The time-consuming and repetitive behaviours associated with OCD may severely impact an individual’s work and/or social functioning and disrupt family life.
Dr Gwen Tonyane, a psychiatrist practising at Netcare Akeso Randburg – Crescent Clinic, explains that OCD is characterised by the presence of obsessions, compulsions or both.
“Obsessions are recurrent and persistent thoughts, urges or images that come to mind but are intrusive and unwanted, causing the person marked anxiety or distress. A person who suffers from OCD may try to self-manage the intrusive thoughts by distracting themselves with another thought or action, or simply trying to ignore the intrusive thought to help ease the anxiety and distress caused, but this is often very difficult,” she says. Resistance to the thought often intensifies it.
“Sometimes the individual may create their own rigid rules that they feel must be followed to neutralise the thoughts and gain a sense of control over their thoughts. These compulsions take the form of repetitive behaviours or mental habits that a person with OCD feels driven to by the obsession.
“The person may feel a responsibility to perform these rituals, believing that this could prevent something dreadful from happening. The person’s response is, however, either excessive or in many cases not even rationally connected to the source of anxiety,” Dr Tonyane explains.
Symptoms typically start gradually, with men often presenting earlier at around 19 years of age and women more commonly around 22 years. “Medical problems or psychosocial difficulties can often exacerbate the OCD symptoms, and often individuals with OCD present to their doctors or psychologists with other mental health concerns, commonly major depressive disorder, social phobia and tics.
“Fortunately, OCD can be successfully managed with both medication and psychotherapy, also known as talk therapy,” she said.
The most commonly prescribed antidepressant medication used to treat OCD is selective serotonin reuptake inhibitors (SSRIs). Although they're traditionally used to treat depression, research has shown SSRIs to be the most effective medications for OCD, as well. In fact, SSRIs have been shown to help as many as 70% of people with OCD.
Four SSRIs are approved by the US Food and Drug Administration (FDA) to treat OCD in adults:
Paroxetine: is used to treat OCD and various conditions, including depression, panic disorder, anxiety, and post-traumatic stress disorder (PTSD). It is approved for people 18 years and older and is taken once a day.
Sertraline: can be used to treat OCD as well as depression, panic disorder, PTSD, social anxiety disorder, and premenstrual dysphoric disorder (PMDD). Sertraline is taken once daily and can treat OCD in adults and children six years and older.
Sertraline was found to be effective in improving quality of life and preventing worsening symptoms in people with OCD.
“Without professional treatment, OCD is usually a long-term condition, often with the person’s mental health status shifting back and forth. Some individuals have episodes where the symptoms intensify, while a minority have a deteriorating course with OCD,” she concluded.