Obsessive Compulsive Disorder (OCD)

What is Obsessive-compulsive disorder?

Obsessions are intrusive, irrational thoughts — unwanted ideas or impulses that repeatedly well up in a person’s mind. Again and again, the person experiences disturbing thoughts, such as “My hands must be contaminated; I must wash them”; “I may have left the gas stove on”; “I am going to injure my child.” On one level, the sufferer knows these obsessive thoughts are irrational. But on another level, he or she fears these thoughts might be true. Trying to avoid such thoughts creates great anxiety.

Compulsions are repetitive rituals such as handwashing, counting, checking, hoarding, or arranging. An individual repeats these actions, perhaps feeling momentary relief, but without feeling satisfaction or a sense of completion. People with OCD feel they must perform these compulsive rituals or something bad will happen.

Most people at one time or another experience obsessive thoughts or compulsive behaviors. Obsessive-compulsive disorder occurs when an individual experiences obsessions and compulsions for more than an hour each day, in a way that interferes with his or her life.

What causes OCD?

A large body of scientific evidence suggests that OCD results from a chemical imbalance in the brain. For years, mental health professionals incorrectly assumed OCD resulted from bad parenting or personality defects. This theory has been disproven over the last 20 years. OCD symptoms are not relieved by psychoanalysis or other forms of “talk therapy,” but there is evidence that behavior therapy can be effective, alone or in combination with medication. People with OCD can often say “why” they have obsessive thoughts or why they behave compulsively, but the thoughts and the behavior continue.

How do people with OCD typically react to their disorder?

People with OCD generally attempt to hide their problem rather than seek help. Often they are remarkably successful in concealing their obsessive-compulsive symptoms from friends and co-workers. An unfortunate consequence of this secrecy is that people with OCD generally do not receive professional help until years after the onset of their disease. By that time, the obsessive-compulsive rituals may be deeply ingrained and very difficult to change.

How long does OCD last?

OCD will not go away by itself, so it is important to seek treatment. Although symptoms may become less severe from time to time, OCD is a chronic disease. Fortunately, effective treatments are available that make life with OCD much easier to manage.

What are other examples of behaviors typical of people who suffer from OCD?

  • Repeatedly checking things, perhaps dozens of times, before feeling secure enough to go to sleep or leave the house. Is the stove off? Is the door locked? Is the alarm set?
  • Fearing they will harm others. Example: A man’s car hits a pothole on a city street and he fears it was actually a body.
  • Feeling dirty and contaminated. Example: A woman is fearful of touching her baby because she might contaminate the child.
  • Constantly arranging and ordering things. Example: A child can’t go to sleep unless he lines up all his shoes correctly.
  • Being excessively concerned with body imperfections — insist on numerous plastic surgeries, or spend many, many hours a day body-building.
  • Being ruled by numbers, believing that certain numbers represent good and others represent evil.
  • Being excessively concerned with sin or blasphemy.

Is OCD commonly recognized by professionals?

Not nearly enough. OCD is often misdiagnosed, and it is often underdiagnosed. Many people have dual disorders of OCD and schizophrenia, or OCD and bipolar disorder, but the OCD component is not diagnosed or treated. Researchers believe OCD, anxiety disorders, Tourette’s, and eating disorders such as anorexia and bulimia can be triggered by some of the same chemical malfunctioning of the brain.

Is heredity a factor in OCD?

Yes. Heredity appears to be a strong factor. If you have OCD, there’s a 25-percent chance that one of your immediate family members will have it. It definitely seems to run in families.

Can OCD be effectively treated?

Yes, with medication and behavior therapy. Both affect brain chemistry, which in turn affects behavior. Medication can regulate serotonin, reducing obsessive thoughts and compulsive behaviors.