Obsessive-Compulsive Disorder (OCD)
What is it?
Obsessive-Compulsive Disorder (OCD) is a type of anxiety disorder. People with OCD have repeated unwanted thoughts, ideas, images, or impulses, called obsessions, over which they feel they have no control. To make these thoughts or images go away and to relieve the anxiety they cause, people with OCD perform some action over and over again. This is called a compulsion. For example, people with an obsession about germs might wash their hands over and over again to relieve their anxiety.
Who gets it?
Obsessive-Compulsive Disorder (OCD) occurs equally in men and women. OCD usually starts during childhood or the teenage years, and can last a lifetime. Approximately 2% of adult Americans have OCD. This condition can run in families.
What causes it?
The tendency toward OCD appears be inherited because, in approximately 25% of all cases of OCD, another family member also has the disorder. Other research has found that some parts of the brain work differently in people with OCD. This could be caused by a chemical imbalance or an overactive portion of the brain responsible for repetitive behavior. Because certain drugs that affect the levels of serotonin in the brain are effective in treating OCD, there also appears to be a link between OCD and serotonin. Serotonin is a neurotransmitter, one of the brain's Òmessengers,Ó which is responsible for feelings of emotional well-being. Researchers have also found a link between repeated episodes of strep throat during childhood and the development of OCD. In some children, the cells the body produces to fight the strep bacteria appear to attack a certain part of the brain, resulting in anywhere from temporary symptoms of OCD to full-blown
OCD.
What are the symptoms?
Symptoms of OCD can range from mild to severe. In most cases, people know their obsessions do not represent true dangers and realize their compulsive behavior is strange or bizarre. However, deep down they are afraid that their fears might be real, and that something bad might happen if they don't act on them. People with mild OCD may check repeatedly whether they've locked the door or turned off the light. Their symptoms do not interfere with everyday life, however, and they may even successfully hide them from others. In severe cases, people with OCD may spend hours on compulsive behaviors. Their symptoms prevent them from living their lives fully and from having normal relationships with others. The most common obsessions and compulsions of people with OCD include checking repeatedly, which usually results from a fear of harm to self or others; cleaning, due to a fear of germs; hoarding items that are repeatedly counted or arranged; repeating a name or phrase or touching something a certain number of times to reduce anxiety; and performing a series of steps in a certain order or doing them over and over until perfect, again to reduce anxiety or protect the person from some unfounded fear. People may have obsessions without compulsions, and vice versa. People with OCD may also be preoccupied with religious feelings, sexual thoughts, and the need for order and symmetry. People with OCD may also have symptoms of depression, Tourette Syndrome, or bipolar disorder. Symptoms usually get worse when the person is under stress.
How is it diagnosed?
There is no diagnostic test for OCD. Your doctor will listen to a history of your symptoms and ask you questions. He or she will want to know what types of obsessions and compulsions you have, and whether they interfere with your everyday life and relationships in any way. You may have OCD if you have thoughts you can't ignore or make go away; you feel the need to check things over and over, such as whether a door is locked or a light switched off; you need to clean objects or your hands repeatedly; your obsessions or compulsions make you feel anxious; and these feelings interfere with your normal activities. It is important to answer the doctor's questions openly and honestly. He or she will also ask about any medications you are taking to be sure they are not causing your symptoms. People with OCD often avoid seeking treatment because they are embarrassed by the condition. While brain imaging studies are not used to diagnose OCD, when researchers have compared positron emission tomography (PET) scans of people with and without OCD, they found different patterns of brain activity in people with OCD.
What is the treatment?
Your doctor may refer you to a psychiatrist who may prescribe a combination of medication and therapy to help your symptoms. Certain medications called serotonin reuptake inhibitors (SSRIs) regulate the brains serotonin levels, which can help control obsessive-compulsive behaviors. These medications include fluoxetine, fluvoxamine, paroxetine, and sertraline. You need to give any medication time, however, to take effect. Therapy involves talking with someone who is trained in techniques for coping with stress and anxiety. The therapist can show you ways to hold off your obsessive thoughts, sometimes by directing your attention to something else, and to avoid compulsive actions. A technique called exposure and response prevention is often effective. The patient is exposed to the obsessive thought, then taught ways to prevent the body's response to the anxiety. Alternative treatments include herbal therapy with St. John's wort, a plant believed to have anti-depressant effects. However, not all people respond well to this herb, and it can cause increased anxiety at first. Brain surgery is only considered in extremely severe cases of OCD, and carries a risk of serious side effects.
Self-care tips
If you believe you have obsessive-compulsive disorder (OCD), it's important to seek treatment, keeping in mind that many people have the same condition. If your doctor prescribes medication, remember to take the recommended dose at around the same time each day. This will maintain a constant level of the medication in your bloodstream. Look for an OCD support group in your area. They are a great resource for people with this condition.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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