Obsessive Compulsive Disorder (OCD)

Obsessive compulsive disorder (OCD) is a common anxiety disorder. It causes unreasonable thoughts, fears, or worries. A person with OCD tries to manage these thoughts through rituals.

Frequent disturbing thoughts or images are called obsessions. They are irrational and can cause great anxiety. Reasoning doesn’t help control the thoughts. Rituals or compulsions are actions that help stop or ease the obsessive thoughts.

Experts aren’t sure of the exact cause of OCD. Genetics, brain abnormalities, and the environment are thought to play a role. It often starts in the teens or early adulthood. But it can also start in childhood. OCD affects men and women equally. It appears to run in families.

Other anxiety problems, depression, eating disorders, or substance abuse may happen with OCD.

Obsessions are unfounded thoughts, fears, or worries. They happen often and cause great anxiety. Reasoning does not help control the obsessions. Common obsessions are:

• A strong fixation with dirt or germs.

• Repeated doubts (for example, about having turned off the stove).

• A need to have things in a very specific order.

• Thoughts about violence or hurting someone.

• Spending long periods of time touching things or counting.

• Fixation with order or symmetry.

• Persistent thoughts of awful sex acts.

• Troubled by thoughts that are against personal religious beliefs.

You may know that the thoughts are unreasonable and not due to real-life problems. But it’s not enough to make the unwanted thoughts go away.

Compulsions are repetitive, ritualized acts. They are meant to reduce anxiety caused by the obsession. Examples are:

• Repeated hand-washing (often 100+ times a day).

• Checking and rechecking to make sure that a door is locked or that the oven is turned off.

• Following extremely rigid rules of order, such as putting on clothes in the same order each day, or alphabetizing the spices, and getting upset if the order becomes disrupted.

Compulsive acts can become excessive, disruptive, and time-consuming. They may interfere with daily life and relationships.

People may stay away from situations where they might have to face their obsessions. Some try alcohol or drugs to calm themselves.

OCD is diagnosed during a physical and psychiatric exam when obsessions and compulsions:     

• Take up at least one hour each day.

• Are distressing.

• Interfere with daily life.

Always see your healthcare provider for a diagnosis.

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment may include:

• Cognitive-behavioral therapy - This type of therapy can help you change unwanted thought patterns. You’ll also learn to control compulsive actions. Working with your therapist, you’ll confront your unwanted thoughts and fears, one step at a time. For most people with OCD, cognitive-behavioral therapy is the first treatment option.

• Family therapy - OCD may also affect your loved ones. They may be confused or angered by your symptoms. Often, they may want to help but don’t know what to do. A family therapist can help them learn more about OCD. They may also find comfort in an OCD support group.

Medicine - Medicines that treat depression may also help control the symptoms of OCD. These medicines don’t cure the disorder, but they can provide some relief. It may take at least 3 weeks for them to work. Once you feel better, don’t stop taking them on your own. If you do, your symptoms will likely come back. Also, keep in mind that most medicines can have side effects. If you’re troubled by side effects, tell your doctor. Changing the dose or type of medicine may help.