Obsessive-compulsive disorder, or OCD, is an anxiety disorder in which someone has repeated, unwanted thoughts or ideas (obsessions) and feels the need to perform actions and rituals (compulsions) to cope with the anxiety produced by those thoughts. While everyone double-checks things once in a while, such as making sure they turned off the stove or locked the front door, someone with OCD is consumed by the need to check things or do simple actions over and over to the point where these thoughts and rituals are distressing and interfere with daily living.
While each person with OCD has his or her own individual obsessions and compulsions, there are some common symptoms. These include:
- Repeated thoughts about different things, such as a fear of germs and dirt; being excessively neat; fear that something will happen to loved ones; harming loved ones; violent or sexual acts; things that conflict with one’s religious beliefs
- Doing the same things over and over. Common rituals include washing hands, turning lights on and off; locking and unlocking doors; counting; tapping an object a certain number of times; and excessive hoarding.
- Inability to control these thoughts and behaviors
Someone with OCD does not get any pleasure from performing the rituals, which merely supply temporary relief from the anxiety caused by the obsessive thoughts. He or she may spend one hour or more every day on these thoughts and rituals. The person often realizes that his or her behavior is not normal and doesn’t make any sense, and this can in turn cause more distress. People with OCD simply can’t control their thoughts and actions. It is the thoughts and actions that control them.
Typically, OCD emerges before the age of 30, often in childhood or adolescence. Most people are diagnosed with the disorder by around the age of 19. About a third of adults with OCD report having had symptoms when they were children. It’s estimated that 2.2 million adults in America have OCD; men and women are more or less equally affected.
It’s not entirely clear what causes obsessive-compulsive disorder. It does tend to run in some families, so there seems to be a significant genetic factor. Other factors could include abnormal functioning in parts of the brain that deal with fear and anxiety.
Symptoms of OCD can fluctuate in frequency and intensity over time, so that some days or weeks may be better than others. When the symptoms become severe, they can prevent someone from carrying out their normal obligations at work or home. For example, a person with OCD may avoid certain everyday situations that trigger obsessive thoughts or compulsive behaviors.
If you exhibit any of the above symptoms to the point where they are interfering with your normal activities, you should consult a doctor, who can do a physical examination to rule out any physical causes for your behavior. Describing the nature of your thoughts and rituals to a mental health professional is also a key step toward determining whether you have OCD. A psychiatrist can perform a mental health evaluation to see if there are any other disorders that may be causing your symptoms. It is not unusual for OCD to be accompanied by another psychological condition such as another type of anxiety disorder, depression, or an eating disorder.
OCD is usually treated with medication, psychotherapy, or a combination of the two. The exact treatment will be different for each person based on the nature and severity of the symptoms. Cognitive-behavioral therapy (CBT) and behavioral therapy are two methods that have been found to be especially effective for dealing with the disorder. They teach you different ways of thinking and behaving in reaction to situations that normally trigger obsessive-compulsive symptoms. One of the most effective of these therapies is known as “exposure and response prevention” (also “exposure and ritual prevention”), or ERP. This involves being exposed again and again to a situation that provokes obsessive thoughts and then gradually learning to tolerate the anxiety without performing the ritual.
There are also several types of medications that can help control the symptoms of OCD, including anti-anxiety medications, mood stabilizers, and antidepressants such as SSRIs. Some people only need medication to see improvement in their symptoms, while others respond better to cognitive-behavioral therapy. Still other patients need both. In general, a combination of the two treatment methods is often more effective than either method alone.
As with all mental disorders, however, your psychiatrist will work with you to determine the exact type of treatment that works best for your particular situation. OCD is a chronic condition. Symptoms can come and go, but they rarely disappear completely. Fortunately, though, most people improve once they are diagnosed and properly treated. It is possible to lead a normal life once your OCD symptoms are under control.