Anxiety – OCD

Symptoms

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines specific criteria to help diagnose generalized anxiety disorder.

Criteria for Diagnosing GAD

• The presence of excessive anxiety and worry about a variety of topics, events, or activities. Worry occurs more often than not for at least 6 months and is clearly excessive.
• The worry is experienced as very challenging to control. The worry in both adults and children may easily shift from one topic to another.
• The anxiety and worry are accompanied with at least three of the following physical or cognitive symptoms (In children, only one symptom is necessary for a diagnosis of GAD:
• Edginess or restlessness
• Tiring easily; more fatigued than usual
• Impaired concentration or feeling as though the mind goes blank
• Irritability (which may or may not be observable to others)
• Increased muscle aches or soreness
• Difficulty sleeping (due to trouble falling asleep or staying asleep, restlessness at night, or unsatisfying sleep)

Excessive worry means worrying even when there is no specific threat present or in a manner that is disproportionate to the actual risk. Someone struggling with GAD experiences a high percentage of their waking hours worrying about something.

The worry may be accompanied by reassurance-seeking from others. In adults, the worry can be about job responsibilities or performance, one’s own health or the health of family members, financial matters, and other every day, typical life circumstances. In children, the worry is more likely to be about their abilities or the quality of their performance (for example, in school).

Many individuals with GAD also experience symptoms such as sweating, nausea, or diarrhea.

• The anxiety, worry, or associated symptoms make it hard to carry out day-to-day activities and responsibilities. They may cause problems in relationships, at work, or in other important areas.
• These symptoms are unrelated to any other medical conditions and cannot be explained by the effect of substances including a prescription medication, alcohol, or recreational drugs.

Source: DSM-5

Other physiological symptoms of anxiety may include:

• Neurological, as headache, paresthesias, fasciculations, vertigo, or presyncope.
• Digestive, as abdominal pain, nausea, diarrhea, indigestion, dry mouth, or bolus.
• Respiratory, as shortness of breath or sighing breathing.
• Cardiac, as palpitations, tachycardia, or chest pain.
• Muscular, as fatigue, tremors, or tetany.
• Cutaneous, as perspiration, or itchy skin.
• Uro-genital, as frequent urination, urinary urgency, dyspareunia, or impotence, chronic pelvic pain syndrome. Stress hormones released in an anxious state have an impact on bowel function and can manifest physical symptoms that may contribute to or exacerbate IBS.

Source: Wikipedia

Obsessive-Compulsive Disorder

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association and provides clinicians with official definitions of, and criteria for, diagnosing mental disorders.

What Is Obsessive-Compulsive Disorder?

Obsessive-compulsive disorder (OCD) is an anxiety disorder in which time people have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do something repetitively (compulsions). The repetitive behaviors, such as hand washing, checking on things or cleaning, can significantly interfere with a person’s daily activities and social interactions.

Many people have focused thoughts or repeated behaviors. But these do not disrupt daily life and may add structure or make tasks easier. For people with OCD, thoughts are persistent and unwanted routines and behaviors are rigid and not doing them causes great distress. Many people with OCD know or suspect their obsessions are not true; others may think they could be true (known as poor insight). Even if they know their obsessions are not true, people with OCD have a hard time keeping their focus off the obsessions or stopping the compulsive actions.

A diagnosis of OCD requires the presence of obsession and/or compulsions that are time-consuming (more than one hour a day), cause major distress, and impair work, social or other important function.

Obsessions

Obsessions are recurrent and persistent thoughts, impulses, or images that cause distressing emotions such as anxiety or disgust. Many people with OCD recognize that the thoughts, impulses, or images are a product of their mind and are excessive or unreasonable. Yet these intrusive thoughts cannot be settled by logic or reasoning. Most people with OCD try to ignore or suppress such obsessions or offset them with some other thought or action. Typical obsessions include excessive concerns about contamination or harm, the need for symmetry or exactness, or forbidden sexual or religious thoughts.

Compulsions

Compulsions are repetitive behaviors or mental acts that a person feels driven to perform in response to an obsession. The behaviors are aimed at preventing or reducing distress or a feared situation. In the most severe cases, a constant repetition of rituals may fill the day, making a normal routine impossible. Compounding the anguish these rituals cause is the knowledge that the compulsions are irrational. Although the compulsion may bring some relief to the worry, the obsession returns and the cycle repeats over and over.

Some examples of compulsions:

• Cleaning to reduce the fear that germs, dirt, or chemicals will “contaminate” them some spend many hours washing themselves or cleaning their surroundings. Some people spend many hours washing themselves or cleaning their surroundings.
• Repeating to dispel anxiety. Some people utter a name or phrase or repeat a behavior several times. They know these repetitions won’t actually guard against injury but fear harm will occur if the repetitions aren’t done.
• Checking to reduce the fear of harming oneself or others by, for example, forgetting to lock the door or turn off the gas stove, some people develop checking rituals. Some people repeatedly retrace driving routes to be sure they haven’t hit anyone.
• Ordering and arranging to reduce discomfort. Some people like to put objects, such as books in a certain order, or arrange household items “just so,” or in a symmetric fashion.
• Mental compulsions to response to intrusive obsessive thoughts some people silently pray or say phrases to reduce anxiety or prevent a dreaded future event.

Source: American Psychiatric Association