Obsessive compulsive disorder (OCD) is an anxiety disorder that causes a person to have obsessions and compulsions. An obsession is an unwanted thought that stays in your mind most of the time. You cannot stop or control this thought. A compulsion is something you do and cannot stop doing because of the obsessive thought. You may become very anxious if you try to stop the compulsion.
Listen in as Marc E Mooney, LP discusses OCD and how you know when you should seek help for yourself or your loved ones.
Selected Podcast
Do You Suffer from Obsessive-Compulsive Disorder (OCD)?
Featured Speaker:
Learn more about Marc Mooney, PhD
Marc Mooney, LP -Clinical Psychologist
Marc E Mooney, LP is a clinical psychologist at Allina Health Mental Health – Abbott Northwestern Clinic with professional interests in anxiety disorder, obsessive-compulsive disorder, and psychotic and mood disorders.Learn more about Marc Mooney, PhD
Transcription:
Do You Suffer from Obsessive-Compulsive Disorder (OCD)?
Melanie Cole (Host): Obsessive Compulsive Disorder, formerly considered a type of anxiety disorder, is now regarded as a unique condition. How can you tell if OCD tendencies are symptoms that require professional help? My guest today is Dr. Mark Mooney. He's a clinical psychologist with specialties in anxiety disorder and Obsessive Compulsive Disorder at Allina Health Mental Health at Northwestern Clinic. Welcome to the show, Dr. Mooney. So, first, tell us: people have heard OCD; they think hand washing. What really are obsessive compulsive disorders?
Dr. Mark Mooney (Guest): They are disorders that involve both problems with thinking and then, also, with behaviors that are interruptive or troublesome.
Melanie: So, what are some symptoms that--well, first of all, let's ask who's at risk for these? Is there a genetic component?
Dr. Mooney: There is a genetic component to these. It does tend to run in families.
Melanie: Okay. So, if it runs in families, you know that this is something that you might have a tendency toward. What do you look for?
Dr. Mooney: Well, interestingly, you would look more for the compulsions than the obsessions, because the obsessions are thoughts. We can't see them. The compulsions are ritualized, repetitive behaviors that can be things like hand washing, checking or cleaning.
Melanie: So, compulsions are ritualized. So, the difference between those is…because we all have crazy . . . not crazy, but wild thoughts sometimes. It's whether we act on them, correct? Or, how does that work?
Dr. Mooney: Well, so, we all can be compulsive and we all can have obsessions, at times. The distinction between sort of typical stuff that most people have in OCD is really the amount of time that is spent obsessing and compulsing. More than one hour a day.
Melanie: So, the sort of starting point is more than one hour a day? And, what if that's sort of broken up and some people have those thoughts scattered throughout the day?
Dr. Mooney: Well, it's in its totality. If you're spending five minutes here and ten minutes there, if it adds up to an hour or more a day, then that's one rule-of-thumb for deciding whether a person needs therapy and medication.
Melanie: So, are there certain environmental factors that can also contribute?
Dr. Mooney: Well, certainly stress and pressure will make a person more obsessive and more compulsive and this is true for normal people, also.
Melanie: So, when would they start to notice? I mean, is this something that you would start in childhood and takes you through or does it typically start in the teen years or even later?
Dr. Mooney: It can definitely start in childhood and the nature of what people obsess about, the bad thoughts that they have differs, I think, with age a little bit, but it certainly can start in children as young as five.
Melanie: So, what's a parent to look for? Because some kids just want to have clean hands and they're told at school so many times to wash their hands, so maybe they overdo it a little bit at the beginning. How long does it go on before then you say, “Okay, this is definitely something that requires professional help”?
Dr. Mooney: I think when it reaches a point where it's interfering with a child's routines and behavior. Where they're late for the school bus; or they're not going to recess because they're washing their hands; or they're not going out to play sports with others because they're avoiding things that, say, they might think are contaminated. That would be a point where an evaluation would be warranted.
Melanie: Will it go away by itself or does it really need treatment?
Dr. Mooney: It really needs treatment.
Melanie: What's treatment involve?
Dr. Mooney: Treatment involves one of two approaches. There are classes of medications that can help make people have less obsessions and then, in terms of psychological treatment, there is what is called cognitive behavioral therapy which involves finding those things that make an obsessive compulsive person anxious and then having them systematically expose themselves to those things until their anxiety goes down.
Melanie: So, are there certain exercises, per se, that you recommend to your patients that they can do at home? And, if people are starting to have some of these obsessive thoughts, is there some way that you tell them that they can sort of do cognitive behavioral therapy on themselves on the off days that they're not seeing you?
Dr. Mooney: In fact, they do and, really, the majority of the effective treatment that happens in psychotherapy for OCD are the exercises or the exposures that patients do when they're not in the clinic.
Melanie: So, give us an example of what you tell people to do.
Dr. Mooney: An example might be that a person has a fear of contamination. Let's say they're afraid of germs. I might have them go to a public place and touch some door handles or knobs and then sit and not wash their hands for an hour.
Melanie: So, in other words, it's restraint from that feeling. How difficult is that for people?
Dr. Mooney: It can be very difficult. On the plus side, though, it's extremely effective when I can get people to do exposures to the things that make them anxious and make them obsess, whether it's disorder or cluttered things, or if it's contamination. They can enjoy a great deal of symptomatic relief in just a matter of two or three months.
Melanie: And, is this something that, by doing these things and using restraint and training their brain, as it were, and through cognitive behavioral therapy, that you can overcome, or is it something you will be working on the rest of your life?
Dr. Mooney: I think that if a person can do a good course of cognitive behavioral therapy for one type of obsession, say, it's contamination, that they will learn skills to help prevent them from developing an obsession in another area.
Melanie: And, what are the medications intended to do?
Dr. Mooney: The medications simply reduce the intensity and the frequency of obsession.
Melanie: How do they do that? Is this a hormonal thing acting on brain hormones, or what does that do?
Dr. Mooney: They achieve this effect primarily through increasing levels of serotonin in the brain which tends to make people less impulsive and more planful. It makes it easier for them to tolerate the stress.
Melanie: So, that's kind of where I was getting, is the serotonin uptake inhibitors that someone might take, and there are certain other therapies that can help increase serotonin levels, like exercise. Do you recommend any of those to kind of help as an adjunct?
Dr. Mooney: I definitely recommend exercise. Meditation practices are also helpful. Anything that decreases the level of stress is going to decrease the frequency of symptoms of OCD.
Melanie: Are there certain movements, repetitions that people can do that don't necessarily say “Yes, they're an OCD”?
Dr. Mooney: This is very true. There are many people who have very orderly routines and patterns of behavior that are not compulsive and they're normal and healthy.
Melanie: So, you can be a very organized person and still not be considered OCD?
Dr. Mooney: Very true.
Melanie: And now, tell us about your group at Allina Health Mental Health.
Dr. Mooney: Our group is an outpatient group that meets weekly and the people who come to the group are adults who have Obsessive Compulsive Disorder and are looking to work on their problems in a group setting.
Melanie: So, wrap it up for us, Dr. Mooney, about OCDs, what you tell people every day about these because this is such a huge problem. Millions of people suffer from them and some people it really, really affects their everyday quality of life. What do you tell people every day about ways to manage them?
Dr. Mooney: I tell them that even though it's a very confusing and disturbing problem to have, that they can get better with treatment and most people will and that it's possible, with a relatively limited amount of effort and time and treatment and with medication, that they can live almost symptom-free lives.
Melanie: Wow. That's great advice, and very hopeful for people suffering with OCDs. Thank you so much for being with us and for more information about Allina Health's Mental Health at Abbott Northwestern Clinic, you can go to AllinaHealth.org. That's AllinaHealth.org. You're listening to The WELLcast with Allina Health. This is Melanie Cole, thanks so much for listening.
Do You Suffer from Obsessive-Compulsive Disorder (OCD)?
Melanie Cole (Host): Obsessive Compulsive Disorder, formerly considered a type of anxiety disorder, is now regarded as a unique condition. How can you tell if OCD tendencies are symptoms that require professional help? My guest today is Dr. Mark Mooney. He's a clinical psychologist with specialties in anxiety disorder and Obsessive Compulsive Disorder at Allina Health Mental Health at Northwestern Clinic. Welcome to the show, Dr. Mooney. So, first, tell us: people have heard OCD; they think hand washing. What really are obsessive compulsive disorders?
Dr. Mark Mooney (Guest): They are disorders that involve both problems with thinking and then, also, with behaviors that are interruptive or troublesome.
Melanie: So, what are some symptoms that--well, first of all, let's ask who's at risk for these? Is there a genetic component?
Dr. Mooney: There is a genetic component to these. It does tend to run in families.
Melanie: Okay. So, if it runs in families, you know that this is something that you might have a tendency toward. What do you look for?
Dr. Mooney: Well, interestingly, you would look more for the compulsions than the obsessions, because the obsessions are thoughts. We can't see them. The compulsions are ritualized, repetitive behaviors that can be things like hand washing, checking or cleaning.
Melanie: So, compulsions are ritualized. So, the difference between those is…because we all have crazy . . . not crazy, but wild thoughts sometimes. It's whether we act on them, correct? Or, how does that work?
Dr. Mooney: Well, so, we all can be compulsive and we all can have obsessions, at times. The distinction between sort of typical stuff that most people have in OCD is really the amount of time that is spent obsessing and compulsing. More than one hour a day.
Melanie: So, the sort of starting point is more than one hour a day? And, what if that's sort of broken up and some people have those thoughts scattered throughout the day?
Dr. Mooney: Well, it's in its totality. If you're spending five minutes here and ten minutes there, if it adds up to an hour or more a day, then that's one rule-of-thumb for deciding whether a person needs therapy and medication.
Melanie: So, are there certain environmental factors that can also contribute?
Dr. Mooney: Well, certainly stress and pressure will make a person more obsessive and more compulsive and this is true for normal people, also.
Melanie: So, when would they start to notice? I mean, is this something that you would start in childhood and takes you through or does it typically start in the teen years or even later?
Dr. Mooney: It can definitely start in childhood and the nature of what people obsess about, the bad thoughts that they have differs, I think, with age a little bit, but it certainly can start in children as young as five.
Melanie: So, what's a parent to look for? Because some kids just want to have clean hands and they're told at school so many times to wash their hands, so maybe they overdo it a little bit at the beginning. How long does it go on before then you say, “Okay, this is definitely something that requires professional help”?
Dr. Mooney: I think when it reaches a point where it's interfering with a child's routines and behavior. Where they're late for the school bus; or they're not going to recess because they're washing their hands; or they're not going out to play sports with others because they're avoiding things that, say, they might think are contaminated. That would be a point where an evaluation would be warranted.
Melanie: Will it go away by itself or does it really need treatment?
Dr. Mooney: It really needs treatment.
Melanie: What's treatment involve?
Dr. Mooney: Treatment involves one of two approaches. There are classes of medications that can help make people have less obsessions and then, in terms of psychological treatment, there is what is called cognitive behavioral therapy which involves finding those things that make an obsessive compulsive person anxious and then having them systematically expose themselves to those things until their anxiety goes down.
Melanie: So, are there certain exercises, per se, that you recommend to your patients that they can do at home? And, if people are starting to have some of these obsessive thoughts, is there some way that you tell them that they can sort of do cognitive behavioral therapy on themselves on the off days that they're not seeing you?
Dr. Mooney: In fact, they do and, really, the majority of the effective treatment that happens in psychotherapy for OCD are the exercises or the exposures that patients do when they're not in the clinic.
Melanie: So, give us an example of what you tell people to do.
Dr. Mooney: An example might be that a person has a fear of contamination. Let's say they're afraid of germs. I might have them go to a public place and touch some door handles or knobs and then sit and not wash their hands for an hour.
Melanie: So, in other words, it's restraint from that feeling. How difficult is that for people?
Dr. Mooney: It can be very difficult. On the plus side, though, it's extremely effective when I can get people to do exposures to the things that make them anxious and make them obsess, whether it's disorder or cluttered things, or if it's contamination. They can enjoy a great deal of symptomatic relief in just a matter of two or three months.
Melanie: And, is this something that, by doing these things and using restraint and training their brain, as it were, and through cognitive behavioral therapy, that you can overcome, or is it something you will be working on the rest of your life?
Dr. Mooney: I think that if a person can do a good course of cognitive behavioral therapy for one type of obsession, say, it's contamination, that they will learn skills to help prevent them from developing an obsession in another area.
Melanie: And, what are the medications intended to do?
Dr. Mooney: The medications simply reduce the intensity and the frequency of obsession.
Melanie: How do they do that? Is this a hormonal thing acting on brain hormones, or what does that do?
Dr. Mooney: They achieve this effect primarily through increasing levels of serotonin in the brain which tends to make people less impulsive and more planful. It makes it easier for them to tolerate the stress.
Melanie: So, that's kind of where I was getting, is the serotonin uptake inhibitors that someone might take, and there are certain other therapies that can help increase serotonin levels, like exercise. Do you recommend any of those to kind of help as an adjunct?
Dr. Mooney: I definitely recommend exercise. Meditation practices are also helpful. Anything that decreases the level of stress is going to decrease the frequency of symptoms of OCD.
Melanie: Are there certain movements, repetitions that people can do that don't necessarily say “Yes, they're an OCD”?
Dr. Mooney: This is very true. There are many people who have very orderly routines and patterns of behavior that are not compulsive and they're normal and healthy.
Melanie: So, you can be a very organized person and still not be considered OCD?
Dr. Mooney: Very true.
Melanie: And now, tell us about your group at Allina Health Mental Health.
Dr. Mooney: Our group is an outpatient group that meets weekly and the people who come to the group are adults who have Obsessive Compulsive Disorder and are looking to work on their problems in a group setting.
Melanie: So, wrap it up for us, Dr. Mooney, about OCDs, what you tell people every day about these because this is such a huge problem. Millions of people suffer from them and some people it really, really affects their everyday quality of life. What do you tell people every day about ways to manage them?
Dr. Mooney: I tell them that even though it's a very confusing and disturbing problem to have, that they can get better with treatment and most people will and that it's possible, with a relatively limited amount of effort and time and treatment and with medication, that they can live almost symptom-free lives.
Melanie: Wow. That's great advice, and very hopeful for people suffering with OCDs. Thank you so much for being with us and for more information about Allina Health's Mental Health at Abbott Northwestern Clinic, you can go to AllinaHealth.org. That's AllinaHealth.org. You're listening to The WELLcast with Allina Health. This is Melanie Cole, thanks so much for listening.