What is Obsessive Compulsive Disorder?
Obsessive Compulsive Disorder (OCD) is a disorder of the brain and behavior that causes severe anxiety in those affected. People with obsessive-compulsive disorder (OCD) suffer intensely from recurrent unwanted thoughts (obsessions) or rituals (compulsions), which they feel they cannot control. They perform rituals such as hand washing, counting, checking or cleaning in hope of preventing obsessive thoughts or making them go away. Performing these rituals is not pleasurable. At best, it produces temporary relief from the anxiety created by obsessive thoughts.
Obsessions can be thoughts, images or impulses that occur repeatedly. The person does not want to have these ideas, and finds them disturbing and intrusive. On one level, he or she knows they are irrational. But on another level, he or she fears these thoughts might be true. Trying to avoid such thoughts creates great anxiety, upset and dysfunction.
The compulsions or rituals repeated by the individual to obtain relief from the discomfort brought on by the obsessions often must be performed to certain “rules.” People with OCD feel they must perform these compulsive rituals or something bad will happen to them or their loved ones.
Left untreated, obsessions and the need to perform rituals can take over a person’s life. OCD is often a chronic, relapsing illness. The course of the disease is quite varied. Symptoms may come and go, ease over time, or get worse. Severe OCD can keep a person from working or carrying out normal responsibilities at home.
How Common is OCD?
According to the International OCD Foundation, OCD affects about 2.2 million American adults. There are also at least 1 in 200 – or 500,000 – kids and teens that have OCD. The National Institute of Mental Health estimates that more than 2 percent of the U.S. population, or nearly one out of every 40 people, will be diagnosed with OCD at some point in their lives. The disorder is two to three times more common than schizophrenia and bipolar disorder. It strikes men and women in roughly equal numbers.
Signs & Symptoms
Obsessions are accompanied by uncomfortable feelings, such as fear, disgust or doubt. Common obsessions include contamination fears, imagining having harmed self or others, imagining losing control of aggressive urges, intrusive sexual thoughts or urges, excessive religious or moral doubt, or a need to tell, ask or confess.
Examples of compulsions are washing, repeating, checking, touching, counting, ordering/arranging, hoarding or saving, and praying. In some instances, a person may suffer from only obsessions or only compulsions.
OCD symptoms cause distress, take up a lot of time (more than an hour a day), or significantly interfere with the person’s work, social life or relationships. They get in the way of important activities the person values.
Most individuals with OCD recognize that their obsessions are not just excessive worries about real problems and that the compulsions they perform are excessive or unreasonable. However, some adults and most children may not realize that their behavior is out of the ordinary.
Symptoms usually appear in childhood, adolescence or early adulthood. One-third of adults with OCD develop symptoms as children, and research indicates that OCD might run in families. However, if OCD symptoms appear suddenly later in life, one’s physician should conduct a thorough medical evaluation to rule out another illness as the cause of these symptoms.
After ruling out another physical problem as the source of one’s symptoms, a doctor may refer you to a mental health specialist, such as a psychiatrist. A proper diagnosis usually involves a thorough face-to-face interview conducted by an experienced mental health professional.
Unfortunately, some people with OCD attempt to hide their problem rather than seek help, often in fear of embarrassment or stigma. They may be remarkably successful in concealing their symptoms from friends and co-workers. As a result, people with OCD frequently do not receive professional help until years after the onset of their disease. By that time, the obsessive-compulsive rituals may be deeply ingrained and very difficult to change. Another obstacle to treatment is limited public awareness of OCD. Until recently, many people did not know there was even a name for their illness and with no name, they assumed there was no treatment.
The most common treatment for OCD is a combination of cognitive-behavioral psychotherapy (CBT) and medication. A type of behavioral therapy known as “exposure and response prevention” (E/RP) is very useful for treating OCD. In this approach, a person is deliberately and voluntarily exposed to whatever triggers the obsessive thoughts (exposure) and is then taught techniques to avoid performing the compulsive rituals (response prevention). The cognitive portion of CBT is often added to E/RP to help challenge the irrational beliefs associated with OCD.
OCD is sometimes accompanied by depression, eating disorders, substance abuse, attention deficit/hyperactivity disorder or other anxiety disorders. When a person also has other disorders, OCD is often more difficult to diagnose and treat. Appropriate diagnosis and treatment of other disorders are important to successful treatment of OCD. On average, people with OCD see three to four doctors and spend over nine years seeking treatment before they receive a correct diagnosis. Studies have also found that it takes an average of 17 years from the time OCD begins for people to obtain appropriate treatment.