, Nicholson’s character (named Melvin) displays certain compulsions associated with his OCD. He would perform rituals - such as turning the lights on and off a certain number of times as well as washing his hands repeatedly with scalding hot water - in order to alleviate what I can only assume are his obsessions. Unfortunately, the audience does not hear the internal dialogue associated with the compulsions but it can be surmised that the behaviors/rituals are for a particular reason. The movie, which is over 20 years old, still stands holds up until this day.
However, it is important to remember that movies do not always accurately represent what actual symptoms may look like; also, some of the behaviors displayed by Melvin may have had other underlying causes.
Obsessive Compulsive Disorder Treatment Options
Cognitive behavioral therapy
One of the treatments available for OCD is cognitive behavioral therapy - also known as CBT (Bourne, 2020). CBT focuses on the thought patterns associated with the obsessions and challenges the person to formulate more realistic thought patterns (Bourne, 2020). Rather than continuing the obsessions-compulsions behavior cycle, a qualified mental health professional encourages the individual to challenge the obsession.
Exposure and Response Prevention
Especially important to the treatment of OCD is the exposure and response prevention (ERP) intervention associated with CBT (Bourne, 2020). The focus of ERP is to have the person experience their obsessions through exposure to a variety of anxiety triggering situations without completing the compulsions (Bourne, 2020). Once the person experiencing OCD is able to reduce the compulsions, then they will be able to work towards processing their obsessions. Typically, ERP is performed with a mental health provider in order to encourage compliance with treatment protocol (Bourne, 2020). “When properly administered, CBT/ERP is an efficacious treatment modality and can be considered a firstline treatment for some patients” (Pittenger et al., 2005, p. 37).
Medication
Another treatment option that has been shown to be effective with symptoms of OCD is medication, particularly SSRI’s. According to Bourne (2020), certain SSRI medications such as Prozac and Zoloft - to name a few - have been found to help about 60-70% of people who have been diagnosed with OCD. SNRI medications have also found to be effective in the treatment of OCD (Bourne, 2020). Important to note, however, is that the use of medication in treating OCD is long term since stopping the medication may lead to symptoms resurfacing (Bourne, 2020).
Treatment Considerations
In order to ensure you are placed on the proper medication regimen, be sure to consult with a physician before starting a new medication. As is the case with any diagnosis, treatment should be tailored to each individual. Reaching out to a qualified professional can be the first step in treatment. Together, you can decide what will work best for you.
Getting Treatment for Obsessive Compulsive Disorder in Miami, Florida
Galen Hope, a mental health treatment center in Miami, Florida, provides comprehensive services for a wide range of diagnoses and related conditions, including: Eating Disorders, Anxiety Disorders, Borderline Personality Disorder, Dependent Personality Disorder, Mood Disorders, PTSD/Trauma, Psychosis, Thought Disorders, and Schizoid Personality Disorder. Our treatment integrates the best concepts of residential programs, partial hospitalization programs, and community psychology in order to provide an experience that not only feels uniquely meaningful to the client, but also breaks the cycle of repeated hospitalizations, over-institutionalization, and isolation from community and family.
To learn more, or to join our community, contact us below.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Bourne, Edmund J. (2020). The Anxiety & Phobia Workbook. New Harbinger Publications.
Pittenger, C., Kelmendi, B., Bloch, M., Krystal, J. H., & Coric, V. (2005). Clinical treatment of obsessive compulsive disorder. Psychiatry (Edgmont (Pa. : Township), 2(11), 34–43.
Rowland, T. A., Jainer, A. K., & Panchal, R. (2017). Living with obsessional personality. BJPsych bulletin, 41(6), 366–367. https://doi.org/10.1192/pb.41.6.366a