Obsessive compulsive disorder | Mental health | NCLEX-RN | Khan Academy

Obsessive compulsive disorder | Mental health | NCLEX-RN | Khan Academy

January 5, 2020 4 By Kody Olson


– [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.