How are OCD and Anxiety Disorders Diagnosed? 

If an individual feels that they have OCD or an Anxiety Disorder, they must seek professional treatment from a clinical psychologist or a psychiatrist who will go through the appropriate diagnostic assessment to determine the disorder the individual has. The Yale Brown Obsessive  Compulsive Scale (YBOCS) is given to individuals to assess and tract the severity of OCD.

An individual may be diagnosed with OCD if he/she:

1.     Has obsessions

2.     Engages in compulsive behaviour

3.     If the obsessions and/or compulsions take a lot of time and interfere or disrupt normal daily functioning such as working, going out with friends, having a shower.

How are OCD and Anxiety Disorders Treated? 

 The most effective first line treatment for OCD and Anxiety Disorders is Cognitive Behaviour Therapy (CBT) which was founded by Dr Aaron Beck in 1970.  CBT is a form of psychotherapy based on the principles of learning theory.  CBT is used to treat a wide range of disorders such as OCD, Anxiety Disorders, Schizophrenia, Eating Disorders and Depression. 

Both CBT and Medication have been found to be effective in treating Anxiety Disorders and OCD. However, CBT has been found to be as or more effective in the treatment of Anxiety Disorders and OCD than medication alone. Medication may assist in reducing anxiety enough to prepare the individual to start and succeed in therapy. Research has found that CBT treatment causes changes in the brain activity of people with mental health disorders suggesting an improvement in brain functioning.

The goal of CBT is to teach individuals how to interpret and change the thoughts, beliefs and attitudes that they possess which contribute to undesired emotional states such as OCD or Anxiety Disorders. 

The way we think influences the way we feel. Therefore, it is important for us to change our thinking to influence our feelings.  Our thoughts and feelings govern our behaviour. CBT stresses the importance that individuals give to evaluating and interpreting their thoughts as well as the content of the thoughts themselves. 

 The two main features of Cognitive Behaviour Therapy; Cognitions (examining and correcting irrational or unrealistic thoughts) and Behaviour Therapy (noticing and manipulating maladaptive behaviours) are used together to ensure success in the treatment of OCD and Anxiety Disorders.

Cognitive Therapy involves:

Identifying thinking styles used by individuals before or during an anxiety provoking situation. By knowing the unhelpful thinking style used, one is able to broaden their perspective and change their thinking (Click here for unhelpful thinking styles document.

Guided discovery and examination into anxiety triggers, fears and core fears.

Looking at evidence to support and challenge fears and the likelihood of them coming true. 

Behaviour Modification Therapy or Exposure Response Prevention involves:

Deliberately exposing the individual to the feared stimulus (object, place, situation or person) in a gradual manner without the use of any safety behaviours or rituals, e.g. checking, reassurance seeking or hand washing.

How effective are first line treatments for OCD? (Data below from McLean Hospital, USA)

70% of patients with OCD will benefit from either medication or CBT and ERP Patients who respond to treatment report 50-80% reduction in OCD Symptoms.

Medications need to be taken regularly which can sometimes be a drawback and patients must actively participate in ERP for treatment to work.

25% of OCD patients refuse behaviour therapy and as many as half of OCD patients discontinue meds due to side effects.