We are an organization dedicated to supporting individuals with OCD, as well as their families, healthcare providers, and committed young individuals. The OCD Network has been offering a range of services including support programs, collaborative events, and fostering a close-knit community for those affected by this condition.
Causes of OCD?
What is OCD?
Obsessive compulsive disorder (OCD), a manageable neurological psychiatric condition, manifests through repetitive behaviors (compulsions/rituals) and unwanted intrusive thoughts (obsessions). These compulsions are undertaken in an individual's endeavor to alleviate obsessions and minimize distress. The time-consuming nature of OCD obsessions and compulsions, coupled with the substantial emotional turmoil they induce, can impede daily activities and interpersonal connections.
How Common is OCD?
The estimated global prevalence rates of Obsessive-Compulsive Disorder (OCD) stand at 1.5% for women and 1% for men over their lifetime. In Singapore, the results from the 2016 Singapore Mental Health Study indicate that the prevalence rates of OCD are slightly higher, with figures of 3.6% and 2.9% for lifetime and 12-month occurrences respectively. This means that approximately one in every twenty-eight individuals in Singapore will experience OCD at some point during their lives. Remarkably, OCD ranks among the top three most commonly occurring mental health conditions in Singapore, trailing only Alcohol Abuse and Major Depressive Disorder (MDD).
While OCD can manifest itself at any age, it typically commences either during childhood between eight and twelve years old or later on during adolescence or early adulthood. Once established, this condition often persists throughout a person's entire life span.
Causes of OCD
There are a number of factors that can contribute to the development of OCD
Research conducted on family dynamics has provided evidence indicating a higher susceptibility to developing OCD among immediate relatives of individuals affected by the disorder, as opposed to the general population. Furthermore, studies have revealed that there exists an 80% concordance rate for monozygotic twin pairs and a 50% concordance rate for dizygotic twin pairs.
Neuroimaging investigations conducted on patients diagnosed with OCD have revealed elevated neural activity and heightened blood circulation within distinct regions of the brain.
Serotonin, a neurotransmitter present in brain cells, plays a crucial role in transmitting information between neurons. Research indicates an inequity of serotonin levels within the brains of individuals suffering from Obsessive-Compulsive Disorder (OCD).
Significant life occurrences, such as the loss of a loved one or experiencing high levels of stress, can activate symptoms of Obsessive-Compulsive Disorder (OCD) in individuals who are predisposed to develop this condition. Furthermore, positive events like childbirth may also serve as potential catalysts for the manifestation of this underlying disorder.
Stress/ Life Events
Certain exceptional instances of Obsessive-Compulsive Disorder (OCD) in children and adolescents have been observed to arise subsequent to severe streptococcal or other infections. These infections possess the potential to elicit OCD symptoms in individuals from this age group who possess a hereditary inclination towards developing the said condition.
Types of OCD
Counting & Checking
Counting and checking are performed in an effort to address obsessive and fearful thoughts or to prevent something bad from happening. Counting can be associated both with the need to avoid danger and the obsession for symmetry and exactness. Checking rituals often involve an impulse to check items such as door locks, light switches,taps, and stoves.
Fear Of Harm
Harming Intrusive Thoughts consist of unwanted thoughts or images that one might harm themselves or someone else on impulse. Individuals within this OCD subtype have no intent to hurt themselves or others and the intrusive thought or image often causes a significant amount of anxiety and disturbance for these individuals.
Germs & Contamination
People commonly associate fears of germs and contamination with Obsessive-Compulsive Disorder (OCD), often with images of someone feverishly using hand sanitizer and Dettol l to reduce their fears. However, this stereotype does not illustrate the correct image of many sufferers.
“Not just right” OCD
“Not just right” OCD, also known as Symmetry and Ordering, is a category of OCD where individuals often experience an overpowering internal sense that the balance, order, place, frequency or position of something is disturbed and must be corrected.
Sexual Intrusive Thoughts
Sexual intrusive Thoughts consist of unwanted sexual thoughts. This may include fears related to one’s sexual orientation or what others might think. It may also contain mental imagery of sexual behaviors that the individual finds immoral or abhorrent.
Immoral or Scrupolous Thoughts
Scrupulosity is the religious form of OCD in which individuals are plagued with obsessions surrounding religion/spirituality and morals. This may include obsessions about sin, offending God, religious or moral failings, and punishment. .
Treatments for OCD
Medications with selective serotonin reuptake inhibitors (SSRIs) have been proven to be effective in the treatment of OCD. They can be given to individuals either together with psychological treatment, or alone, depending on the severity of the OCD.
Exposure ResponsePrevention (ERP) therapy
Exposure and response prevention (ERP) is the gold standard treatment for OCD. Exposures are opportunities to confront feared thoughts, situations, and beliefs without engaging in compulsions or avoidance behaviors.
Barriers to treatment
In the recent Singapore Mental Health Study done in 2016, it was found that amongst those who sought help for mental health conditions, treatment delay was longest for those with OCD at 11 years.
What families should know
Your loved one’s OCD isn’t anyone’s fault. OCD is a neurological problem. The obsessions are involuntary and the person experiencing them cannot simply control or get rid of them by an effort of will. Family members, caregivers and friends often feel helpless, not knowing how to reach out or what to do to help their loved one. They often respond to OCD with antagonistic or accommodating behaviours, both of which may cause OCD symptoms to flare up. People with OCD often feel even more distress when they are subjected to criticism or blame.
Here's what you can do to help your loved one suffering from OCD:
Educate yourselfThe more you know about OCD, the better equipped you will be to avoid pitfalls, cope with challenges and, most importantly, help your loved one.
Help them to get treatmentErosion of a person’s motivation through OCD can be a barrier to their seeking treatment. To manage OCD in a supportive way, share with your loved one what you know about the disorder, and provide information about both the medications and Exposure and Response Prevention Therapy (ERP). Help your loved one to access these treatments.
Don’t blame yourselfParents often feel they are responsible for their child’s OCD, when it is something over which they truly have no control. Once you accept that OCD is nobody’s fault, you will be able to take action that is honest and helpful, and not clouded by ideas of what you could or should have done.
Recovery is not a competitionRemember that everyone progresses at their own pace, and your loved one is not weaker or stronger than another OCD patient based on the speed of his or her recovery. Some may have more setbacks than others, even in treatment. When you stop making comparisons, you can truly be happy for your loved one when they accomplish their goals. It is important to be patient, encouraging and supportive.
Be supportiveAvoid criticizing or mocking your loved one’s symptoms. Do not suddenly spring a situation on them in which they are bound to feel anxious. Learn how you can be supportive without accommodating your loved one’s compulsions.
Be a teamWork closely with the psychiatrist, psychologist and other mental health professionals to help your loved one fight OCD.
Recognise victories, even small onesHowever successful or unsuccessful the efforts made have been, praise your loved one for standing up to his or her OCD. Acknowledging their efforts and recognizing improvements (even when the wins seem small), will encourage your loved one to keep trying.
CommunicateKeep communication simple, and avoid complicated explanations.
Motivate your loved oneOCD treatment is hard work, often exhausting for your loved ones. Remind them of their motivation and their recovery goals, as this may encourage them to continue the treatment progress so that they can get their life back.
Support taking medication as prescribedBe sure to follow the medication instructions that have been prescribed. Do not try to reduce or increase the dosage of the medication without consulting the doctor. All medications have side effects that range in severity. If you have any concerns, you could periodically (if your loved one agrees to this) attend the doctor’s appointment with him/her, so that you can ask questions, learn about side effects and report any behavioural changes that you have noticed.
Set realistic boundariesDo not change your family routine to accommodate your loved one’s OCD behaviours. Discuss your expectations ahead of time and do not engage in boundary discussions during stressful events. Remember that it is in the individual’s best interests to tolerate exposure to their fears and be reminded of others’ needs. As they begin to return to normal functioning, their wish to do more will increase.
Join a support groupShare and listen to other caregivers how they handle their loved ones’ OCD behaviours. Get feedback about how you can better manage your family member’s OCD demands and/or support them in their recovery journey.
Take care of yourselfLiving with someone with OCD is stressful for the entire family. Don’t become so preoccupied with your loved one’s OCD that you neglect your own needs. It is important to engage in activities that are important to you. Self-care is an essential part of caring for others. Make sure you have your own support, so that you can be emotionally recharged.
Myths about OCD
All neat and clean freaks have OCD.
One common sign of OCD is an obsession with cleanliness – such as constantly washing your hands or excessively cleaning household items. But a preoccupation with cleanliness could also be a personality trait. If it is a personality trait, you have control – you can choose whether or not to do it. If you have OCD, you are doing it out of unrelenting, debilitating anxiety or distress.