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.
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. The repetitive thoughts often center 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.
What are the symptoms of OCD?
Obsessive-compulsive disorder usually includes both obsessions and compulsions. But it's also possible to have only obsession symptoms or only compulsion symptoms. You may or may not realize that your obsessions and compulsions are excessive or unreasonable, but they take up a great deal of time and interfere with your daily routine and social, school or work functioning.
Obsession symptoms are repeated, persistent and unwanted thoughts, urges or images that are intrusive and cause distress or anxiety. You might try to ignore them or get rid of them by performing a compulsive behavior or ritual. These obsessions typically intrude when you're trying to think of or do other things. 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
Compulsion symptoms 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.
Are there any risk factors for OCD?
Factors that may increase the risk of developing or triggering OCD include:
- Family history. Having family members with the disorder can- increase your risk.
- 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 such as anxiety, depression, substance abuse or tic disorders.
Is there treatment for OCD?
OCD is typically treated with medication, psychotherapy, or a combination of the two.
Medication. Selective serotonin reuptake inhibitors (SSRIs) are used to help reduce OCD symptoms. SSRIs often require higher daily doses in the treatment of OCD than of depression and may take 8 to 12 weeks to start working, but some patients experience more rapid improvement. Sometimes, antipsychotic medication may help manage symptoms as well.
Psychotherapy can be an effective treatment for adults and children with OCD. Research shows that certain types of psychotherapy, including cognitive behavior therapy (CBT) and other related therapies (e.g., habit reversal training) can be as effective as medication for many individuals. Research also shows that a type of CBT called Exposure and Response Prevention (EX/RP), spending time in the very situation that triggers compulsions (e.g. touching dirty objects) but then being prevented from undertaking the usual resulting compulsion (e.g. handwashing, is effective in reducing compulsive behaviors in OCD, even in people who did not respond well to SRI medication.
When to see a doctor?
There's a difference between being a perfectionist ie someone who requires flawless results or performance, for example, and having OCD. OCD thoughts aren't simply excessive worries about real problems in your life or liking to have things clean or arranged in a specific way. If your obsessions and compulsions are affecting your quality of life, see your doctor or mental health professional.
References
NIMH » Obsessive-Compulsive Disorder (nih.gov)
Obsessive-compulsive disorder (OCD) - Symptoms and causes - Mayo Clinic