How is OCD Cleaning-Related?
In some people with OCD, cleaning obsessively is the main symptom. They have obsessions (the "O" of "OCD") about contamination, and they believe that they need to wash themselves whenever they touch something that may have been contaminated, such as a doorknob or someone else's hand. People who have contamination obsessions may wash their hands constantly until their hands are raw and bleeding, or they may bathe excessively, especially after using the facilities. Dermatologists often pick up on this type of OCD first due to the chapped skin or other skin problems that excessive washing can cause.
If a person has this contamination-related form of OCD, they can slowly regain control of the disorder by going through Cognitive Behavioral Therapy (CBT). This therapeutic technique is based on the concept that people can control their thoughts, and thereby control their actions. You will need to find a therapist who is trained in CBT techniques to provide this therapy, and progressing through the stages of the therapy can take several months or longer, depending on the severity of the OCD symptoms.
The actual process of Cognitive Behavioral Therapy differs from person to person, based on the main OCD symptoms that they have, especially with regards to washing themselves. For example, if a person obsesses about the contamination on doorknobs, and therefore refuses to touch one and compulsively washes his hands each time he does, the therapist might choose to focus on this first. The person with OCD would first begin to discuss his feelings, including his thoughts about where they may stem from, and he might even keep a journal on the topic. The therapist would then slowly coach him through touching a doorknob for a split second, dissecting his reaction, and discussing the reaction from a logical point of view. The person with OCD would not be given the chance to wash his hands after touching the doorknob, which will at first increase his obsessions, but would gradually come to reduce his anxiety when he sees that nothing actually happens to him. With time, the therapist would encourage him to touch the doorknob for longer and longer periods of time until the anxiety disappears completely. This process would continue for each of the person's major obsessions and compulsions, until he would be able to deal with each of them with a minimal amount of anxiety.
For people with contamination-related OCD who do not respond to therapy, medication may be warranted. Medication may also be used as a prelude to therapy, in order to ease an anxious person into therapy. There are two main types of medication that are shown to help this condition: SSRIs (selective serotonin reuptake inhibitors) and TCAs (tricyclic antidepressants). SSRIs are usually the preferred choice for most anxiety disorders, including this type of OCD, especially because they are relatively safe. SSRIs are based on the theory that people with OCD have lower levels of serotonin, a neurotransmitter that affects mood and behavior. SSRIs prevent reabsorption of serotonin, leaving more of it available in the brain. Once you use medication to treat OCD rituals, cleaning obsessions and compulsions will hopefully be a thing of the past.