Obsessive Compulsive Disorder

Obsessive-compulsive disorder or OCD is a mental illness that causes anxiety. People with OCD have uncontrollable obsessions (fears, thoughts or urges). They try to lessen anxiety with repetitive actions, called compulsions. OCD causes distress and interferes with normal life. Cognitive-behavioral therapy and medications can help.

What is obsessive-compulsive disorder? #

Obsessive-compulsive disorder (OCD) is a mental illness, with a chronic (long-lasting) state of anxiety. It traps people in a constant cycle of repeated obsessions and compulsions:

• OCD obsessions: People with OCD have repetitive and distressing fears or urges they can’t control. These obsessive thoughts cause intense anxiety.

• OCD compulsions: To control obsessions and anxiety, people with OCD turn to certain behaviors, rituals or routines. They do so repeatedly. They don’t want to perform these compulsive behaviors and don’t get pleasure from them. But they feel like they have to follow along or their anxiety will get worse. Compulsions only help temporarily, though. The obsessions soon come back, triggering a return to the compulsions. This loop leads to a constant cycle of anxiety.

What causes obsessive-compulsive disorder? #

Scientists don’t understand exactly what causes OCD. Certain factors or events may increase a person’s chances of developing the condition, or cause an episode of OCD:

• Changes in living situation, such as moving, getting married or divorced, or starting a new school or job.

• Death of a loved one or other emotional trauma.

• History of abuse.

• Illness (if you get the flu, for example, you may start a cycle of obsessing about germs and washing compulsively).

• Low levels of serotonin, a natural substance in the brain that maintains mental balance.

• Overactivity in areas the brain.

• Problems at work or school.

• Problems with an important relationship.

What are the symptoms of obsessive-compulsive disorder? #

• The symptoms of OCD are obsessions and compulsions that interfere with normal activities.

• For example, symptoms may often prevent you from getting to work on time.

• Or you may have trouble getting ready for bed in a reasonable amount of time.

• A person with OCD may know they have a problem but can’t stop.

How is obsessive-compulsive disorder diagnosed? #

• There’s no test for OCD.

• A healthcare provider makes the diagnosis after asking you about your symptoms.

• The provider uses criteria explained in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V).

• People often use the phrases obsessing, obsessed and OCD very casually in everyday conversations.

But OCD, according to the DSM-V, is diagnosed based on specific factors:

• The person has obsessions, compulsions or both.

• The obsessions or compulsions take up a lot of time (more than an hour per day).

• The obsessions or compulsions cause distress or affect participation in social activities, work responsibilities or other life events.

• The symptoms aren’t caused by drugs, alcohol, medications or another medical problem.

• The symptoms aren’t explained by another mental disorder (such as generalized anxiety disorder, eating disorder or body image disorder).

What treatments are available for obsessive-compulsive disorder? #

If you have symptoms of OCD that interfere with your daily life, you should talk to a healthcare provider. A professional who is specially trained in mental illness can offer several strategies:

• Cognitive-behavioral therapy (CBT): Cognitive-behavioral therapy is a type of psychotherapy. You will talk to a therapist, who will help you examine and understand your thoughts and emotions. Over several sessions, CBT can help you stop negative habits, perhaps replacing them with healthier ways to cope.

• Medications: Drugs called serotonin reuptake inhibitors (SRIs), selective SRIs (SSRIs) and tricyclic antidepressants may help. They increase levels of serotonin. Examples include clomipramine, fluoxetine, fluvoxamine, paroxetine and sertraline.

• Exposure and response prevention (EX/RP): With this therapy, you do the thing that causes anxiety. The healthcare provider then prevents you from responding with a compulsion. For example, the provider may ask you to touch dirty objects but then stop you from washing your hands.