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Obsessive Compulsive Disorder (OCD) is experienced through a combination of cognitive obsessions, along with either behavioral or cognitive compulsions to carry out specific actions. With OCD, obsessions and compulsions are related. Compulsions are carried out in an attempt to prevent, reduce, or neutralize the discomfort or anxiety caused by the obsessions. Obsessions take the form of unwanted or disturbing thoughts, images, or urges, such as a fear of hurting others, contamination, or troubling religious or sexual thoughts. Compulsions of a behavioral nature may take the form of hand washing, checking or cleaning. Those of a cognitive nature may take the form of counting, praying, or other mental repetition. Often, people are occupied by intrusive obsessions and compulsions for a considerable amount of time. However, they may be able to maintain work or school responsibilities. Over time, resistance to such symptoms may weaken. Time-consuming rituals may make it increasingly difficult to maintain relationships, work or school responsibilities, fundamental health needs, and even financial stability.
There has been less academic research on anxiety disorders than depression. Therefore, structured assessment tools such as questionnaires are less sophisticated and well-developed than in the field of depression. Some simple questionnaires are available online, which can help you determine if you might have an anxiety disorder. Doctors use operationally defined criteria such as those in ICD-10. Anxiety disorders are usually diagnosed by a doctor or psychiatrist after a review of the patient’s symptoms and a general health assessment.
Occasionally, physical causes can be found, such as hyperthyroidism. Commonly, symptoms occur with no clear concurrent medical illness. For patients where a physical cause is suspected, or where the condition does not respond to treatment, blood tests, urine tests, and occasionally brain imaging are necessary.
Anxiety treatment can be divided into three broad areas: biological treatment, psychological treatment, and social or lifestyle interventions.
Biological treatment refers mainly to psychiatric medication, such as antidepressants that are used to treat anxiety disorders. There are a wide range of effective medications with different side effects that can be chosen. Psychological treatment includes familiar approaches such as counseling and psychotherapy. New evidence-based therapies such as cognitive behavioral therapy and relaxation techniques are also an option. Social or lifestyle interventions refer to strategies such as exercise programs, breathing exercises, meditation, healthy eating, addressing lifestyle factors, such as alcohol use, and social issues, such as employment problems, career stress, and financial debt.
About one third of people with an anxiety disorder also have a mood disorder such as depression. It is important that your treating doctor checks to see if you are also depressed. This is important when considering your treatment options.
If you are suffering from symptoms of anxiety, the following tips can be helpful coping skills during periods of distress:
If you are struggling to manage anxiety, you should seek assessment from a doctor or our psychologist and discuss what treatment might be helpful for you. We would be more than happy to help you.
Psychiatric Service: Come see us at our Tokyo-based psychiatry clinic at American Clinic Tokyo in Akasaka for assessment. Dr Andrew Kissane, our UK-trained, British psychiatrist is a native English speaker. He is on the General Medical Council’s specialist medical register in the UK, a member of the Royal College of Psychiatrists, and holds a Japanese medical license.
Counseling or Psychology Service: If you do not wish to take a medical approach to your anxiety, but instead prefer to explore a psychological approach such as cognitive behavioral therapy, breathing exercises, stress management, counseling or behavioral interventions, please use our online enquiry form to request a psychological assessment or counseling appointment. Alternatively, you can email us with your questions at [email protected]