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What is Obsessive-Compulsive Disorder?
Obsessive-Compulsive Disorder,
OCD, is an anxiety disorder and is characterized by recurrent,
unwanted thoughts (obsessions) and/or repetitive behaviors
(compulsions). Repetitive behaviors such as handwashing,
counting, checking, or cleaning are often performed with
the hope of preventing obsessive thoughts or making them
go away. Performing these so-called "rituals," however,
provides only temporary relief, and not performing them markedly
increases anxiety.
People with obsessive-compulsive disorder (OCD) have persistent,
upsetting thoughts (obsessions) and use rituals (compulsions)
to control the anxiety these thoughts produce. Most of the
time, the rituals end up controlling them.
For example, if people are
obsessed with germs or dirt, they may develop a compulsion
to wash their hands over and over again. If they develop
an obsession with intruders, they may lock and relock their
doors many times before going to bed. Being afraid of social
embarrassment may prompt people with OCD to comb their
hair compulsively in front of a mirror-sometimes they get “caught” in the mirror and can’t
move away from it. Performing such rituals is not pleasurable.
At best, it produces temporary relief from the anxiety created
by obsessive thoughts.
Other common rituals are a need to repeatedly check things,
touch things (especially in a particular sequence), or count
things. Some common obsessions include having frequent thoughts
of violence and harming loved ones, persistently thinking
about performing sexual acts the person dislikes, or having
thoughts that are prohibited by religious beliefs. People
with OCD may also be preoccupied with order and symmetry,
have difficulty throwing things out (so they accumulate),
or hoard unneeded items.
Healthy people also have rituals, such as checking to see
if the stove is off several times before leaving the house.
The difference is that people with OCD perform their rituals
even though doing so interferes with daily life and they
find the repetition distressing. Although most adults with
OCD recognize that what they are doing is senseless, some
adults and most children may not realize that their behavior
is out of the ordinary.
OCD affects about 2.2 million American adults,1 and the
problem can be accompanied by eating disorders,6 other anxiety
disorders, or depression.2,4 It strikes men and women in
roughly equal numbers and usually appears in childhood, adolescence,
or early adulthood.2 One-third of adults with OCD develop
symptoms as children, and research indicates that OCD might
run in families.3
The course of the disease is quite varied. Symptoms may
come and go, ease over time, or get worse. If OCD becomes
severe, it can keep a person from working or carrying out
normal responsibilities at home. People with OCD may try
to help themselves by avoiding situations that trigger their
obsessions, or they may use alcohol or drugs to calm themselves.4,5
OCD usually responds well to treatment with certain medications
and/or exposure-based psychotherapy, in which people face
situations that cause fear or anxiety and become less sensitive
(desensitized) to them. NIMH is supporting research into
new treatment approaches for people whose OCD does not respond
well to the usual therapies. These approaches include combination
and augmentation (add-on) treatments, as well as modern techniques
such as deep brain stimulation.
Signs & Symptoms
People with OCD may be plagued by persistent, unwelcome
thoughts or images, or by the urgent need to engage in certain
rituals. They may be obsessed with germs or dirt, and wash
their hands over and over. They may be filled with doubt
and feel the need to check things repeatedly.
Treatment
Effective treatments for obsessive-compulsive disorder are
available, and research is yielding new, improved therapies
that can help most people with OCD and other anxiety disorders
lead productive, fulfilling lives.
More Information
- Obsessive-Compulsive
Disorder: What It Is and How to Treat It (American
Academy of Family Physicians). Also available in Spanish
- When
Unwanted Thoughts Take Over: Obsessive-Compulsive Disorder (National
Institute of Mental Health). Also available in Spanish
- Information from The Massachusetts General Hospital
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