OCD

OBSESSIVE COMPULSIVE DISORDER

Obsessive-compulsive disorder (OCD) features a pattern of unwanted thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). These obsessions and compulsions interfere with daily activities and cause significant distress. They are perceived by the patient as nonsensical (unlike delusion beliefs)

You may try to ignore or stop your obsessions, but that only increases your distress and anxiety. Ultimately, you feel driven to perform compulsive acts to try to ease your stress. Despite efforts to ignore or get rid of bothersome thoughts or urges, they keep coming back. This leads to more ritualistic behavior — the vicious cycle of OCD.

OCD often centers around certain themes — for example, an excessive fear of getting contaminated by germs. To ease your contamination fears, you may compulsively wash your hands until they’re sore and chapped.

Cause of obsessive-compulsive disorder

The cause of obsessive-compulsive disorder isn't fully understood. Main theories include:

Biology

OCD may be a result of changes in your body's own natural chemistry or brain functions.

Genetics

OCD may have a genetic component, but specific genes have yet to be identified.

Learning

Obsessive fears and compulsive behaviors can be learned from watching family members or gradually learned over time.

Risk Factors

Factors that may increase the risk of developing or triggering obsessive-compulsive disorder include:

Family history.

Having parents or other family members with the disorder can increase your risk of developing OCD.

Stressful life events

If you've experienced traumatic or stressful events, your risk may increase. This reaction may, for some reason, trigger the intrusive thoughts, rituals and emotional distress characteristic of OCD.

Other mental health disorders

OCD may be related to other mental health disorders, such as anxiety disorders, depression, substance abuse or tic disorders.

Complications

Problems resulting from obsessive-compulsive disorder may include, among others:

Excessive time spent engaging in ritualistic behaviors
Health issues, such as contact dermatitis from frequent hand-washing
Difficulty attending work, school or social activities
Troubled relationships
Overall poor quality of life
Suicidal thoughts and behavior

Signs And Symptoms

Obsession symptoms

OCD obsessions are repeated, persistent and unwanted thoughts, urges or images that are intrusive and cause distress or anxiety Obsessions often have themes to them, such as:

Fear of contamination or dirt
Doubting and having difficulty tolerating uncertainty
Needing things orderly and symmetrical
Aggressive or horrific thoughts about losing control and harming yourself or others
Unwanted thoughts, including aggression, or sexual or religious subjects

Examples of obsession signs and symptoms include:

Fear of being contaminated by touching objects others have touched
Doubts that you’ve locked the door or turned off the stove
Intense stress when objects aren’t orderly or facing a certain way
Images of driving your car into a crowd of people
Thoughts about shouting obscenities or acting inappropriately in public
Unpleasant sexual images
Avoidance of situations that can trigger obsessions, such as shaking hands

Compulsion symptoms

OCD compulsions are repetitive behaviors that you feel driven to perform. These repetitive behaviors or mental acts are meant to reduce anxiety related to your obsessions or prevent something bad from happening. However, engaging in the compulsions brings no pleasure and may offer only a temporary relief from anxiety.

You may make up rules or rituals to follow that help control your anxiety when you’re having obsessive thoughts. These compulsions are excessive and often are not realistically related to the problem they’re intended to fix.

As with obsessions, compulsions typically have themes, such as:

Washing and cleaning
Checking
Counting
Orderliness
Following a strict routine
Demanding reassurance

Examples of compulsion signs and symptoms include:

Hand-washing until your skin becomes raw
Checking doors repeatedly to make sure they’re locked
Checking the stove repeatedly to make sure it’s off
Counting in certain patterns
Silently repeating a prayer, word or phrase
Arranging your canned goods to face the same way

Treatment

The most effective treatments for OCD are Cognitive Behavior Therapy (CBT) and/or medication. More specifically, the most effective treatments are a type of CBT called Exposure and Response Prevention (ERP), which has the strongest evidence supporting its use in the treatment of OCD, and/or a class of medications called serotonin reuptake inhibitors, or SRIs.

Taken together, ERP and medication are considered the “first-line” treatments for OCD.

Severity varies

OCD usually begins in the teen or young adult years, but it can start in childhood. Symptoms usually begin gradually and tend to vary in severity throughout life. The types of obsessions and compulsions you experience can also change over time. Symptoms generally worsen when you experience greater stress. OCD, usually considered a lifelong disorder, can have mild to moderate symptoms or be so severe and time-consuming that it becomes disabling.

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OCD