Everyone had experienced minor obsessions, like worrying about whether the iron was left on or if they remembered to lock the front door. And we’ve all had compulsions, like avoiding stepping on the cracks on a sidewalk. These behaviors are short-lived – they don’t cause significant disruption to daily life – and they go away quickly. However, for those who are affected by obsessive-compulsive disorder (OCD), the behaviors are not short-lived, and they don’t go away on their own.
What is Obsessive-Compulsive Disorder?
Obsessive-compulsive disorder is a mental illness that includes intense and chronic anxiety. People with OCD become stuck in an ongoing cycle of obsessions and compulsions:
- Obsessions – People with OCD have distressing and repetitive fears and distressing urges that are uncontrollable. The obsessive thoughts result in intense anxiety.
- Compulsions – To help control obsessive thoughts and anxiety, people with OCD perform certain actions, routines, or behaviors. And they perform them repeatedly. It isn’t that they want to continue the compulsive behaviors; in fact, most of the time, they don’t want to. But they feel like they have to do them, or their anxiety will increase. Performing this behavior only works to lessen anxiety for a short time. Then the obsessive thoughts return, and the compulsions follow. This causes an ongoing cycle of anxiety.
What Causes OCD?
Exactly what causes OCD isn’t known. There are factors that experts believe contribute to the likelihood of developing OCD, though. Brain abnormalities, genetics, and environmental factors are thought to play a role. OCD frequently starts when a person is in their teens or early twenties. However, it can start at younger ages. Men and women are equally affected by the disorder, and it seems to run in families.
It is common for people with OCD to also have other anxiety issues, eating disorders, substance use disorder, or depression at the same time.
What Are the Symptoms of OCD?
Just because someone has obsessive thoughts or fears or they perform compulsive behaviors, it doesn’t mean that they have OCD. To people with OCD, the intrusive thoughts and behaviors are extremely distressing, they take up a lot of time, and they interfere with interpersonal relationships and daily life.
Most people with OCD have obsessive thoughts and compulsions. However, some people just have one of the two.
Examples of Obsessive Thoughts
Obsessions are uncontrollable, unwanted, and intrusive thoughts, worries, or fears that lead to increased anxiety. They occur often, and reasoning cannot control them. Some examples of obsessions include:
- Fear of harming to someone
- Fear of dirt or germs
- Fear of being embarrassed in public
- Fear of making a mistake
- Need for constant reassurance
- Need for neatness, order, or symmetry
- Feelings of doubt or distrust
- Sexual thoughts that may be considered unacceptable
Examples of Compulsive Behaviors
Compulsions are the actions that a person takes to try to get rid of obsessive thoughts or anxiety. These behaviors can be disruptive, excessive, and time-consuming. They may disrupt daily life and interpersonal relationships. Some examples of compulsions are:
- Cleaning, bathing, or washing hands repeatedly
- Placing things in a specific way
- Constantly making sure that they haven’t harmed anyone
- Checking specific things repeatedly, like a lock or the oven
- Eating food in a specific order
- Hoarding or collecting things that hold no value (personal or financial)
- Counting repeatedly or saying certain words or phrases while doing other tasks
- Performing tasks a specific number of times, such as flipping a light switch five times.
- Refusing to touch objects that others touch a lot, like doorknobs
- Refusing to shake hands
Individuals with obsessive-compulsive disorder may also have tics. These are quick, sudden, repetitive actions or movements, such as:
- Shrugging their shoulders
- Blinking eyes
- Jerking their head
- Clearing their throat or sniffling their nose
How is OCD Diagnosed?
Obsessive-compulsive disorder can be difficult to diagnose because its symptoms are similar to several other mental illnesses, like anxiety disorders. It is also possible and often is the case that people with OCD will also have another disorder.
To arrive at a diagnosis of OCD, a doctor will first do a medical examination and obtain a medical history of the person. Then, if there isn’t a physical problem that is causing symptoms, the individual will likely be referred to a mental health provider for evaluation.
If the person has symptoms of OCD as well as the following, the diagnosis may be OCD:
- Unable to control thoughts and behavior even though the person knows they are excessive
- Spends at least one hour a day on obsessive thoughts and compulsions
- Has significant problems in daily life because of symptoms
- Doesn’t get pleasure when performing compulsive behaviors, though doing them may provide temporary relief from anxiety
How is Obsessive-Compulsive Disorder Treated?
People who have OCD and receive effective treatment commonly experience an improvement in their quality of life. Like many other mental illnesses, the treatment options for OCD are typically twofold: medication and cognitive behavioral therapy (CBT).
Selective serotonin reuptake inhibitor (SSRI) medications, or antidepressants, can be effective in treating OCD. Usually, the dosage of SSRIs has to be higher for the treatment of OCD than it is when treating depression. There may be other psychiatric medications that are also effective. What works for one person may not work for another. It may take time to figure out what the right medication or combination of medications and dosages are right for a specific person. Some people with OCD have success with just medication, but often, they need therapy as well.
Cognitive Behavioral Therapy
The most common type of CBT that is used for patients with OCD is exposure and response prevention. During this type of therapy, patients are exposed to situations or images that focus on their obsessions. To begin with, the exposure will lead to increased anxiety. They are then instructed not to follow through with their typical compulsive behaviors (this is known as response prevention). Because they stay in a feared situation without anything bad happening, patients begin to learn that they can actually cope with their thoughts without acting on them with ritualistic action. Over time, exposure and response prevention therapy will start to reduce the amount of anxiety the person feels when the compulsions are no longer performed.
Manage OCD with Effective Treatment
If you think you have OCD or you have a loved one with symptoms, it’s important to consult with a trained therapist, psychiatrist, or mental health treatment center as soon as possible. The disorder won’t go away by itself; treatment is needed to alleviate symptoms. Fortunately, many people with OCD are able to manage their obsessions and compulsion with the treatment of medication, CBT, or both, and enjoy their lives, families, and friends.