Obsessive Compulsive Disorder (OCD)

Obsessive-compulsive disorder (OCD) is a disorder in which people have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do something repetitively (compulsions). The repetitive behaviors, such as hand washing, checking on things or cleaning, can significantly interfere with a person’s daily activities and social interactions.

A diagnosis of OCD requires the presence of obsessions and/or compulsions that are time-consuming (more than one hour a day).

Obsessions and Compulsions

Obsessions are involuntary thoughts, images, or impulses that occur repeatedly in your mind. You don’t want to have these ideas, but you can’t stop them. Unfortunately, these obsessive thoughts are often disturbing and distracting.

Compulsions are behaviors or rituals that you feel driven to act out again and again. Usually, compulsions are performed in an attempt to make obsessions go away. For example, if you’re afraid of contamination, you might develop elaborate cleaning rituals. However, the relief never lasts. In fact, the obsessive thoughts usually come back stronger. And the compulsive rituals and behaviors often end up causing anxiety themselves as they become more demanding and time-consuming. This is the vicious cycle of OCD.

Common compulsive behaviors in OCD include:

• Excessive double-checking of things, such as locks, appliances, and switches.
• Repeatedly checking in on loved ones to make sure they’re safe.
• Counting, tapping, repeating certain words, or doing other senseless things to reduce anxiety.
• Spending a lot of time washing or cleaning.
• Ordering or arranging things “just so”.
• Praying excessively or engaging in rituals triggered by religious fear.
• Accumulating “junk” such as old newspapers or empty food containers.

Common obsessive thoughts in OCD include:

• Fear of being contaminated by germs or dirt or contaminating others.
• Fear of losing control and harming yourself or others.
• Intrusive sexually explicit or violent thoughts and images.
• Excessive focus on religious or moral ideas.
• Fear of losing or not having things you might need.
• Order and symmetry: the idea that everything must line up “just right”.
• Superstitions; excessive attention to something considered lucky or unlucky.

What Causes OCD?

OCD has no single cause, but a variety of risk factors can make someone more susceptible to the disorder. Like some mental health conditions, OCD seems to have a strong genetic link. This means that someone with close biological relatives who have OCD is more likely to develop the disorder.

Even without a genetic cause, people can develop OCD. Trauma, chemical imbalances in the brain, and structural differences in the brain can all trigger OCD.

Treatment for OCD

Individuals with OCD who receive appropriate treatment commonly experience an increased improved quality of life and improved functioning. Treatment may improve your ability to function at school and work, develop and enjoy relationships, and pursue leisure activities.

Cognitive-behavioral therapy is the most effective treatment for obsessive-compulsive disorder and typically involves two components:

• Exposure and response prevention, which requires repeated exposure to the source of your obsession, as explained above.
• Cognitive therapy, which focuses on the catastrophic thoughts and exaggerated sense of responsibility you feel. A big part of cognitive therapy for OCD is teaching you healthy and effective ways of responding to obsessive thoughts, without resorting to compulsive behavior.

Other treatment options include medication, group therapy, and family therapy.