Obsessive-Compulsive Disorder - OCD

By: Tina Shahian, PhD

Last Updated: Mar 1, 2019

Overview

Obsessive-compulsive disorder (OCD) is a mental illness characterized by recurring unwanted thoughts (obsessions) that produce fear and anxiety. These obsessions trigger repetitive behaviors (compulsions) performed in an attempt to control the obsessions and relieve anxiety.

Typical obsessions include excessive fear of germs or suffering harm. Common compulsions are excessive cleansing and repeatedly checking the same thing over and over.

OCD equally affects males and females. Typically, the disorder starts in childhood, adolescence, or young adulthood. Untreated OCD causes disruptive chronic symptoms, which persist for years. However, proper treatment can be very effective in alleviating this condition.

Causes

The cause of OCD is unknown. Research suggests that the disorder involves some sort of abnormality in the parts of the brain that control fear and anxiety. OCD runs in certain families, supporting the possibility of a genetic component in this condition. Environmental factors, stress, or infections may also play a role in triggering this disease.

Symptoms

The most common symptom of OCD is anxiety. Individuals with OCD spend a tremendous amount of time engaged in fearful thoughts and behaviors that interfere with their ability to function at work or school. Overwhelming anxiety and abnormal behaviors eventually harm close personal relationships.

Obsessions

In OCD, a person is plagued by intrusive thoughts, which cause worry, anxiety, and fear. These thoughts will not go away and cannot be controlled.

Obsessions associated with OCD include the following:

• Fear of germs, dirt, or infections
• Fear of illness
• Fear of harm to oneself or loved ones
• Driving need for perfection
• Fear of a terrible consequence occurring when some task is left undone
• Recurring thoughts of violence or disturbing sexual acts
• Religious anxieties.

Compulsions

In response to an obsession, a person with OCD is driven to perform certain rituals or repetitive behaviors to guard against a feared situation. Such behaviors are an attempt to briefly dispel anxiety. Most people with OCD find their rituals distressing, senseless, and futile. Nevertheless, they feel unable to stop the behaviors.

Typical compulsions include the following:

• Repeated hand washing
• Repeatedly arranging objects to maintain perfect order
• Demonstrating excessive tidiness
• Checking things over and over
• Counting items repeatedly
• Locking and unlocking doors again and again
• Hoarding
• Praying to prevent a feared situation.

Diagnosis and Treatment

The diagnosis of OCD is generally based on the presence of classic symptoms and behaviors. Although OCD is a mental illness, the evaluation should include a complete physical examination to rule out medical conditions that affect mental capacities.

The goal of treatment is to reduce anxiety and improve a person’s functioning in daily life. Effective treatment for OCD requires a considerable amount of time and cooperation on the part of the patient.

Treatment for OCD

• Cognitive-behavioral therapy. Exposure and response prevention is a specific type of cognitive-behavioral therapy used to treat OCD. A person is slowly exposed to the very conditions that trigger fear, anxiety, and compulsive behavior. In a series of treatment sessions, the exposure is repeated until the person develops a new way of thinking and can experience a situation without feeling anxious. For example, individuals who fear germs are instructed to touch items that they consider dirty and not wash their hands. With repeated exposure, the fears gradually decrease to the point that they can touch the objects without becoming anxious.
• Medications. Medications are often used in combination with cognitive behavior therapy. Antidepressant medications, particularly selective serotonin reuptake inhibitors (SSRIs), are commonly used to treat OCD. Prozac® and Zoloft® are examples of SSRI medications. In certain cases, anti-anxiety medication may also be prescribed.

Prevention

There are no known methods to prevent OCD. Early treatment is recommended to control the disorder and prevent worsening symptoms.

Sources

• Obsessive-Compulsive Disorder (OCD). National Institute of Mental Health website. http://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml. Accessed March 31, 2015.
• Obsessive compulsive disorder. American Psychiatric Association website. http://www.psychiatry.org/obsessive-compulsive-disorder. Accessed March 31, 2015.
• Obsessive-Compulsive Disorder. Department of Psychiatry University of Michigan Health System website. http://www.psych.med.umich.edu/mental_health/obsessive-compulsive_disorder.asp. Accessed March 31, 2015.
• Obsessive-compulsive disorder (OCD). Mayo Clinic website. http://www.mayoclinic.org/diseases-conditions/ocd/basics/prevention/con-20027827. Accessed March 31, 2015.