Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder (OCD) is an anxiety disorder of repetitive thoughts and behaviors that make no sense. These obsessive thoughts and compulsive behaviors are extremely difficult to overcome. If severe and untreated, OCD can destroy the ability to function at work, at school, or at home.

Causes

The cause of OCD is not known. It is believed to develop from neurobiological, environmental and psychological factors. An imbalance of the brain chemical serotonin probably plays a significant role in the development of OCD.
OCD is associated with other neurological disorders, including:
  • Tourette syndrome
  • Trichotillomania – the repeated urge to pull out scalp hair, eyelashes, eyebrows or other body hair
  • Body dysmorphic disorder – imaginary or exaggerated defects in appearance
  • Eating disorders, such as bulimia or anorexia nervosa
  • Hypochondriasis – unfounded fear of having a serious disease
  • Substance abuse

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.
  • Age: Late adolescence, early adulthood
  • Family members with a history of OCD
  • Other anxiety disorders
  • Depression
  • Tourette syndrome
  • Personality disorder
  • Attention-deficit disorder

Symptoms

Symptoms of OCD are:
  • Obsessions – unwanted, repetitive and intrusive ideas, impulses or images
  • Compulsions – repetitive behaviors or mental acts usually performed to reduce the distress associated with obsessions
People with OCD know that their thoughts and behaviors are nonsensical and would like to avoid or stop them. Common obsessions include:
  • Persistent fears that harm may come to self or a loved one
  • Unreasonable concern with being contaminated
  • Unacceptable religious, violent, or sexual thoughts
  • Excessive need to do things correctly or perfectly
Common compulsions include:
  • Excessive checking of door locks, stoves, water faucets, light switches, etc.
  • Repeatedly making lists, counting, arranging, or aligning things
  • Collecting and hoarding useless objects
  • Repeating routine actions a certain number of times until it feels just right
  • Unnecessary re-reading and re-writing
  • Mentally repeating phrases

Diagnosis

OCD is usually diagnosed through a psychiatric assessment.

Treatment

Treatment reduces OCD thoughts and behaviors, but does not completely eliminate them.
Treatments include:
Medications
Selective serotonin reuptake inhibitors (SSRIs) reduce OCD symptoms by affecting the neurotransmitter serotonin. This function is independent of their antidepressant effects. Common SSRIs include:
  • Fluoxetine (Prozac)
  • Fluvoxamine (Luvox)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)
Another medication often used is clomipramine (Anafranil). This is a tricyclic antidepressant drug that alters serotonin levels.
Behavior Therapy
This helps you gradually confront the feared object or obsession without succumbing to the compulsive ritual associated with it.

Prevention

There are no guidelines for preventing OCD because the cause is not known. However, early intervention may provide help before the disorder becomes severely disruptive.