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Oct.01.2020View related content
 Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a brain-based disorder. This type of disorder happens when parts of the brain cannot communicate well with each other. People with OCD have obsessions or compulsions, or both. Obsessions are unwanted and distressing thoughts, ideas, or urges that keep entering your mind. You may find yourself trying to ignore them. You may try to stop or undo them with a compulsion.
Compulsions are repetitive physical or mental acts that you feel you have to do. They may reduce or prevent any anxiety, but in most cases, they do not help. Compulsions can take a lot of time to do, often more than one hour each day. They can interfere with personal relationships and normal activities at home, school, or work.
OCD can begin in childhood, but it usually starts in young adulthood and continues throughout life. Many people with OCD also have depression or another mental health disorder.

What are the causes?

The cause of this condition is not known.

What increases the risk?

This condition is more likely to develop in:
  • People who have experienced trauma.
  • People who have a family history of OCD.
  • Women during and after pregnancy.
  • Some children between the ages of 3 and 12 who have had a recent streptococcal infection.
  • People who have other mental health conditions.
  • People who misuse substances, such as alcohol, prescription medicines, or illegal drugs.

What are the signs or symptoms?

Symptoms of OCD include obsessions and compulsions. Most people with OCD have both of these, but some people with OCD have just one or the other. People with obsessions usually have a fear that something terrible will happen or that they will do something terrible. Common obsessions include:
  • Fear of contamination with germs, waste, or toxic substances.
  • Fear of making the wrong decision.
  • Violent or sexual thoughts or urges toward others.
  • Need for symmetry or exactness.
Common compulsions include:
  • Excessive handwashing or bathing due to fear of contamination.
  • Checking things again and again to make sure you finished a task, such as making sure you locked a door or unplugged a toaster.
  • Repeating an act or phrase again and again, sometimes a specific number of times, until it feels right.
  • Arranging objects again and again to keep them in a certain order.
  • Having a very hard time making a decision and sticking to it.
Everyone at times will repeat a behavior or check something again. However, people who have OCD feel that they do not have any control over their repeat thoughts or compulsive behaviors.

How is this diagnosed?

OCD is diagnosed through an assessment by your health care provider. Your health care provider may:
  • Ask questions about any obsessions or compulsions you have and how they affect your life.
  • Ask about your medical history, prescription medicines, and drug use. Certain medical conditions and substances can cause symptoms that are similar to OCD.
  • Refer you to a mental health specialist who will ask you questions and may give you tests to confirm this diagnosis. He or she will help you create a plan for treatment.

How is this treated?

OCD may be treated with:
  • Cognitive therapy. This is a form of talk therapy. The goal is to identify and change the irrational thoughts associated with obsessions.
  • Behavioral therapy. A type of behavioral therapy called exposure and response prevention is often used. In this therapy, you will be exposed to the distressing situation that triggers your compulsion and be prevented from responding to it. With repetition of this process over time, you will no longer feel the distress or need to perform the compulsion.
  • Self-soothing. Meditation, deep breathing, or yoga can help you manage the symptoms of anxiety and can help with how you think.
  • Medicine. Certain types of antidepressant medicine may help reduce or control OCD symptoms. Medicine is most effective when used with cognitive or behavioral therapy.
Treatment usually involves a combination of therapy and medicines. For severe OCD that does not respond to talk therapy and medicine, brain surgery or electrical stimulation of specific areas of the brain may be considered. Examples of electrical stimulation are:
  • Deep brain stimulation (DBS).
  • Transcranial magnetic stimulation (TMS).
  • Transcranial direct current stimulation (tDCS).

Follow these instructions at home:

  • Take over-the-counter and prescription medicines only as told by your health care provider. Do not start taking any new medicines unless your health care provider approves.
  • Consider joining a support group for people with OCD. Visit www.nami.org to learn about support groups.
  • Keep all follow-up visits as told by your health care provider. This is important.

Where to find more information

Contact a health care provider if:

  • You are not able to take your medicines as prescribed.
  • Your symptoms get worse.

Get help right away if:

  • You have thoughts of suicide or thoughts about hurting yourself or others.
If you ever feel like you may hurt yourself or others, or have thoughts about taking your own life, get help right away. Go to your nearest emergency department or:
  • Call your local emergency services (911 in the U.S.).
  • Call a suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255. This is open 24 hours a day in the U.S.
  • Text the Crisis Text Line at 741741 (in the U.S.).

Summary

  • Obsessive-compulsive disorder (OCD) is a brain-based disorder. People with OCD have obsessions or compulsions, or both, and cannot control them.
  • OCD can interfere with personal relationships and normal activities at home, school, or work.
  • Treatment usually involves a combination of therapy and medicines.
  • Consider joining a support group for people with OCD.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.