Obsessive-Compulsive Disorder
Although not always classified as an anxiety disorder (for example, in the most recent version of the DSM-V), Obsessive-Compulsive disorder has so much in common with anxiety disorders and the treatment is so similar that I still consider it in the same category.
Obsessive-Compulsive Disorder refers to people who are impaired by obsessions (intrusive, irrational thoughts) and compulsions (physical or mental actions taken to neutralize or counter their obsessions). The most common pairs of obsessions and compulsions are: contamination/washing, perfectionism/slowness, symmetry/organizing, doubt/checking or repeating, and, finally, disturbing images or impulses/avoidance of triggers.
When OCD gets intense enough, it impairs a patient’s concentration (because are always thinking about it) and takes up too much of their time (to the exclusion of other activities such as work or socializing). Some patients also find it difficult to socialize and/or leave the house because it brings up too many triggers.
OCD specifically targets whatever a person’s culture considers to be stigmatizing or distasteful. A few centuries ago, the main OCD symptoms were almost always religious - concern about being sinful or disobeying God - because that was the worst thing people feared. As modern-day society has become more secular, a fear of germs, mistakes, harm, STDs, and various sexual preferences have become more common. Whatever the culture you grew up with considered to be stigmatizing or "bad", unfortunately, is likely to be what your OCD will center around.
OCD has a tendency to fluctuate with time (i.e. it goes up or down over the course of months or years) and also tends to switch topics with time. You may have an issue with germs in your teens, but then an issue with checking in your twenties, and then an issue with intrusive images in your thirties. This is a natural part of the disorder and every cluster of symptoms is responsive to the same type of treatment. OCD also tends to get worse when you are under stress, but not always. I have some patients whose OCD intensified even when there were no obvious external stressors.
OCD is very responsive to Cognitive-Behavioral Therapy; in particular, to a form of it called "ERP" (Exposure and Response Prevention). This form of treatment is what I call the "Berserker Style" on this website.
How do I find out if I have Obsessive-Compulsive Disorder?
The best way to find out whether or not you have Obsessive-Compulsive Disorder is by meeting one-on-one with a mental health professional (i.e. a therapist or a psychiatrist). Short of that, you can still get a good idea about the diagnosis from the DSM-V and various online scales.
The DSM-V (short for Diagnostic and Statistical Manual, version 5) contains the criteria that psychiatrists such as myself use to make a diagnosis. The criteria attempt to be objective and clear-cut, but, in practice, we have to use a lot of judgment to decide whether or not a patient meets each of the criteria. The DSM-V criteria are copyright protected, but if you google “DSM-V Obsessive-Compulsive Disorder” you will find similar criteria on-line and also on-line scales (such as the Y-BOCS) to assist you.
Even if you do not have full-fledged Obsessive-Compulsive Disorder, the techniques found on this website will be likely to help with whatever level of obsessions and compulsions you do have.
What are the treatments for Obsessive-Compulsive Disorder?
Generally speaking, psychotherapy and medications are the most effective treatments for Obsessive-Compulsive Disorder. Doing both together is usually the most effective, but either one can work alone.
Cognitive Behavioral Therapy (i.e. the therapy described on this website) is the most effective and the most well-researched form of psychotherapy for the treatment of Obsessive-Compulsive Disorder (and, for that matter, all of the anxiety disorders). It is a collection of techniques which, in practice, usually take 5-7 sessions to learn. Treatment itself is usually continued for several weeks or months in order to guide you in using the techniques and help monitor your progress.
There are many other forms of psychotherapy which can also be effective for Obsessive-Compulsive Disorder. If a particular therapist’s approach and personality appeal to you, then they are likely to be helpful regardless of the type of therapy that they practice.
Medications are also highly effective for Obsessive-Compulsive Disorder (the more so when they are combined with Cognitive Behavioral Therapy). The best way to learn about medication options, and whether or not they are right for you, is to have a one-on-one evaluation with a qualified medical professional (such as your primary medical doctor and/or a psychiatrist).