• Contamination — A fear of germs or illness that lead to excessive washing, cleaning, use of protective gear (e.g., gloves), and avoidance of people, places or objects perceived as dirty or toxic.
• Checking — A fear of harm or feelings of doubt or impending doom that result in ritualistic behaviors, such as checking and rechecking locks, on/off switches, etc.
• Symmetry/Orderliness — A preoccupation with symmetry, order, preciseness, or perfection leading to repeatedly arranging, rearranging, touching, or counting items.
• Purely Obsessional (Pure O) — Experiencing intrusive thoughts inconsistent with one’s values or beliefs, such as harming oneself or others, with or without mental compulsions such as counting or praying.
• Relationship OCD (ROCD) — Experiencing intrusive thoughts and doubts about romantic relationships and constantly seeking reassurance from partners, friends, etc. to relieve doubts and fears.

Potential Causes & Factors Related to Obsessive Compulsive Disorder

The National Institute of Mental Health explains that the exact cause of OCD is unknown. However, it identifies the following risk factors that tend to increase the chances of developing OCD.(2)

• Genetics — Individuals with a family history of OCD or similar disorders may be at a higher risk of developing the condition, and certain genes have been implicated.
• Biology — Brain imaging reveals that some people with OCD have unique frontal cortex and subcortical structures in their brains. These areas impact the ability to control emotions and behaviors.
• Temperament — Some studies suggest that people who exhibit more reserved behaviors, experience negative emotions, and show symptoms of anxiety and depression as children are more likely to develop OCD.
• Childhood Trauma — While additional studies are needed to cement this relationship, there appears to be an association between OCD and childhood trauma. 

Recognizing the Common Signs & Symptoms of OCD

In addition to obsessive, unwanted thoughts and compulsive, ritualistic behaviors, a range of signs and symptoms are associated with OCD. Their occurrence and intensity can vary between individuals, and they can change over time.

Signs & Symptoms Include:

• Interference With Daily Functioning — Maintaining obsessions and compulsions is time-consuming and often interferes with work, school, relationships, and other aspects of daily life.
• Anxiety and Distress — High levels of distress and anxiety associated with obsessions and compulsions can be temporarily relieved but continue to persist in the long run.
• Avoidance — OCD symptoms can include an unyielding avoidance of people, places, things, or situations that provoke obsessive thoughts and anxiety.
• Reassurance — Those with OCD may have a constant desire for reassurance from others to relieve the anxiety and uncertainties associated with obsessive thoughts.
• Perfectionism — Symptoms can include a strong need for things to be perfect or “just right,” leading to behaviors intended to achieve order or preciseness.
• Unrealistic Beliefs — Irrational beliefs or an overestimation of the risk of harm can result in compulsive behaviors aimed at averting the dreaded consequences.
• Relationship Strain — May individuals also experience negative effects on relationships, and they struggle to maintain normal social interactions and control over preoccupations.

OCD Evaluation & Diagnosis

Assessing the presence of OCD typically begins with a comprehensive evaluation performed by a behavioral health professional. They will interview the individual, gather information, and use formal criteria to determine a diagnosis and discuss treatment options.

The OCD Evaluation and Diagnosis Process Includes:

• Initial Assessment — A structured interview performed by a behavioral health specialist to gather information about an individual’s personal history, current symptoms, and concerns.
• Detailed History — A comprehensive history of the person’s symptoms, their onset, their duration, and impact on their life.
• Clinical Interview — A series of questions about the nature and severity of the person’s obsessions and compulsions.
• Diagnostic Criteria — Use of criteria outlined in the Diagnostic and Statistical Manual of Mental Illnesses (DSM-5) to determine if the individual should be formally diagnosed with OCD and to identify the condition’s severity. 
• Ruling Out Other Conditions — A determination that the person’s symptoms are not related to another clinical condition that shares some of these symptoms, such as generalized anxiety disorder or panic disorder.
• Severity Assessment — Evaluation of the severity of symptoms, considering their effects on the person’s relationships, daily functioning, and overall quality of life.
• Duration and Persistence — An assessment of the duration of the person’s symptoms and whether they have remained relatively consistent over time.
• Decision-Making — A collaboration between the behavioral health specialist and the person to discuss the diagnosis and determine how to proceed with a treatment plan.

Outpatient OCD Treatment at Our Portland, ME, Mental Health Clinic

Outpatient mental health programs are a common form of treatment that can be very effective for treating those with mild-to-moderate OCD. Outpatient treatment, including virtual/telehealth care at Bishop Health, provides therapy and support while allowing clients to maintain their daily routines and live at home. These programs are flexible and typically meet several hours a day, a few days per week.

Individual Therapy for OCD Treatment

According to insights from Psychology Today, cognitive behavioral therapy (CBT), specifically exposure and response prevention (ERP), is considered the “gold standard” and most widely used therapeutic approach for OCD treatment. ERP therapy exposes individuals to situations that provoke obsessions and teaches them how to tolerate them and prevent the related behaviors. In this way, it aims to break the cycle of obsessions and compulsions.(3)

OCD Group Therapy

Group therapy sessions provide additional support and a sense of community or comradery. Group environments allow those with OCD to share their experiences, challenges, and coping mechanisms.

Medication Management for OCD Treatment

Medical treatment may be prescribed as a component of outpatient care, especially for those with more severe symptoms. Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), are often used to treat OCD.