Overview
Obsessive-Compulsive Disorder (OCD) is a common disorder characterized by intrusive, obsessive thoughts and ritualistic compulsive behaviors. Those who struggle with the disorder experience distressing thoughts that they struggle to control, even if they often realize the thoughts may not be logical or likely to occur. Ritualistic and compulsive behaviors are often used to alleviate the symptoms of distress that come from the intrusive thoughts.
Being a neat” or tidy” person who is concerned with order is not enough to warrant a diagnosis of OCD. Individuals who experience the disorder have obsessions and compulsions that significantly interfere with daily life.
Symptoms
Symptoms can fluctuate over time. It is typical for symptoms to worsen during times of personal stress or transition. Sometimes individuals with OCD worry about “going crazy” as they feel they cannot be rid of their distressing thoughts despite recognizing they are not “real” or likely to occur. Despite these fears, OCD is a relatively common condition that typically responds to treatment.
Obsessions are intrusive thoughts, urges, or images that cause distress. Obsessions tend to be “ego-dystonic,” meaning they are often in opposition to what the person actually wants to occur. Common obsessions include:
- Fear of getting sick.
- Thinking about hurting a loved one or stranger.
- Focusing on some type of aggressive sexual act.
- Need for organization or symmetry.
- Worry over small tasks, often safety-related (did I unplug the curling iron, etc.).
Compulsions are repetitive behaviors that a person with OCD feels the urge to do in response to an obsessive thought. Common compulsions include:
- Excessive washing or cleaning.
- Checking and re-checking.
- Mental rituals or thought patterns such as saying a particular phrase, or counting to a certain number.
- Avoiding particular places, people or situations to avoid an intrusive thought.
- Avoidance of things that could cause harm to others (kitchen knives, chemicals, cars).
Everyone double checks things sometimes. But a person with OCD generally:
- Struggles to control thoughts or behaviors, even when those thoughts or behaviors are recognized as excessive and at times not logical.
- Spends a significant part of each day on these thoughts or behaviors.
- Doesn't get pleasure when performing the behaviors or rituals, but may feel brief relief from the anxiety the thoughts cause.
- Experiences significant distress in their daily life due to these thoughts or behaviors.
Treatment
The most effective treatments typically involve a combination of counseling and medication.
Counseling
Psychotherapy can be an effective treatment for adults and children with OCD. Common treatments include Cognitive-Behavioral Therapy (most typically Exposure and Response Prevention) and Acceptance and Commitment therapy. These therapies tend to focus on reducing the amount of distress caused by intrusive thoughts and helping to block ritualistic compulsions, replacing these behaviors with more adaptive anxiety reduction techniques. Research also shows that Exposure and Response Prevention is effective in reducing compulsive behaviors in OCD, even in people who did not respond well to medication.
Medication:
Talk with your doctor or a pharmacist to make sure you understand the risks and benefits of taking a medication to treat OCD. Serotonin reuptake inhibitors (SRIs) and selective serotonin reuptake inhibitors (SSRIs) are most typically used to help reduce OCD symptoms. These medications typically take up to 6-8 weeks to start working. Do not stop taking a medication without talking to your doctor first. Suddenly stopping a medication may lead to "rebound" or worsening of OCD symptoms. Other uncomfortable or potentially dangerous withdrawal effects are also possible. Report any concerns about side effects to your doctor right away.
Resources
In addition to suggestion laid out above, here are additional resources to successfully cope with OCD.
Apps:
- The nOCD app – designed to help individuals struggling with OCD using evidence-based therapy methods. You can download the app for free on iPhone.