Obsessive-Compulsive Disorder

Obsessive-compulsive disorder, also known as OCD, is an anxiety disorder characterized by unreasonable thoughts, fears or worries that cause anxiety, which the affected person attempts to manage through a ritualized activity. The frequently occurring disturbing thoughts or images are called obsessions, and the rituals performed to try to prevent or dispel them are referred to as compulsions. According to the National Institute of Mental Health, approximately 2.2 million Americans have OCD.
Causes of OCD
OCD affects men and women equally and appears to run in families. It is not unusual for other anxiety disorders, depression, eating disorders or substance abuse to accompany OCD and worsen or complicate the disorder.
Symptoms of OCD
The first signs of OCD often begins in adolescence or early adulthood, but they can also first occur in childhood.
The following are among the common obsessions in patients diagnosed with OCD:
  • An extreme preoccupation with dirt or germs
  • Repeated doubts (for example, about having turned off the stove)
  • A need to have things in a very particular order or symmetry
  • Thoughts about violence or hurting someone
  • Spending long periods of time touching things or counting

In persons with OCD, compulsions can become excessive, disruptive and time-consuming and may interfere with daily activities and relationships. Common compulsions include the following:
  • Repeated hand washing (often 100+ times a day)
  • Checking and rechecking multiple times that a door is locked or an oven is off
  • Following rigid rules of order (putting on clothes in the very same sequence every day, alphabetizing spices in the cabinet and becoming upset if the order becomes disrupted)

Diagnosing OCD
The symptoms of OCD may come and go and either lessen or worsen over time. Generally, OCD is diagnosed only when obsessive or compulsive activities interfere with daily life (that is, they consume at least one hour daily and cause significant distress).

Your doctor will perform a thorough physical exam and obtain a medical and social history. Because OCD commonly occurs in tandem with eating disorders, other anxiety disorders or depression, your doctor will identify the signs and symptoms of those disorders as well.
Treating OCD 
Specific treatment for OCD is determined by your individual circumstances and takes in to account the following:
  • Your age, overall health and medical history
  • Extent of your disease
  • Your tolerance for specific medications, procedures, or therapies
  • Your expectations for the course of the disease
  • Your opinion or preference

Your treatment for OCD may vary depending on the factors listed above. Often used together, two of the more common types of treatment include:
  • Medication (anti-anxiety drugs and antidepressants) to reduce the anxiety that leads to obsessive and compulsive behavior
  • Psychological treatment (cognitive-behavioral, or talk therapy; or exposure response and prevention therapy), which aims to help you feel less anxious or fearful and reduce obsessive thoughts and compulsive actions

Obsessive-compulsive disorders are often difficult to manage, and you may require long-term treatment to change your behavior and thought patterns.