Tag Archives: Mental Healthcare

All You Need to Know About Obsessive-Compulsive Disorder (OCD)

obsessive compulsive disorder

Obsessive Compulsive Disorder (OCD)

Obsessive-compulsive disorder (OCD) is characterized by intrusive thoughts, which may or may not be accompanied by compensatory acts to reduce the stress caused by these thoughts; these are referred to as obsessions and compulsions, respectively. Adolescents are more likely to have OCD, which is under-reported and under-treated. Early intervention is critical since it can cause serious debilitation. This exercise covers the assessment and treatment of obsessive-compulsive disorder, as well as the role of the interprofessional team in assessing and treating patients with this problem.

Objectives:

  • Describe the indications and symptoms that can be used to identify the obsessive-compulsive disorder in a patient.
  • Summarize the obsessive-compulsive disorder treatment plan.
  • Explain how OCD affects neural networks.
  • Examine the value of strengthening interprofessional care coordination to improve the delivery of care for individuals with obsessive-compulsive disorder.

Introduction

Obsessive-compulsive disorder (OCD) is a disabling condition characterized by persistent intrusive thoughts that cause distress. Compulsions or routines may be used by the patient to alleviate the worry and suffering connected with these ideas. These rituals can be personal and private, or they can involve others; the rituals are used to compensate for the ego-dystonic sentiments associated with obsessional ideas, and they can result in a severe loss of function.

Among the most prevalent obsessions are:

  • Anxieties of contamination,
  • Aggression/harm,
  • Sexual worries
  • Religious fears
  • The drive to get things “exactly so”.

Some of the compensating compulsions for these obsessions are:

  • Washing and cleaning
  • Checking
  • Reassurance-seeking
  • Repeating
  • Sorting and Arranging.
  1. Obsessions, compulsions, or both are present:

The following two points are used to define obsessions:

  • Recurrent thoughts, desires, or visions that are perceived as undesired at some point during the disturbance and generate significant distress in most people.
  • The individual tries to repress such ideas, urges or visions with another thought or action (i.e., by replacing them with a compulsion).

The following two factors define compulsions:

  • Repetitive actions or thoughts that a person feels compelled to perform as a result of an obsession.
  • The behavioral or mental acts that are intended to reduce worry or suffering, or to prevent some dreaded situation; nevertheless, they do not correlate in a realistic way with the problem they are intended to prevent, or they are manifestly excessive.
  1. Obsessions take up a lot of time or create clinically substantial distress or impairment in social, occupational, or other vital aspects of life.
  2. The physiological consequences of a substance (e.g., a drug of abuse, a medicine) or another medical condition are not the factors causing obsessive-compulsive symptoms.
  3. The symptoms of another mental disorder do not better explain the disturbance
  • Excessive worries, as in a generalized anxiety disorder;
  • preoccupation with appearance, as in a body dysmorphic disorder;
  • difficulty discarding or parting with possessions, as in a hoarding disorder;
  • hair pulling, as in trichotillomania a hair-pulling disorder;
  • skin picking, as in excoriation [skin-picking] disorder;
  • stereotypies, as in a stereotyping disorder;
  • Eating disorders are characterized by ritualized eating habits.
  • drug or gambling obsession, as observed in substance-related and addiction disorders;
  • sickness anxiety disorder is characterized by an obsession with having an ailment;
  • Impulses, as seen in disruptive, impulse-control, and conduct disorders;
  • sexual drives or fantasies, as shown in paraphilic disorders;
  • thought insertion or delusional preoccupations, as seen in schizophrenia spectrum and other psychotic illnesses; or
  • repetitive behavior patterns, as seen in autism spectrum disorders.

OCD is listed as one of the ten most debilitating conditions by financial loss and a deterioration in the quality of life by the WHO because it has the potential to impede one’s social growth and development.

Causes

Obsessive-compulsive disorder (OCD) has no recognized cause, however, it is most likely multifactorial. There is a genetic tendency since genetic factors account for 45 to 65 percent of the variance in OCD.

An inability to cope with uncertainty, a sense of greater responsibility, and magical thinking appears to predispose people to obsessive-compulsive behaviors.

OCD appears to be inherited, as evidenced by twin and family studies. According to studies, children’s heritability ranges from 45 percent to 65 percent, whereas adults’ heredity ranges from 27 percent to 45 percent. Having an OCD family member raises your chances of having OCD. OCD has been linked to a variety of neurological disorders, including Parkinson’s disease, Sydenham chorea, traumatic brain injury (TBI), Tourette syndrome, Huntington’s disease, and epilepsy, to name a few.

Evaluation

Screening for the correct symptoms of obsessive-compulsive disorder is critical. The brief OCD screener is a standard tool.

It asks the patient to rank the following items in order of severity:

  • Obsessive thoughts and compulsions take up a lot of time.
  • Obsessive thoughts are interfering with your life.
  • Obsessive thoughts cause a lot of pain.
  • Obsessions must be overcome.
  • Controllability of obsessive ideas
  • The amount of time devoted to compulsive behavior
  • Compulsive behavior’s interference
  • The anguish that comes with compulsive conduct
  • Anti-compulsive behavior resistance
  • Controllability of obsessive behaviors

Treatment / Management

SSRIs and cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) are the mainstays of obsessive-compulsive disorder (OCD) treatment.

ERP entails exposing the patient to their anxieties while also encouraging them to resist the impulse to conduct a compulsion. The goal is to rebuild the mind and change the habitual patterns that have developed as a result of participation in the compulsion.

CBT seeks to change negative and harmful ideas. The patient can use mindfulness approaches like meditation and relaxation in addition to CBT and ERP. In a 2012 study focusing on Mindfulness-Based Cognitive Therapy, they discovered that over the course of eight weeks, two-thirds of their patients had a decrease in OCD symptoms. Unlike ERP, MBCT does not require deliberately exposing patients to their fears. Nonetheless, when a stressful incident occurs, the patient is urged to take time to reflect on their thoughts and feelings. MBCT focuses on the attitude toward preoccupation rather than the ideas.

A Word from Tulasi Healthcare

Tulasi Healthcare is a psychiatric rehab center in Gurgaon providing treatment for people suffering from mental disorders. Obsessive-compulsive disorder (OCD) is a crippling condition that is frequently under-reported. Screening people for symptoms of the disease is critical. It is critical to educate medical professionals, as well as those who work in educational systems with teenagers, to be more alert.

We’re getting closer to identifying what OCD is by pinpointing specific locations in the brain and focusing on the chemicals involved. Because OCD affects such a large percentage of the population, having therapists who are trained to deal with it is critical. As health care providers, it is our obligation to promote awareness and inform patients about treatment alternatives.

Primary care professionals, psychiatrists, psychologists, psychiatric nurses, social workers, and pharmacists work together to enhance outcomes. Prescriptions are reviewed by pharmacists, who also educate patients and their families and aid the team by screening for drug interactions. Clinicians can also seek advice from board-certified psychiatric pharmacists in order to administer the most effective medications.

Psychiatric nurses keep track of patients, educate them, and keep the rest of the team up to date on their progress. Patients with OCD may benefit from this multidisciplinary approach to treatment.

 

A New Beginning – The Story of My Journey of Recovery

addiction recovery

It usually starts with legal intoxicants like cigarettes and alcohol, the oft cited “Gateway drugs” in which some tend to include marijuana as well. Mine is a similar story, experimenting initially with the “legal” drugs it wasn’t long before I started meddling with the “illegal” and “hard” drugs ranging from prescription medication, cannabis and opiates to hallucinogens like LSD.

The start was out of curiosity, to try and feel the various “highs” each different drug had to offer, the journey saw me dabbling with “party” drugs like mdma and meth and even “designer” drugs like 2CB. Eventually, before one realises it, escapism takes over, not feeling good today take something, feeling low, tense or under pressure due to life struggles, take something, if you took “uppers” or stimulants and are having a hard time getting back to normal (so that you can get your appetite back and then sleep peacefully) take some “downers” or sedatives.

It was not long before I realised that I need help, self-administering substances is not the normal way to lead one’s life. Through divine grace, I was fortunate to get the medical help which so many people desperately need and only some are lucky enough to get. I was admitted to Tulasi Healthcare Centre by my parents, the round the clock availability of medical experts ranging from psychiatrists, psychologists and nurses, to support staff of social workers, was a God sent.

The psychologists helped me identify the problem areas and to heal past emotional traumas, to introspect and get to the realisation, to a stage of acceptance of the fact that I have a drug problem and that it is a disease which I will have to be careful about throughout my life. Only then will I be able to walk on the path of recovery which like life is a “journey” and not a “destination”.

Recovery is not something which can be taken lightly, the problem of drug abuse is basically a problem of emotions, I was not dealing with my emotions in a healthy way, trying to fix them by taking external substances, in the process making things worse, losing perception of reality and blaming circumstances for my condition rather than accepting the fact that it is my own reactions that are faulty.

Circumstances, by and large, in my life are still the same, if not worse, but it is the acceptance of the whole deal, of the game of life, that we are not in control of the things that happen to us but the way we perceive them and then act (or react) to them.

I cannot thank the people at Tulasi Healthcare Centre enough, they have played an immense role in providing me with a new lease of life. Ultimately, I will thank God, in thanking him I will be able to thank everyone from my parents to Dr. Gorav Gupta who has proved to be a beacon of light to the countless souls progressing on the path of recovery like me.

Author: Ajitinder Singh Sandhu Ex patient at Tulasi Healthcare.

Role of Family during Rehabilitation of Relatives Suffering from Mental Illness

rehabilitation center in delhi

Dependence on substances has adverse effects on all facets of life. Addiction to substances such as alcohol and tobacco has detrimental effects on both psychosocial and physical health, which in turn can lead to major mental health concerns and even mental disorders. Further consequences may include difficulty in decision making, quitting a job, severing ties with close relatives and family members, etc. which leads to long-term repercussions.

A habit of abusing substance(s) links intensely to all spheres of a person’s life. This is one reason why dependence on substance(s) can be hard to overcome without assistance.

While undergoing treatment, in order to quit the habit and to quit for keeps, an alcoholic or an addict must make holistic changes to his/her lifestyle, which includes but is not limited to avoiding or successfully coping with conditions which may result in a relapse, building around oneself an atmosphere which is best suited for performing professional tasks efficiently and more significantly, re-establishing ties with family members.

Because of the fact that close relatives are a priceless resource of recovery, it is imperative for these kith & kin to participate in the rehabilitation of individuals struggling with substance addiction.

The families of individuals struggling with addiction play a major role in the rehabilitation of these individuals in order to leverage the strength of family support & also to mitigate the passive effects of substance addiction on the relatives, such as inhalation of second hand smoke by family members of an individual addicted to smoking, who also smokes at home.

In addition to educating the family about the mental condition and other aspects, making family members understand how some of their non-verbal cues or actions can instigate their young ones to relapse and resort to substance abuse, and helping such family members find alternatives & solutions to minimize such threats to continuing sobriety, can facilitate the rehabilitation process.

Assisting family members with using more effective communication tools is another feature of involving family members in the rehabilitation process of their relative.

Re-establishing responsible relationships with either parent (mother or father) goes a long way in rehabilitating an individual residing with his/her parents, as the parents can then put in remedial efforts into reviving the struggling patient’s relationships with the society and with other members of his/her family.

Families of individuals can assist with formulating strategies for an addict or an alcoholic to recognize social, economic, medical or psychiatric threats to ongoing rehabilitation and revitalization to prevent the onset of a relapse.

Patient Safety in Mental Hospitals located in Delhi

Patient Safety in Mental Hospitals

psychiatric hospital in delhi

In spite of the rising global awareness about patient security, there has been a lack of its application in mental health hospitals located in Delhi.

Safety of patients residing in mental hospitals refers to the deterrence of injury or damage caused to the physical or mental health of the patients as a result of violence or other forms of aggression while they are receiving mental healthcare services. This also includes and is not limited to happenings like errors made during treatment and mishaps that ensue during residence of patients in mental hospitals. Of late, the interest in patient safety as a discipline has been increasing at an escalating rate.

It is not easy to provide mental healthcare safely in a mental hospital, to those patients who are sensitive and more vulnerable to picking fights with other resident patients.

Some groups of patients who look for mental healthcare, approach psychologists and psychiatrists at mental hospitals with complications that distinguish themselves from those patients who are not very prone to violence. Treatment of such patients is a greater challenge for the team of service providers at mental hospitals as compared to the treatment of those patients who cooperate with the staff and other patients.

While also facing the perils of the common mishaps occurring while being treated (falling, wrong medication being administered, contracting infections, etc), violent resident individuals with mental health illnesses or disorders are also at the risk of compromising other patients’ safety.

Patient safety issues may also arise out of self-harming behavior such as attempts at suicide & absconding from daily activities conducted at mental hospitals.

More difficulties arise due to the inconsistency between security procedures and autonomy of resident patients. The guiding principles laid down by mental health care hospitals located in Delhi, which aim at improving prospects of patients’ safety in mental health settings, are often perceived as contentious and immoral because of their effect on patients’ human rights. The measures taken while implementing these guidelines can include locking entities and putting restraints on patients’ activities & behavior, frisking, confiscation of items which are forbidden and the use of CCTV in order to keep a better check on patient activity. More impediments also arise because the emphasis on prevention of physical harm to patients residing at mental hospitals sometimes disregards the psychological trauma endured by these patients.

All of the above mentioned points indicate towards a dire need for an improved understanding of the unique challenges facing mentally ill patients, especially those who are sensitive and more prone to violence. It is important for psychiatrists, psychologists and the paramedical staff at each and every mental health hospital located in Delhi to ensure that the patients residing within the four walls of these mental hospitals not onlyreceive safe and secure care, but also in a manner that doesn’t negotiate on their humane poise, it being courteous and considerate of their exclusive requirements.