Obsessive-Compulsive Disorder
(OCD)

Alternative Names: OCD.

Obsessive-Compulsive Disorder is characterized by obsessive thoughts and/or compulsive behaviors that significantly interfere with normal life.  Obsessions are unwanted, recurrent, and disturbing thoughts which the person cannot suppress and which can cause overwhelming anxiety.  Compulsions are repetitive, ritualized behaviors that the person feels driven to perform to alleviate the anxiety of the obsessions.  The obsessive and compulsive rituals can occupy many hours of each day.  It affects men, women, and children, as well as people of all races, religions, and socioeconomic backgrounds. OCD is a medical illness recognized by experts throughout the world.  People with OCD are not "crazy", although they may sometimes feel that way because they are troubled by thoughts and actions that they know are inappropriate.  People with OCD are often anxious and depressed; they often believe they are the only ones who have irrational, obsessive thoughts, and are therefore often ashamed and afraid to tell anyone or to seek help.  Having OCD is not a sign of weakness or a lack of willpower in stopping the thoughts and behaviors.  At least 80% of patients with OCD have both obsessions and compulsions.  Probably under 20% have only obsessions or compulsions.

The most common obsessions are:

• Fear of contamination
• Fear of causing harm to another
• Fear of making a mistake
• Fear of behaving in a socially unacceptable manner
• Need for symmetry or exactness
• Excessive doubt

The most common compulsions are:

• Cleaning/Washing
• Checking
• Arranging/Organizing
• Collecting/Hoarding
• Counting/Repeating

Incidence; Causes and Development

OCD is the fourth most common mental illness and affects approximately 5 million people in the United States.

Although the exact cause is not known, OCD appears to be caused by increased activity in the orbital frontal cortex and caudate nucleus of the brain.  OCD may also involve abnormal functioning (low levels) of the neurotransmitter serotonin in the brain.

Stress does not cause OCD; however, a stressful event like the death of a loved one, birth of a child, or divorce can trigger the onset of the disorder.

Diagnosis and Tests

Diagnosis is delayed until the symptoms are "unmasked".

Treatment and Prevention

OCD is a treatable disease, and effective medications and therapy techniques are available: Sufferers can get better if they seek help and get the appropriate treatment.

The two most effective treatments for OCD are conventional drug therapy and behavioral therapy.  It is generally most effective if the two can be used together.

Complications

Obsessions can cause anxiety, causing the sufferer to engage in compulsions in an attempt to alleviate the distress caused by the obsessions.  Carrying out these compulsions, or rituals, does not result in any permanent change, and in fact, the OCD symptoms worsen.