Obsessive-Compulsive Disorder (OCD)
Management and Resources
At home
Home is a great place for individuals with OCD to practice the exposure exercises learned in therapy. For instance, when one's therapist designs behavioral exposure (desensitization) homework, their home can become a laboratory. Individuals can practice touching household items or even certain food that may invoke anxiety and lead them to maladaptive behaviors (excessive washing, checking, reassurance seeking). Or, if the individual feels dirty after visiting public places, they can practice going out in public and extending the period before showering. Home is also a good place to practice leaving one's appliance plugged in if they worry about setting a fire, and not returning to check for several hours.
It is important for family members living with someone who has OCD to recognize their role in the treatment. Often, the distress of OCD makes the individual seek reassurance and comfort that their dreaded fear will not materialize. While a mother may believe she is helping her loved one, this “reassurance giving” may actually make her daughter dependent upon others to make her better. Furthermore, the mother may lose credibility if her daughter knows that mom will always tell her what she wants to hear. A better strategy would be for the family member to resist giving reassurance and instead to guide the person suffering with OCD to engage in more fulfilling activities that will distract her from her unpleasant thoughts.
Some organizations recommend key steps that individuals with OCD can take to help reduce their symptoms, such as developing a basic mindful “in-the-moment” attitude through meditation, yoga, or other therapeutic techniques. It can also help to stay healthy by getting exercise every day. Exercise generates endorphins, which are natural mood-elevating biochemicals that make people feel better. It is still possible to have OCD symptoms with exercise, but exercising can help to distract the mind.
Lastly, those with OCD often benefit from making certain to get enough sleep every night. Many people are seriously sleep-deprived, and insufficient sleep increases the risk for OCD symptoms as well as symptoms of other issues such as depression and anxiety. Making sure one's bedroom is a place they use primarily for sleep is recommended. When a person perceives their bedroom as a relaxing place, this is far more conducive to helping them obtain the sleep they need.
At work and school
Many people with OCD exhibit perfectionistic tendencies which are amplified when a boss or teacher passes judgment on performance. The school and work settings tend to be conducive to rituals including checking, deleting or erasing, correcting, rechecking. This may slow down completion of tasks and contribute to missing deadlines. A person with OCD may spend an inordinate amount of time on work related tasks compared to their peers.
Not only can these rituals affect quality of life and one's ability to devote energy to more pleasurable pursuits, but they can also affect academic achievement and career advancement.
Structured therapeutic exercises to increase exposure to clerical errors at first is an effective technique to reduce the fear of a dreadful outcome. This should be managed with a trained CBT therapist, assessing the reward versus the risks of such homework. Receiving ADA accommodations can also help relieve the distress, but should not replace the goal of challenging the thoughts and confronting the perceived “worst-case scenario.”
Additional resources on OCD
There are private and governmental organizations that can provide information and support on OCD, which may be very helpful to the individual with the disorder as well as family members who are concerned.
Organizations
National Institute of Mental Health (NIMH)