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Obsessive-Compulsive Disorder (OCD)

What is obsessive-compulsive disorder?

Obsessive-compulsive disorder (OCD) is an anxiety disorder in which a person has an unreasonable thought, fear, or worry that he or she tries to manage through a ritualized activity to reduce the anxiety. Frequently occurring disturbing thoughts or images are called obsessions, and the rituals performed to try to prevent or dispel them are called compulsions.

What are obsessions, as they relate to OCD?

Obsessions are irrational thoughts, fears, or worries that frequently recur and cause great anxiety, but cannot be controlled through reasoning. Common obsessions include the following:

  • An extreme preoccupation with dirt or germs

  • Repeated doubts (for example, about having turned off the burners on a stove)

  • A need to have things in a very particular order

  • Thoughts about violence or hurting someone

  • Spending long periods of time touching things or counting

  • Preoccupation with order or symmetry

  • Persistent thoughts of performing repugnant sexual acts

  • Troubled by thoughts that are against personal religious beliefs

Although an individual with an obsession realizes that the thoughts are unreasonable and not related to real-life problems, this knowledge is not enough to make the unwanted thoughts go away.

In an attempt to get rid of the obsessive thoughts, people with OCD engage in compulsive behavior.

What are compulsions, as they relate to OCD?

Compulsions are repetitive, ritualized behaviors enacted to reduce anxiety caused by the obsession(s). Examples of compulsions include:

  • Repeated hand washing (often 100+ times a day)

  • Checking and rechecking (repeatedly) to ensure that a door is locked or that the oven is turned off

  • Following rigid rules of order (for instance, putting on clothes in the very same sequence every day, alphabetizing the spices in the spice cabinet, and becoming upset if the order becomes disrupted)

Compulsive behaviors can become excessive, disruptive, and time-consuming, and may interfere with daily activities and relationships.

Who is affected by obsessive-compulsive disorder?

OCD affects approximately 1 percent of American adults. OCD often begins in adolescence or early adulthood, but can also first occur in childhood. 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. People may avoid situations in which they might have to confront their obsessions, or try unsuccessfully to use alcohol or drugs to calm themselves.

How is OCD diagnosed?

The disorder is diagnosed only when such activities:

  • Consume at least one hour each day.

  • Are very distressing.

  • Interfere with daily life.

Always see your doctor for a diagnosis.

Treatment for obsessive-compulsive disorder

Specific treatment for OCD will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent of the disease

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Treatment may include:

  • Medication

  • Psychological treatment (for instance, cognitive behavioral or behavioral therapy)