What Is OCD?
Obsessive-compulsive disorder, or OCD, is a chronic mental disorder characterized by the need to relieve unwanted anxious thoughts (obsessions) through the repetition of specific behaviors (compulsions). People with OCD don’t take pleasure in performing the compulsive behaviors; they are usually plagued by the unshakable belief that something bad will happen if they don’t do a certain thing (and, in many cases, do this thing a certain number of times).
Symptoms of obsessive-compulsive disorder appear by early adulthood; some people begin to display compulsive behaviors as children. The exact causes of OCD aren’t known, but, as with other anxiety disorders, many experts think that obsessive-compulsive disorder might be caused by a problem with serotonin levels in the brain. Other researchers of OCD support the idea that certain types of childhood infections might trigger obsessive-compulsive symptoms.
OCD symptoms revolve around the obsession-compulsion cycle of being unable to get rid of thoughts or impulses and the anxiety they bring, and, as a result, having to complete ritualistic behaviors.
Obsessive-compulsive disorder is more common than you might think. The National Institute of Mental Health estimates that it affects almost 1 in 40 Americans. Many people with OCD go undiagnosed because they are embarrassed to admit their symptoms.
Common types of obsessive thoughts include fear of dirt and infection, fear of harm coming to loved ones and fear of home intrusion. Some obsessive-compulsive people have an intense need for symmetry, order and control, although these people may suffer from a closely related condition, obsessive-compulsive personality disorder (OCPD). Unlike those with OCD, people with OCPD don’t consider their obsessive thoughts unwanted — they believe their thoughts and actions are correct and proper.
Compulsive behaviors commonly displayed by OCD sufferers include hand washing, counting, arranging, and checking or touching things frequently and/or a certain number of times. Hoarding is another form of compulsive behavior.
Sometimes there is an identifiable (though still irrational) relationship between the obsession and the compulsion; for example, that the house will burn down if you don’t check seven times that you turned off the coffee maker, or that your hands will become infected with germs if you don’t wash them for exactly three minutes each time.
On the other hand, sometimes there is no apparent connection between the two, such as the fear that a loved one will get into a car accident if objects on a shelf are not arranged in a particular order. The only way someone with OCD feels they can get relief from their nagging, obsessive thoughts is to engage in whatever they identify as the corresponding compulsive behavior.
OCD can often be effectively treated through a combination of medication and counseling.
- Medication. Most often, antidepressants called selective serotonin reuptake inhibitors, or SSRIs, are prescribed to treat OCD. Paxil, Prozac and Zoloft are examples of common SSRIs. You should notice an improvement in your symptoms after three weeks of taking an SSRI, but it can take as long as three months to experience full effects.
- Counseling. Some OCD sufferers benefit from exposure therapy, a kind of psychotherapy that has proven effective for treating phobias. Exposure therapy involves a controlled and gradually increasing exposure to the source of anxiety or fear; for people with obsessive-compulsive disorder, they are exposed to not completing their ritualized behavior and, in turn, not seeing the feared negative result (for example, working up to only checking once that the coffee maker is off, and repeatedly seeing that this behavior, or lack of behavior, does not cause their house to burn down).
Cognitive behavioral therapy (CBT) is also useful for OCD patients. A therapist trained in CBT can help the OCD sufferer to work on actively displacing their irrational beliefs and obsessive thoughts with more positive, rational ways of thinking.