What is Obsessive-compulsive disorder
Obsessive-compulsive disorder is characterized by anxious thoughts or
rituals you feel you can't control. If you have OCD, as it's called, you
may be plagued by persistent, unwelcome thoughts or images, or by the urgent
need to engage in certain rituals.
You may be obsessed with germs or dirt, so you wash your hands over and
over. You may be filled with doubt and feel the need to check things repeatedly.
You might be preoccupied by thoughts of violence and fear that you will
harm people close to you. You may spend long periods of time touching things
or counting; you may be preoccupied by order or symmetry; you may have
persistent thoughts of performing sexual acts that are repugnant to you;
or you may be troubled by thoughts that are against your religious beliefs.
The disturbing thoughts or images are called obsessions, and the rituals
that are performed to try to prevent or dispel them are called compulsions.
There is no pleasure in carrying out the rituals you are drawn to, only
temporary relief from the discomfort caused by the obsession.
A lot of healthy people can identify with having some of the symptoms
of OCD, such as checking the stove several times before leaving the house.
But the disorder is diagnosed only when such activities consume at least
an hour a day, are very distressing, and interfere with daily life.
Most adults with this condition recognize that what they're doing is
senseless, but they can't stop it. Some people, though, particularly children
with OCD, may not realize that their behavior is out of the ordinary.
OCD strikes men and women in approximately equal numbers and afflicts
roughly 1 in 50 people. It can appear in childhood, adolescence, or adulthood,
but on the average it first shows up in the teens or early adulthood. A
third of adults with OCD experienced their first symptoms as children.
The course of the disease is variable—symptoms may come and go, they may
ease over time, or they can grow progressively worse. Evidence suggests
that OCD might run in families.
Depression or other anxiety disorders may accompany OCD. Some people
with OCD have eating disorders. In addition, they may avoid situations
in which they might have to confront their obsessions. Or they may try
unsuccessfully to use alcohol or drugs to calm themselves. If OCD grows
severe enough, it can keep someone from holding down a job or from carrying
out normal responsibilities at home, but more often it doesn't develop
to those extremes.
Research by NIMH-funded scientists and other investigators has led to
the development of medications and behavioral treatments that can benefit
people with OCD. A combination of the two treatments is often helpful for
most patients. Some individuals respond best to one therapy, some to another.
Medications that have been found effective in treating OCD are fluvoxamine,
paroxetine, sertraline, clomipramine and fluoxetine. Others are showing
promise and may soon be available.
Behavioral therapy, specifically a type called exposure and response
prevention, has also proven useful for treating OCD. It involves exposing
the person to whatever triggers the problem and then helping him or her
forego the usual ritual—for instance, having the patient touch something
dirty and then not wash his hands. This therapy is often successful in
patients who complete a behavioral therapy program, though results have
been less favorable in some people who have both OCD and depression.
For more detailed information about OCD, see the OCD
brochure in the Library, which includes an OCD
self-assessment test.
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