Q and A: Obsessive-Compulsive Disorder
Obsessive-compulsive disorder (OCD) is a common and long-lasting disorder. People
with OCD have unwanted thoughts that keep coming back (obsessions) and behaviors that
keep repeating (compulsions), which they feel they can't control. Rituals, such as
handwashing, counting, checking, or cleaning, are often done in hope of preventing
obsessive thoughts or making them go away. But these rituals provide only temporary
emotional relief. Not doing them greatly increases anxiety. Left untreated, obsessions
and the need to do rituals can take over a person's life. OCD is often an illness
that occurs over and over again.
People with these symptoms may feel ashamed to talk about them. They also worry that
they are crazy. Or they think that nothing could possibly help. Fortunately, effective
treatments have been developed to help people with OCD.
How common is OCD?
OCD affects adults and children of all ethnic groups and backgrounds. About 1 in 100
adults have OCD. It may run in families. People with OCD often notice symptoms during
childhood, teen years, or early adulthood. OCD is a chronic condition that lasts throughout
a person’s life, If the disorder is very bad, the person can face serious limits in
their daily life.
What are obsessions?
Obsessions include:
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Thoughts that are often inappropriate and that keep returning. They cause stress or
anxiety. This leads to efforts to dismiss those thoughts.
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Thoughts that are not simply excessive worries about real-life problems
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Recognition that the thoughts come from their own mind
What are compulsions?
Compulsions include:
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Physical behaviors that are done over and over (for example, handwashing) or mental
behaviors (for example, counting and repeating words or phrases)
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Behaviors that are aimed at preventing distress. These are not connected in a real
way to what they are intended to lessen the effect of. These behaviors usually come
before an almost uncontrollable drive to do them.
Other qualifiers
Other reasons that a person would be considered to have OCD:
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The person recognizes the obsessions or compulsions go beyond what is considered normal
and reasonable.
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The obsessions or compulsions cause distress, are time-consuming, and interfere with
the person’s life.
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The obsession or compulsion is not a specific symptom of some other mental disorder.
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The obsessions and compulsions are not caused by a substance (alcohol, drugs, or medicines).
What causes OCD?
Experts now believe OCD is caused by the brain and nervous system and not by family
problems or behaviors learned in childhood. Genes may play a role in OCD.
Brain imaging studies using a method called positron emission tomography (PET) have
compared people with and without OCD. Those with OCD have patterns of brain activity
that differ from people with other mental illnesses or people with no mental illness
at all. PET scans also show that in people with OCD, both behavioral therapy and medicines
result in changes in the brain.
What treatments are available for OCD?
Both medicines and psychotherapy can help most cases of OCD. A combination of both
works even better. Support from family and friends is also important.
Several medicines can help people with OCD. These include a tricyclic antidepressant,
SSRIs (selective serotonin reuptake inhibitors), and other antidepressants. There
are many choices. Talk with your healthcare provider about trying another medicine
if one doesn't work well.
Another treatment is a type of cognitive behavioral therapy known as "exposure and
response prevention." In this approach, a person is voluntarily exposed to whatever
sets off the obsessive thoughts. They are then taught ways to stay away from doing
the compulsive rituals and to deal with the anxiety.
Resources to help
Resources are available to help manage OCD, Talk with your healthcare provider or
local healthcare organizations. Or visit the following national websites:
Can people with OCD also have other physical or emotional illnesses?
A person with OCD may also have depression, eating disorders, substance abuse, attention
deficit hyperactivity disorder, or other anxiety disorders. OCD often is harder to
diagnose and treat when a person also has other disorders. Symptoms of OCD also can
coexist and may even be part of a range of nervous system disorders. They include
Tourette syndrome. Appropriate diagnosis and treatment of other disorders is important
to successful treat OCD. It's important that the person with OCD has an initial evaluation
by a psychiatrist or other mental health specialist to make sure of a correct diagnosis.