What is obsessive-compulsive disorder?

Obsessive-compulsive disorder, or OCD, is among the psychiatric conditions called anxiety disorders. As the name suggests, OCD involves two aspects: recurrent, troubling obsessions and repetitive actions, or compulsions.

Obsessions are frequent, unwelcome thoughts that a person is unable to stop themselves from experiencing. They may take the form of unpleasant or disturbing images that keep intruding on a person’s thoughts, or they may be recurring fears that persist even when the person knows the thoughts are unreasonable.

Though not limited to these, obsessions commonly take the following forms:

strong fears of germs, dirt or intruders to the home
unwanted thoughts of violent or sexual acts, or thoughts that go against religious beliefs
fear of harming loved ones
a need for things to be symmetrical or exact

Because persons with OCD are unable to control these unwanted thoughts, fears and images, they often feel compelled to perform certain actions (compulsions) in order to feel they are in greater control. While these acts do not permanently halt the obsessions, they may provide temporary relief.

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Some common compulsions include:

rituals involving repetition of certain activities, such as washing hands, locking/unlocking doors, or combing hair
rituals that are performed at a specific time of day or a certain number of times in order to keep obsessions at bay
cleaning for hours in order to eradicate perceived contaminants or germs
“checking” rituals, such as returning home to make sure the gas stove is turned off, or going back to lock and relock the doors of a car
rearranging things so they are symmetrically perfect
praying or repeating certain phrases to drive away unwanted thoughts

To some extent, everyone occasionally checks things in a ritual fashion to ease anxieties. What makes a person with OCD different is that these rituals often can interfere with their daily functioning. OCD patients can get “stuck” in a repetitive loop of compulsions at the expense of their work, family or social lives.

Generally speaking, people with OCD usually spend at least 1 hour a day on their compulsions; some people can spend several hours a day on these activities. These behaviors are almost never enjoyable to the OCD patient; they are often very frustrating. Yet despite knowing that the compulsions are irrational, an individual with OCD believes there is no choice but to carry out the rituals.

OCD currently affects more than 2 million people in the US. Symptoms often first appear in childhood or the teen years, and most people with OCD have been diagnosed by age 19. Although the cause of OCD is not yet fully understood, it is thought to be an inherited condition.

Treatment for OCD often consists of cognitive-behavioral therapy, and sometimes also includes medication. One type of therapy commonly used is called exposure and response prevention. With this treatment, patients come into contact with the situations that cause their anxiety and trigger compulsive behaviors. This exposure gradually enables a patient to reduce the need to act out rituals, and eventually to stop them.

Along with therapy, some OCD patients also may benefit from medication. Anti-anxiety medications may be used for the short term to provide relief from severe episodes. A certain kind of antidepressant, known as serotonin reuptake inhibitors also have been found to be effective in some patients with OCD. These medications can be taken for longer periods of time.

Sources:

http://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml

http://www.psychiatry.org/obsessive-compulsive-disorder