Category: OCD

Complications of Obsessive Compulsive Disorder

Millions of people are impacted by a health condition called obsessive compulsive disorder or OCD.  OCD is a very complicated and challenging mental illness that can present itself in a number of different ways.  The symptoms of OCD can begin in early childhood and will likely continue as you age.  It could be something that will plague you for the rest of your life if it is left untreated.  Even with proper treatment, it is possible that some of the complex symptoms will never subside.

Some of the complications that can arise as a result of living with OCD can include:

Substance Abuse

It is somewhat common for people with OCD to also have a problem with substance abuse.  Often, you or the person you love who has OCD will begin using drugs or alcohol as a way self-medicate and alleviate some of your OCD symptoms.  However, what starts out as self-medicating can quickly turn to substance abuse and addiction.  The two most common substances of abuse used by people with OCD are alcohol and benzodiazepines.  Benzodiazepines are meant to reduce the symptoms of anxiety.

Reduced Productivity

Getting things done while fighting OCD can be very difficult.  Low productivity can have an effect on all areas of your life particularly when it comes to work or school performance.  Much of your time is likely being spent on compulsive rituals or fighting with yourself over unwanted thoughts and urges.  It can be exhausting and, ultimately, you may not have enough time to get done all of the other things that you need to in a day.  The responsibilities of your everyday life can quickly take a backseat to your compulsions.

Work or School Difficulties

As mentioned above, OCD compulsions can be exhausting and time consuming.  And getting fired from a job is pretty easy if your employer thinks that you are not accomplishing all that you should be in a day.  The same is true for being a student.  Teachers will rarely believe that you did not do your homework because you had to turn on and off all of the light switches in your house 12 times each before you could do anything else.  Also, it is difficult to be productive at work or at school when your obsessive thoughts and the anxiety that go with them are impossible to put aside.

Physical Difficulties

Certain types of compulsive behaviors can cause physical difficulties.  This is especially true for people who have compulsions toward cleaning or washing behaviors.  Taking many showers in a day or constantly scrubbing your skin can lead to skin irritation, delayed healing, and excessive skin dryness.  It can also lead to skin disorders such as contact dermatitis from soap and other cleansers.  Some of these items can lead to permanent scarring.


Most people who suffer from OCD have experienced shame or humiliation in relation to their OCD.  The reactions of others can be harmful and degrading to anyone who has experienced snickering, whispers, or outright discrimination because of their obsessive and compulsive tendencies.  This shame can go straight to the heart of an OCD sufferer leading to feelings of despair and worthlessness.


The shameful feelings and distressing treatment that an OCD sufferer often experiences can lead to depression.  Living all day every day with such a challenging and exhausting condition can cause you to lose hope.  Life can be extremely difficult for people with OCD, and this makes them more inclined to be depressed.

The list of complications involved with OCD can look like it is impossible to overcome, but with the proper treatment, many of these complications can be relieved.  OCD treatment typically involves cognitive behavior therapy as it has proven to be one of the most effective methods of treatment available.  Cognitive behavior therapy is meant to make progress in changing maladaptive behaviors or irrational thoughts that are the basis for OCD compulsions and obsessions.  Medication is sometimes used in addition to therapy and has been very effective in some people.

It will take time and commitment for you or someone you love to be able to overcome OCD.  With proper treatment and hard work, it can be possible to handle the troubling compulsions and obsessions that are currently keeping you from the life that you would like that have and move on to the life you would like to live.

Treating OCD in Boca Raton

In treating OCD in Boca Raton it is important that we understand that OCD stands for “Obsessive Compulsive Disorder,” a type of anxiety disorder that can be incredibly disturbing to people’s functioning.  In treating OCD in Boca Raton keep in mind that the ‘Obsessive’ component refers to unwanted and intrusive thoughts that come repeatedly despite the fact that the individual is disturbed by their presence.  Obsessive thoughts can take many forms including fears that one has not adequately washed their hands, have not sufficiently turned off appliances or locked doors.  In addition, in treating OCD in Boca Raton we discover that many people have intrusive and repetitive thoughts of sacrilegious content, harming others, or engaging in inappropriate sexual acts. Read more

Different Types Of Tics And How To Treat Them

We are often asked about different types of tics and how to treat them.   Not “Tick” the bug that bites you while walking through wooded areas, but rather “tic” which is a sudden, repetitive, non-rhythmic motor movement or vocalization involving a specific muscle or a group of muscles.  The biggest question we get regarding different types of tics and how to treat them is “Do we see people with Tourette’s syndrome and is that really bad compared to simple motor or vocal tics?”   The answer to the first part is simple.  Yes we specialize in treating many individuals with Tic disorders, including Tourette’s.  As for the second part of the question the answer is: it depends.  To better understand different types of tics and how to treat them it is important to define what are the different kinds of tics.

In general when considering when it comes to different types of tics and how to treat them, there are two kinds of tics.  Motor Tics or Vocal Tics and these can occur alone or in combination with each other.  Additionally, they can be simple or complex and thus we end up with Simple Vocal Tics, Simple Motor Tics, Complex Vocal Tics and Complex Motor Tics.  Next we look at how often these tics occur. Transient Tics disappear within a year, but Chronic Tics can last for a year or more.  When we put all this information together we end up with these basic categories of tics: Transient Tic Disorder, Chronic Motor or Vocal Tic Disorder, and Tourette’s Syndrome or Tourette’s disorder.

In considering different types of tics and how to treat them, now that we know about different kinds of tics we ask the next question:  How frequent are the tics and how severe are they?  With regard to different types of tics and how to treat them, it is important to keep in mind that an individual could be considered to have Tourette’s Syndrome if they had a mild constant sniffing sound (without having a cold or allergy, of course) and would also rub their nose to the point it would become red and irritated.   This is so subtle that most people would think nothing of this.  Let’s contrast this to someone who would make sudden high-pitched squealing sounds, every few seconds.  This person could be heard far away and the sounds would be very penetrating, disturbing and distractible to all those around the person.  They could even be subjected to ridicule, or even punished by a teacher, as happened to one of my child patients whose teacher thought he was doing it on purpose to distract the class.  This is a Chronic Vocal Tic Disorder.  So when it comes to different types of tics and how to treat them, clearly the person with Tourette’s in the example above may go unnoticed or be thought as having a chronic cold or allergies and thus receive no treatment.  However, when it comes to different types of tics and how to treat them we would definitely want to help the child with the Chronic Vocal Tic Disorder.  So, in essence, when it comes to different types of tics and how to treat them we treat for the comfort of the patient and that depends on how bad the tics impact their life.  In considering different types of tics and how to treat them, the names we use to define the tics are merely classifications, not necessarily suggestive of the severity and discomfort they cause.

So when it comes to different types of tics and how to treat them, how do we treat these tics?  When thinking of different types of tics and how to treat them the treatment of tics is a delicate balance and requires correct identification, not only of the presence of these tics, but any coexisting problems that can make them worse.  Keep in mind that with different types of tics and how to treat them, people with tics may also have ADHD, Obsessive Compulsive Disorder, Anxiety, Bipolar Disorder, and the list goes on.  With regards to different types of tics and how to treat them, all of these coexisting problems must be addressed when it comes to different types of tics and how to treat them. The reason is that each one of these, or their treatment can have an effect on tics.  For instance when it comes to different types of tics and how to treat them, ADHD medications may make tics worse, but the anxiety and stress of untreated ADHD can also lead to Anxiety that also makes tics worse.  When it comes to different types of tics and how to treat them people with tics, may have obsessive behaviors, which affect the tics and may co-occur with them.  The medications for OCD or Anxiety (antidepressants called SSRI’s, for instance) could result in improvement of tics, albeit indirectly.  However, depending on the individual, some may make them worse.

So with regard to different types of tics and how to treat them, once tics and any co-occurring problems are correctly identified we can begin treatment.  This is far from a cookie-cutter approach and requires a mix of therapy and very likely medications.  The final goal in different types of tics and how to treat them is to create an internal state of relaxation and calmness right down to the involuntary nervous system itself. With different types of tics and how to treat them, this is done in therapy by addressing any personal or environmental triggers that create stress and thereby amplify tics.  With different types of tics and how to treat them, medications are used that “tone down” the nervous system so that the individual goes from a revved up state of “flight or fight” to a calm and relaxed state.  In essence, imagine constantly feeling as if you were running for your life versus the relaxed state of lying on a quiet beach with the waves gently lapping on the shore.  An individual with tic disorders that feels the first way will be having a lot of tics, but if that individual feels the second way there would be minimal if any noticeable tics.  To achieve the ideal relaxed state could involve, personal therapy, relaxation and stress management, family therapy, etc.  Medications include those that are also used to treat high blood pressure, which can result from what is called an “increase sympathetic tone”.  By lowering this “sympathetic tone” the tics can be minimized or eliminated all together.  Sometimes this isn’t enough and other medications called Neuroleptics are used.  These medications act at the level of the brain to decrease tics in the body.

In conclusion, when we think of different types of tics and how to treat them it comes down a careful combination of science and art for different types of tics and how to treat them.  For different types of tics and how to treat them, it first involves correctly identifying what is going on in the specific and unique individual you have in front of you.  Then when it comes to different types of tics and how to treat them we tailor make a treatment that helps him or her get past the stranglehold the tics have on their life.  No two persons are the same so their treatment won’t be either, but rest assured that with persistence and perseverance we would work to provide you significant relief from tics.

Obsessive-Compulsive Disorder

What is OCD? 

Obsessive-Compulsive Disorder (OCD), a type of anxiety disorder, is a potentially disabling illness that traps people in endless cycles of repetitive thoughts and behaviors. Obsessive-Compulsive Disorder is characterized by recurrent intense obsessions and/or compulsions that cause severe discomfort and interfere with day-to-day functioning. Obsessions are recurrent and persistent thoughts, impulses, or images that are unwanted and cause marked anxiety or distress. Compulsions are repetitive behaviors or rituals (like hand washing, hoarding, keeping things in order, checking things over and over, asking questions over and over again, etc.) or mental acts (like counting, or repeating words silently). Performing such rituals is not pleasurable. At best, it produces temporary relief from the anxiety created by obsessive thoughts. Most people who have Obsessive-Compulsive Disorder are aware that their obsessions and compulsions are irrational, yet they feel powerless to stop them. These can interfere with a person’s normal routine, schoolwork, job, family, or social activities. Several hours every day may be spent focusing on obsessive thoughts and performing seemingly senseless rituals. Children can suffer from Obsessive-Compulsive Disorder as well. Unlike adults, however, children with Obsessive-Compulsive Disorder do not realize that their obsessions and compulsions are excessive.

What are some of the symptoms of OCD? 

Obsessive symptoms may include:

• Fear of dirt or contamination by germs

• Fear of causing harm to another

• Fear of making a mistake

• Excessive doubt and the need for constant reassurance

• Fear of being embarrassed or behaving in a socially unacceptable manner

• Fear of thinking evil or sinful thoughts

• The need for order, symmetry or exactness.

Compulsive symptoms may include:

• Repeatedly bathing, showering or washing hands

• Refusing to shake hands or touch doorknobs

• Repeatedly checking things, such as locks or stoves

• Constantly counting, mentally or aloud

• Constantly arranging things in a certain way

• Eating foods in a specific order

• Repeating specific words, phrases, or prayers

• Needing to perform tasks a certain number of times

• Collecting or hoarding items with no apparent value.

If people are obsessed with germs or dirt, they may develop a compulsion to wash their hands over and over again. If they develop an obsession with intruders, they may lock and relock their doors many times before going to bed (children may insist on sleeping with their parents, even between them for extra protection). People with Obsessive-Compulsive Disorder may also be preoccupied with order and symmetry, have difficulty throwing things out, so they accumulate, or hoard, unneeded items. Healthy people also have rituals, such as checking to see if the stove is off several times before leaving the house. The difference is that people with Obsessive-Compulsive Disorder perform their rituals even though doing so interferes with daily life and they find the repetition distressing. Symptoms may come and go, ease over time, or get worse. If Obsessive-Compulsive Disorder becomes severe, it can keep a person from working or carrying out normal responsibilities at home. People with Obsessive-Compulsive Disorder may try to help themselves by avoiding situations that trigger their obsessions, or they may use alcohol or drugs to calm themselves. If Obsessive-Compulsive Disorder is left untreated, it may start to interfere with all aspects of life.

What Causes OCD? 

Studies have shown that a combination of biological and environmental factors may be involved. The brain is a very complex structure. It contains billions of nerve cells, called neurons, that must communicate and work together for the body to function normally. The neurons communicate via electrical signals. Special chemicals, called neurotransmitters, help move these electrical messages from neuron to neuron. Research has found a link between low levels of one neurotransmitter, called serotonin, and the development of Obsessive-Compulsive Disorder.  In addition, there is evidence that a serotonin imbalance may be passed on from parents to children. This means the tendency to develop Obsessive-Compulsive Disorder may be inherited, although this doesn’t mean the child will definitely develop symptoms if a parent has the disorder. A child may also develop Obsessive-Compulsive Disorder with no previous family history. There are environmental stressors that can trigger Obsessive-Compulsive Disorder in people such as: abuse, changes in living situation, illness, death of a loved one, work- or school-related changes or problems, and also relationship concerns.  Additionally, some studies also have found a link between a certain type of infection caused by the Streptococcus bacteria and Obsessive-Compulsive Disorder. This infection, if recurrent and untreated, may lead to the development of Obsessive-Compulsive Disorder and other disorders in children or adults.

How Common Is OCD? 

Obsessive-Compulsive Disorder affects about 2.2 million American adults and about 1 million American children. This problem can be accompanied by eating disorders, other anxiety disorders, or depression. It strikes men and women in roughly equal numbers and usually appears in childhood, adolescence, or early adulthood. One-third of adults with Obsessive-Compulsive Disorder developed symptoms as children.

How Is OCD Treated? 

Seeking help from a psychiatrist (or in children a child and adolescent psychiatrist) is important both to better understand the complex issues created by Obsessive-Compulsive Disorder as well as to get help. Most individuals with Obsessive-Compulsive Disorder can be treated effectively with a combination of psychotherapy (cognitive behavior therapy) and certain medications.  These include: Tricyclic antidepressants (i.e. Anafranil), and selective serotonin reuptake inhibitor (SSRI) antidepressants, such as Celexa, Lexapro, Paxil, Prozac and Zoloft. Obsessive-Compulsive Disorder usually responds well to treatment with medications and/or exposure- based psychotherapy.

Exposure-based psychotherapy is when people are faced with situations that cause fear or anxiety and causes them to become less sensitive (desensitized) to them. The goal of these cognitive behavior therapies are to teach people with OCD to confront their fears and reduce anxiety without performing the ritual behaviors. Therapy also focuses on reducing the exaggerated or catastrophic thinking that often occurs in people with Obsessive-Compulsive Disorder. Family support and education are also central to the success of treatment. Antibiotic therapy may be useful in cases where Obsessive-Compulsive Disorder is linked to streptococcal infection.  In very severe cases of Obsessive-Compulsive Disorder and in people who do not respond to medical and behavioral therapy, electroconvulsive therapy (ECT) or psychosurgery may be used to treat Obsessive-Compulsive Disorder.  During ECT, electrodes are attached to the patient’s head, and a series of electric shocks are delivered to the brain, which induce seizures. The seizures then cause the release of neurotransmitters in the brain. Obsessive-Compulsive Disorder will not go away by itself, so it is important to seek some kind of treatment.

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